Health System in The Netherlands - Finanzas en Holanda

If you have just arrived in the Netherlands or have recently moved to the Netherlands, one of the most important things to be aware of is the health care system. Here is a clear and simple guide to familiarize yourself with how it works and what steps you need to take to make sure you have access to the medical care you need.

Registration in the Municipality

The first thing you should do when you arrive in the Netherlands is to register with the municipality (Gemeente) where you will live. This registration will provide you with a citizen identification number (BSN), which is essential for accessing health and other public services.

Mandatory Health Insurance

In the Netherlands, basic health insurance is compulsory for all residents over 18 years of age. You have up to four months from your arrival to take out Dutch health insurance. Don’t take too long to take it out as you will not save anything on the monthly premium, as the charge is retroactive, i.e. if you take it out 3 months after you registered, you will be charged for those 3 months that have passed since registration.

Basic insurance

The basis of medical coverage in the Netherlands is the basic health insurance “basispremie”, mandatory for all persons residing or working in the country who are 18 years of age or older. This insurance covers health care costs that the government deems necessary. The composition of the basic health insurance package is determined by the government. But what exactly does this package include and what kind of coverage do you get when you pay your basic insurance premium?

What is included in the basic insurance?

Basic insurance covers a variety of essential medical services. For medical care in the basic package, you pay a monthly or annual insurance premium. In addition, for some medical services, you first pay the deductible. This is the amount you pay yourself for medical care. The rest of the medical costs are covered by the insurer. In addition to the deductible, there is a statutory personal contribution. The government determines for which medical services this contribution applies and how much it is. The personal contribution is not paid all at once, but each time the service is used.
Below are some of the services included and whether the deductible or a personal contribution applies.

Visit to the general practitioner (huisarts)

Primary care physician visits are included in the basic package. No deductible or personal contribution applies. The insurer pays the doctor directly.

Visit to the dentist

For children under 18 years of age, dental visits are included in the basic package with no deductible or personal contribution, including checkups and treatments, as well as fluoride treatments.

For those over 18 years of age, regular dental visits are not included in the basic package. They can be paid privately or through additional dental insurance. However, surgical dental aid and radiological examinations are covered, although the deductible applies.

Hospitalization

Hospital stays, surgeries and emergencies are also covered in the basic package. These services are subject to a deductible but not to a personal contribution. The same applies for ambulance transportation. Medical transportation by car, cab or public transportation is also subject to deductible and personal contribution.

Physiotherapy

Children under 18 years of age receive a maximum of 18 sessions (2×9) covered with no deductible or personal contribution. From the age of 17, physiotherapy and exercise therapy are covered from the 21st session onwards, applying the deductible but no personal contribution.
For those over 18 years of age you must take out additional insurance to cover normal physiotherapy.

Medications

Medicines prescribed by the general practitioner or a specialist are generally covered by the basic insurance. In some cases, a personal contribution must be paid, which in 2024 is a maximum of € 250 per person per year.

Other services covered by the basic package

Below is a table detailing other types of medical care included in the basic package, indicating whether deductible or personal contribution applies:

Type of care	Description	Deductible	Personal Contribution
Medical specialist	Visits to specialists such as maxillofacial surgeons, internists or allergists	Yes	No
Blood tests	Performed through the general practitioner and medical specialists	Yes	No
Mental health	Basic care, specialized care and the first 3 years in an institution	Yes	No
Physiotherapy	Pelvis therapy, hip and knee osteoarthritis, intermittent claudication, and COPD therapy.	Yes	No
Speech therapy	Treatments with a medical objective	Yes	No
Ergotherapy	Maximum 10 hours of treatment per calendar year	Yes	No
Dietary counseling	Maximum 3 hours of treatment per calendar year	Yes	No
Prenatal and delivery care	Obstetric and postnatal care	No	Hourly contribution for postnatal care
Home nursing	Including the personal budget for home nursing	No	No
Technical aids	As hearing aids or orthopedic shoes	Yes	Depends on device
Attention to the disabled	For those with hearing, visual or language development problems, and treatment by a physician who specializes in the disabled.	Yes	No
Geriatric care	Rehabilitation and treatment by a specialist in geriatrics	Yes	No
Lifestyle intervention	Care for overweight or obese persons	No	No

Source: Rijksoverheid. For specific details on coverage, refer to the summary provided by the government and always check the terms and conditions of your insurer’s policy.

What is not included in the basic insurance?

In addition to dental and physiotherapy costs for non-chronic conditions, the basic insurance does not cover regular eyeglasses and contact lenses, nor alternative therapies. For these services, you can take out supplementary insurance (aanvullende verzekering).

What is the best health insurance?

There is no single best health insurance plan. The best health insurance varies from person to person. The best insurance depends on your personal situation and desires.

What does happen is that the basic insurance has different prices in each of the insurance companies even though it covers practically the same thing.

Deductible (Eigen Risico)

Since January 1, 2008, the Dutch health insurance system includes a mandatory deductible. This means that sometimes you have to pay part of the health care costs (see table above). The deductible is a legal obligation in basic health insurance.

