Being French, I was used to having access to a super nice healthcare system my whole life. When I moved to the Netherlands, I was a bit surprised to find out that the Dutch healthcare system (zorgverzekering) is soooo unique.
You might have a very different experience of healthcare based on where you are from, so I am going to give you a whole tour on how the Dutch healthcare system works.
How does the Dutch healthcare system work?
You have to know that it is compulsory to have a Dutch health insurance when you move to the Netherlands. You need to have at least basic insurance (basisverzekering).
The state offers mandatory health insurance that it funds but which is managed by private insurance companies. There are many different health insurance providers.
You will pay a monthly fee (or you can choose to pay everything at once for the year) for the health insurance. The cost depends on your provider, as well as the coverage options you choose.
For example, you can choose an insurer that provides you with the ability to attend any hospital or a cheaper insurer which stipulates which hospitals you can go to if you want to be covered.
Every insurance will have the ‘own risk’ (eigen risico) feature. It is the maximum amount you will be charged if you incur healthcare costs. It is annually determined by the Dutch government. In 2020, the minimum own risk is €385 but it can go up to €885 if you want to lower your monthly insurance fee. The own risk is valid for the entire year.
When you incur medical costs, you will have to pay your ‘own risk’ amount yourself. The insurer pays only the costs above this amount. If you have paid your own risk in full for the year and are still incurring other healthcare costs, your insurer will pay for the additional costs.
For instance, if your own risk for 2020 is €385 (also without additional coverage options) and you get a hospital bill of €500, you will have to pay €385 from your pocket and your insurance will pay the rest. If later the same year you receive another hospital bill of €200, your insurance will pay for the full €200 because you already reached your maximum own risk with the previous bill. If later that year you need to go to the dentist, you will have to pay the costs yourself.
When do you have to pay your own risk?
You have to pay your own risk for:
- Ambulance transportation costs
- First aid
- Hospital admissions
You do not have to pay your own risk for (these are free):
- Visits to your GP
- Obstetrics and maternity care
- Children under 18
- Home care aids
Additional insurance (aanvullende verzekeringen)
However, know that the basic insurance does not cover all types of costs. You can choose additional insurance (aanvullende verzekeringen) options if you want a broader coverage: dental treatment, glasses or contact lenses, …
If you choose additional insurances (dentistry, vaccines, contraception…), then your insurance will cover the full costs without you having to pay your own risk.
When can I change my insurance provider?
Once a year, around December, you have the possibility to change your health insurance provider. This enables you to change your own risk and options, thus your coverage according to your medical needs or forecast for the next year.
For instance, you can pick an insurance that covers contraception or dentistry if you know that next year you will need these services.
What to do if you get ill in the Netherlands?
If you need medical assistance, you first need to visit your general practitioner (huisarts). He/she then decides to send you to a specialist or the hospital if needed.
For medicines, you need a prescription from your GP. Then, you can collect what you need from your local pharmacy (apotheek).
How can I register for healthcare in the netherlands?
First, you will need to register with your local council (gemeente) to get a citizen service number (it’s called a BSN – Burgerservicenummer). You need this number for most things in the Netherlands, so it’s usually the first thing to get when you move there.
Then you have to choose a health insurance provider. You can easily do this online.
Finally, you will need to register with a local general practitioner (huisarts).
Tip: I advise you to Google the GPs around your neighbourhood, look at their reviews (no one wants a badly-rated doctor!) and then call them to see if they still accept new registrations. If yes, you will be able to register online or directly at the doctor’s practice.
If you stop working or if you leave the Netherlands, do not forget to change/cancel your health insurance.
Do I need health insurance in the Netherlands?
Yes. If you are working or living in the Netherlands, a Dutch health insurance is compulsory.
If you are not sure you need one, you can always contact the Sociale Verzekeringsbank (SVB) to request a free investigation (6-8 weeks).
If you do not get health insurance within 3-month of your arrival and registration, you might get a warning letter from the CAK about your insurance obligation and could get a fine of €400 if you still do not get one.
What about students?
For students, it’s different and depends on different situations.
- If you are just studying in the Netherlands, you do not legally need a Dutch health insurance. However, be sure to have health insurance from your home country that can cover medical costs if needed.
- For students from the EU, you can get a European Health Insurance Card (EHIC) to cover for your necessary medical costs during your stay.
- If you are a student doing an internship and are paid at least the Dutch minimum wage, you have to get health insurance.
- If you are a student with a part-time job (or just working), you also have to get health insurance.
If you are an international student and want/need to work on the side, you have to get health insurance. No worries, you can also apply for a health care subsidy (zorgtoeslag) via the Dutch Tax Office (Belastingdienst).
How much does healthcare cost in the Netherlands ?
Visits to your local doctor (huisarts) are free. For everything else, it depends on the health insurance you picked and your situation (working or studying).
When you choose your health insurance, you have the choice between a LOT of options. What you choose will determine the monthly cost of your insurance and what you have to pay for medical costs later on.
Know that sometimes, the company you are working for could have discounts with one of the health insurance providers available (KLM does).
Consider that your monthly fee can vary from €100 to way more!
What is the cheapest option?
At first sight, the cheapest option is around €100 in 2020, but it’s not always the cheapest in the end. I can tell you this because that’s what I chose for my first two years of living in the Netherlands, and I will not do it again.
I am young, sporty and have a healthy diet. In France, as an adult, I never had to go to the hospital and never had any health issues except for a seasonal cold here and there. So naturally, I was expecting not to need much health coverage.
So I chose the health insurance with the lowest monthly cost (it was around €90 in 2018) and thus the highest own risk amount I could have: €885.
This meant that if in that year I had to go to the hospital and received a bill (they are HUGE by the way), then I would have to pay for the first €885 and the rest would be paid for by my insurance. It also meant that for my next hospital visits of that year, the insurance would pay because I would have reached my own risk for the year anyway.
Well, you guessed it. Two years in a row this happened to me. I was sent to the hospital by my doctor and ended up paying my full own risk. From year three, I decided to go with a more expensive insurance (€110 a month) with a lower ‘own risk’ (€385) and it was worth it because I ended up at the hospital (again!), but at least I only had to pay €385 this time.
So in the end, the cheapest monthly fee might not lead to the overall cheapest option. Make sure to be aware of this.
How to choose a health insurance provider in the Netherlands ?
Well, this depends on:
- Your situation (employee, student…)
- Your affinity with risk
- Your healthcare needs
What I (and probably most people living in the Netherlands) do, is use Independenter to compare all the options and make a decision.
First, you need to choose your own risk (eigen risico). You have several options (these are for 2020):
- €385 (standard)
- €885 (maximum)
The higher the own risk, the cheaper the monthly insurance cost is but the riskiest it is if you get sick. So the €885 own risk option will lead to a cheap monthly fee, but you will have to pay that own risk if you go to the hospital.
Then you need to select options you want your insurance to cover as well (fysiotherapy, pregnancy, contraception, dentistry…). At the end, you will be offered with different providers and their monthly costs so you can choose.
I advise you to keep track of your medical needs and forecast them, so you know which options to choose from.