HEALTH INSURANCE IN NL

It is obligatory to have Health Insurance in the Netherlands. However, it is not a ‘one insurance plan fits all’ kind of system in this country! Your line of work, your annual income, and the condition of your health all impact the type of coverage you will need, and how much it will cost you. You yourself have a say in what kind of health insurance you would like to take out in NL as well. This page will explain what your options are, as an expat. Find out how you can compare Dutch insurances, what they will protect you against and how you can fund them in NL.

Dutch Health Insurance: The Basics!

Health insurance is perhaps the most important kind of insurance to arrange in the Netherlands! Here’s why:

• You cannot predict when you might fall ill
• If you do unexpectedly require medical assistance, the last thing you will want to deal with is discovering that your treatment is not covered in the Netherlands
• What’s more, all residents of Holland are obligated to arrange health insurance, in order to be able to legally reside in the Netherlands

Other Kinds of Dutch Insurance

For a better understanding of how insurance works in NL, and which kinds are on offer to you, take a look at our page on ‘Dutch Insurance‘. It will take you through:

• The basics of Dutch insurance
• How to compare insurance packages in NL
• Insurance for students in NL
• Disability insurance
• Home insurance
• Liability insurance
• Legal aid insurance

For all things transport and travel insurance related, be sure to check out ‘Insurance for Getting Around in NL‘ too.

The system for funding your health insurance coverage in NL works as follows:

• To receive Dutch health insurance, you must pay a fixed contribution of approximately € 1,450
• You need to pay an income-dependent contribution on top of this
• This income-dependent contribution should be compensated by your employer
• Your employer will pay the money directly to the Dutch tax authorities
• The size of your income-dependent contribution will be reassessed annually 
• The tax authorities carry out this assessment

Health Insurance for Self-Employed Persons in NL

• If you are unemployed or self-employed, you will receive no compensation for your income-dependent contribution in NL
• The Dutch tax authorities will calculate the size of your income-dependent contribution, by estimating what you are likely to earn in the year to come
• If you pay more than the tax authorities predicted you could afford, you will be reimbursed at the end of said year, following your final tax assessment
• Dutch insurance companies cannot turn down an application for health insurance based on a person’s age, gender or health

If you want to explore your options by comparing insurance packages, the following organizations can help you:

• Independer
• Zorgkiezer
• Zorgwijzer

Picking a Package

We recommend that you you take the following matters into consideration, when comparing insurance packages in NL:

• What level of dental care you will be covered for
• Will alternative therapies be included
• The size of the deductible. In Dutch, this is described as ‘eigen risico‘, which translates literally as ‘own risk’. We will explain this in more detail a little later on
• What kind of coverage you will receive if you fall ill whilst you are abroad

If you are traveling within Europe, ask your insurance company to issue you a ‘European Health Insurance Card‘:

• This card is commonly referred to as the ‘EHIC’ card
• It allows you to receive either free, or reduced cost, medical care in any EU or EEA country, or Switzerland
• If you require treatment whilst you are in another European country, or if you are suffering from an existing chronic condition, you can use your EHIC card to receive medical care
• Bare in mind that the card has not been created for those who go abroad specifically to receive medical care
• Be sure to ask your insurance company what, if any, further conditions apply

All health insurance policies have an ‘own risk’ clause written into them:

• In Dutch this is called the ‘eigen risico’
• This is an amount that you have to pay your insurance company, out of your own pocket
• For 2018, the own risk deductible amounts to € 385. This amount is, however, subject to change each year
• The idea behind it is that residents of the Netherlands will make considered healthcare claims

Exceptions to ‘Own Risk’ in NL

There are certain people, and instances, in NL to whom the own risk clause does not apply. They are:

• Children under 18
• Visits to the GP
• Visits to the midwife
• Maternity care
• Care covered by ‘voluntary additional insurance‘
• Dental care for children/young people under the age of 21

Choosing a Higher Deductible

You could also save money, by opting to pay a voluntary, higher deductible:

• A deductible can be as much as € 885 a year
• By paying a larger own risk deductible, your healthcare insurance premium will be lower
• How much your premium will be lowered by will depend on your healthcare insurance supplier
• We recommend that you compare insurance companies, in order to get the deal that best suits you

When you are arranging your insurance in NL, you will probably run into the following terms: ‘Natura polis’ and ‘restitutie polis’

1. The Dutch ‘Natura Polis’

• In English, ‘natura’ loosely translates as ‘in kind ‘
• It means that your insurance company will pay your medical bills directly to a healthcare provider, on your behalf
• However, they will only pay medical service providers with whom they have a contract
• You are, however, free to select your own GP and your insurance company will pay them for you

2. The Dutch ‘Restitutie Polis’

• ‘Restitutie Polis’ translates as ‘restitution policy’
• ‘Restitution insurance’ is slightly more expensive than ‘insurance in kind’ in NL
• Still, it gives you more freedom to choose from whom you accept your medical assistance
• With a restitution policy, you will have to pay your medical bills yourself
• You must then show the bills to your insurance company, who will reimburse you

Long Term Medical Care in NL

Everyone who legally resides and works in the Netherlands has a right to be covered by the ‘WLZ’ scheme:

• WLZ stands for ‘Wet Langdurige Zorg‘, which translates as the ‘Long Term Care Act’ in English
• This is a national Dutch insurance scheme
• It insures people against risks that cannot be covered by their own personal insurance
• This means that it takes care of medical expenses that are simply not affordable for the average citizen
• As a resident of the Netherlands, you have to pay social security contributions. Part of these will go towards the WLZ scheme
• How large a contribution you will have to make, is calculated based on your salary and on which benefits you are receiving
• Self-employed persons living in the Netherlands are also obligated to contribute to this scheme, if they are considered financially capable

The Dutch Personal Budget

A special aspect of ‘exceptional medical expenses’ is a feature called the ‘PGB‘:

• PGB stands for ‘persoonsgebonden budget‘, meaning ‘personal budget’
• It as a Dutch governmental subsidy
• Through this scheme you can be granted a certain amount of money with which you can ‘purchase’ personal care
• Anyone who requires some form of ‘exceptional medical care’, for a condition like a disability or a disorder, is eligible to receive this subsidy
• The care could be in the form of having help from a nurse or a personal carer

Dental Insurance in NL

Dental care is not included in any basic insurance package in the Netherlands. Therefore, you will have to pay for your own private dental care, unless you:

• Are a child aged 18 or under
• Require ‘specialist’ dental care, such as dentures

You can take out additional insurance to cover the costs of your dental care in NL. Remember, however, that this is a waste of money if either of the above points apply to you or your situation.

Insurance for Medication in NL

Insurance coverage for medication in NL works as follows:

• Types of medication are ‘clustered’ in the Netherlands
• This means that all medication is put into a category, or ‘cluster’
• Dutch insurance companies have a maximum price, which they are prepared to pay for each medication ‘cluster’
• If you are prescribed medication, then the maximum price for the cluster to which your medicine belongs will be covered by your insurance
• If your medication is more expensive than the maximum price for its cluster, you will have to pay the difference
• You may be able to take out an additional policy, to cover the extra costs of more expensive medication or homeopathic medicine in NL. Ask your insurance company whether they offer this option

Insurance for Pregnancy and Childbirth

The Dutch take Pregnancy and Childbirth very seriously. Therefore, the following parts of your parental journey will be covered by a basic Dutch healthcare insurance plan:

• Visits to a midwife, during your pregnancy and in the build up to your delivery
• At least two ultrasounds, so long as they are medically required
• All elements of having a home birth
• If your midwife, GP or specialist decides that, for health and safety reasons, your baby should be delivered in hospital, your hospital delivery will be fully covered

Hospital Births in NL

If you voluntarily choose to have your baby in hospital:

• There are only certain insurance companies who will cover your birth
• If you are with an insurance company who does not offer full coverage for a voluntary hospital birth, you will have to contribute towards the costs of your hospital delivery