In 2024 the mandatory deductible is 385 euros. Optionally, the deductible can be increased up to a maximum of 885 euros per year. If you do this, your monthly premium will be lower. There are some occasions when it is appropriate to increase the deductible up to the maximum.

Types of policies in the Netherlands

There are four varieties of health insurance policies: reimbursement (restitutie), combined (combinatie), contracted care (natura) and budget (budget). These insurances present notable differences, especially with regard to the premium and the number of medical service providers contracted. Here you can see what the differences are between these health insurance options so that you can be better informed when choosing your health insurance.

What is a reimbursement policy? (restitutiepolis)

With a reimbursement policy, you have total freedom to choose your medical care. This means that you can go to any health care provider included in the basic coverage without having to pay extra. There is no need to consider contracts. However, for most health care services covered by basic insurance, you must always pay your own deductible first.

In the case of additional insurance services, such as physical therapy or alternative medicines, it is important to verify whether your insurer has a contract with the medical service provider. Some insurers offering reimbursement policies may not fully reimburse for those services if there is no contract.

Keep in mind: Do you plan to go to an expensive private clinic, resulting in exorbitant health care costs? In that case, the insurer may decide not to cover the entire bill.

What is a combined policy? (combinatiepolis)

The combined policy has similarities with the reimbursement policy. In this case, you enjoy freedom of choice in your medical care and, in many cases, you can go to a variety of health care providers. However, these options vary depending on the type of medical care. For example, you can choose any hospital, but not all clinical centers. In a combined policy, the insurer has contractual agreements with health care providers.

What is a contracted assistance policy? (naturapolis)

If you have a natura policy, it is very important to examine the contracts that your insurer has established with the health care providers. If you go to a non-contracted provider, the insurer will not fully cover the bill. Often, you would have to pay 20% of the costs on your own. Fortunately, insurers with a natura policy usually have a wide choice of contract health care providers.

What is a contracted-budget assistance policy? (naturapolis-budget)

Similar to the natura policy, an insurer with an affordable policy has established contracts with health care providers. If you visit a contracted health care provider, the insurer will reimburse you for the entire bill. However, if you go to a non-contracted supplier, you generally have to pay 20% of the invoice yourself.

In contrast to the natura policy, the supply of contract health care providers in the low-cost insurers is not extensive. It is important to take this detail into account before taking out health insurance.

Type of Policy	Main features
Restitutiepolis	– Free choice of hospital or medical provider. – Medical care covered at 100% of the basic coverage (except for the deductible). – Exception: bills that are significantly higher than average may not be fully covered.
Combinatiepolis	– You have the flexibility to choose your own hospital or medical provider. – If the supplier has a contract: 100% reimbursement. – If the supplier does not have a contract: reimbursement up to a maximum limit. This limit varies according to the insurer.
Naturapolis	– Almost all hospitals are covered. – Not all clinical centers and physical therapists are covered. – If you choose a non-contracted health care provider, you will have to pay part of the bill yourself.
Naturapolis-budget	– A limited number of hospitals are covered. – A limited number of clinics and physical therapists are covered. – If you choose a non-contracted health care provider, you will have to pay part of the bill yourself.

Main features of the types of health insurance policies in the Netherlands

How much does health insurance cost?

The cost varies depending on the insurer, it is best to use an insurance comparator such as Pricewise o IndependerThere you can fill in your information and what you want the insurance to cover and they will present you with the best offer.

In the table below you can see an example of a monthly health insurance payment with additional insurance with a deductible of € 385 per year for a 25 year old person.

Basic Insurance (Basisverzekering)	€ 131.95
Additional insurance (Aanvullende verzekering) for 6 physiotherapy sessions per year	€ 7.25
Dental Insurance(€ 200 per year)	€ 15.95
Total	€ 155.15

Sample medical insurance premium including additional insurances

If you want to save on your monthly health insurance premium it is possible to increase the deductible from 385 to 885 euros, you can read more about this in the post How to save on health insurance (Zorgverzekering).

Registration with a General Practitioner (Huisarts)

The family doctor (huisarts) is your first point of contact for any health problem. You should register with a huisarts in your area as soon as you have your health insurance. The huisarts:

Performs general check-ups and basic treatments.
Refer you to specialists if necessary.
Maintains your medical records.

To find a huisarts near you, you can use the Zorgkaart Nederland website.

Emergency Care

In case of emergency, you can go to the emergency room (Spoedeisende Hulp) of a hospital. If you need an ambulance, call 112. For minor emergencies outside the hours of your huisarts, you can contact the on-call service (huisartsenpost). You can look it up on the internet.

Pharmacies

Pharmacies (apotheek) are widely available. Your huisarts will provide you with prescriptions for any medications you need. Be sure to always carry your health insurance and BSN when you visit a pharmacy.

Financial Assistance/Grants

If your income is low, you may be eligible for a health insurance subsidy (zorgtoeslag). You can apply through the Tax Agency’s website (Belastingdienst).