You finally received your residency permit and it's time to get health insurance!
Who needs heath insurance in the Netherlands?
Dutch social security legislation mandates that health insurance is compulsory for anyone who works or resides long-term in the Netherlands. Yes, you expats, that means as a term of residency, you are required to obtain a basic Dutch health insurance policy (basisverzekering) within four months of registration with city hall (EU, EEA and Swiss citizens) or receipt of a residence permit (outside EU). An international policy which covers you in the Netherlands does not preclude you from maintaining a separate Dutch policy.
Foreign students may be exempt*
What if I don’t get Dutch Coverage within four months?
Failure to obtain a policy can result in fines and retroactive billing. If the government becomes aware that you did not take out a basisverzekering within four months of receiving your residency, the below steps are taken:
A letter from Zorginstituut Nederland is sent via mail, requesting sign up for health insurance within three months.
If coverage is not obtained in three months, the Zorginstituut will issue a fine for approximately 366 euros.
If coverage is still not obtained in six months, the Zorginstituut will another fine in the same amount.
If coverage hasn’t been obtained within nine months of the first letter, the Zorginstituut will register you with an insurer on your behalf and will deduct the monthly premium from your salary.
What are the types of health care coverage in the Netherlands?
Dutch healthcare policies are offered in two categories:
Compulsory basic insurance (basisverzekering), is the base line insurance which is required of all who live and work in the Netherlands. Coverage includes - general practitioner visits, short-term hospital stays, specialist care, and limited dental care for adults over 18. I was especially impressed that they also cover, fertility treatment (vruchtbaarheidsbehandelingen), maternity care (kraamzorg), aged care (ouderenzorg), mental health care (geestelijke gezondheidszorg), blood tests (bloedonderzoek), and some prescriptions!
Optional additional insurance (aanvullende verzekering), is available as a supplement of sorts. Glasses and contact lenses (brillen en lenzen), alternative medicine (alternatieve geneeswijzen), and even cosmetic procedures (plastische chirurgie) can be added to your policy as an option for an additional cost.
There are two main costs that you need to pay for your Dutch health insurance:
The premium (premie), a fixed fee that is deducted monthly from your bank account for basic and supplemental insurance, if applicable.
The own risk (eigen risico), fee is an annual amount that you must pay “out of pocket” for some treatments, labs, and prescriptions before health insurance will cover cost. In 2017 the eigen risico is maximum set at €385. Services which do not require an eigen risico contribution include:
*Long-term care, including disability costs, is covered by mandatory state insurance.
What is the health care structure in the Netherlands?
Doctors & General Practice
Doctors & General Practitioners (husiart) are the first point of contact in any non-emergency. They are the gate keepers to more nuanced medical assistance. Similar to the HMO set-up in the U.S., it is one of the most cost effective and frustrating processes in the Dutch system. Doctors in the Netherlands are all trained in every area of medicine so GPs are a filter used keep milder cased from clogging the more expensive “Specialist” layer. As an American accustomed to seeing a specialist when I feel it’s needed, being blocked by a GP can be madding. Although the affordable €105 monthly price tag certainly makes for a nice trade off. Carefully vet a trusted GP and making register with a priority since having a doctor familiar with any conditions you may have will speed up a needed referral to specialist or hospital.
Gynecologist & Obstetrics, Ophthalmologist, Orthopedics, Dermatology, Oncology, Cardiology, and Dental Surgery all fall in the specialist category and require the referral of a GP before you can even make an appointment, even if you agree to pay out of pocket.
Hospitals in the Netherlands are compartmentalized a little differently than in the US. There are three different types of hospitals - Academic, for specialist care and research, Teaching, for training healthcare practitioners and general, for less specialized care.
Dental Hygiene and Orthodontics are privatized in the Netherlands and not covered by basic insurance policies (except for children under 18). Dentists (Tandarts) in the Netherlands usually work in their own single-dentist practice in larger cities there are also dental hygiene practices. A referral from a regular dentist is needed to visit the Orthodontist or children’s dentist.
How do I choose the Dutch Health Insurance best for me?
Great comparison tools when deciding which Dutch health insurance to choose is to compare services, prices and reviews are Zorgwijzer or Independer. We used Independer, which had an English option and was easy to navigate.