Health Insurance and Healthcare in the Netherlands Explained

Jump right in:

• How does healthcare work in the Netherlands?
• Pros and cons of the Netherlands healthcare system
• An overview of private health insurance
• How to find a doctor or dentist
• Giving birth in the Netherlands

The healthcare system in the Netherlands is unlike many others around Europe. The country has a universal healthcare system based on mandatory health insurance provided by private insurers but regulated by the state, rather than a purely public service.

Does the Netherlands have free public healthcare?

In short, no, healthcare in the Netherlands is not free. Everyone who lives or works in the country must take out a health insurance plan from a private insurer under the government-regulated system.

The Netherlands healthcare facts

• To be granted health insurance in the Netherlands you must have a Dutch resident permit.
• International insurance for residents may be accepted only in specific cases, such as students, temporary workers or EU officials with JSIS, but does not replace the mandatory Dutch basic insurance.
• You need to take out medical insurance in the Netherlands within four months of your arrival.
• If you do not take out the mandatory health insurance within the first four months in the country, the CAK will notify you. If you fail to get it within the following three months you will receive a fine of 528 EUR. If you remain uninsured after a second fine, the government will assign you a Dutch health insurance policy.
• You can switch your health insurance once a year. To do so, you have to cancel your current policy before 1 January and get a new one before 1 February.
• In case of an emergency you should call the EU emergency number 112 or go to a hospital’s emergency care. If you opt for the latter option, calling your general practitioner (GP) in advance is advisable.

How does healthcare work in the Netherlands?

Residents in the Netherlands must purchase basic health insurance (Zvw), which covers general practitioner visits, hospital care, prescribed medication, and maternity care. Insurers must accept everyone, regardless of pre-existing conditions or lifestyle. Children under 18 are automatically covered under their parents’ plan, including supplementary benefits, at no extra cost. Residents can also purchase supplemental insurance for services like physiotherapy, dental care, or hearing aids. Long-term care for the elderly and chronically ill is provided under the Wlz, funded through income-based contributions. Low-income individuals may receive a healthcare allowance (zorgtoeslag) to help with premiums.

The Netherlands healthcare system explained

The government in the Netherlands is responsible for the quality and accessibility of healthcare; however, they do not manage it. They decide what has to be included in basic insurance packages, but they cannot set the price for premiums. Why is the Netherlands’s healthcare so expensive? At the moment, the premiums are on the rise becauseof growing healthcare costs, staff shortages, and increasing salaries of medical professionals. Additionally, the population is aging which requires more care, and new required medicines keep being added to standard policies.

The Netherlands Healthcare Costs

In addition to paying direct monthly premiums for the insurance of your choosing, you also need to make contributions to the Zorgverzekeringswet (Zvw). This payment, often called the ZVW contribution, and is income related. Each month, your employer takes a certain percentage off your salary and makes the contribution.

Pros

• The care for critical illnesses is of very high quality.
• Waiting times for GP appointments are very short (around 2 days), but specialist treatments and elective surgeries can take several weeks.
• Many professionals speak English as well as other languages, such as German or French.

Cons

• The healthcare is not public and can be expensive.
• Basic care can be limited as many family doctors choose a very non-intervening approach to medical care. This means that medication is only prescribed when the doctor is sure that your issue is serious.
• Preventive healthcare programs exist, but overall spending on prevention is lower compared to some other European countries.

How does health insurance work in the Netherlands? You pay monthly installments directly to your insurer and cover the deductible. In turn, most of your visits to medical facilities are covered once the deductible is met, although some services may still require additional payment or supplemental insurance.

Health insurance coverage*

The standard health insurance plan includes the following:

• outpatient care (by GPs, specialists, and obstetricians)
• hospital care
• medication
• medical devices
• maternity care
• dental care (children up to 18 years old)
• limited therapies (physiotherapy, speech therapy, occupational therapy, dietary advice, etc.)

You will need to take out supplementary insurance if you want your policy to cover:

• dental care (for adults)
• glasses and contact lenses
• physiotherapy
• homeopathic and alternative medicine

Types of health insurance plans

While there are many plans and providers you can choose from, medical insurance is categorized into two basic types:

• Restitutie – allows you to visit any hospital or clinic of your choosing
• Natura – only allows you to go to medical facilities that your insurance company has a contract with. You are not forbidden for visiting other hospitals, but they will not be covered by your insurance.

The Netherlands health insurance average costs

When budgeting for your expenses, it is important to know how much health insurance in the Netherlands is. The price for a standard package can cost 130-160 EUR (150-190 USD) per month. The average monthly price for most is around 159 EUR (186 USD). In addition to that, you will need to pay the deductible, also called policy excess in the Netherlands. This is a sum you need to pay before your insurance starts covering your expenses. The deductible is set by the government and is 385 EUR (425 USD).

How to get dutch health insurance as a self-employed person

The mandatory insurance needs to be taken out by everyone, including entrepreneurs. Self-employed individuals must take out health insurance directly with a Dutch insurer, and the amount you pay depends on the premium you choose and the mandatory deductible set by the government.

If the thought of how to find a doctor and dentist who speaks your language worries you, know that you should not have many problems in the Netherlands. Many doctors are very well-versed in English and other common languages such as German and French. However, if you do not feel comfortable using these languages, you are allowed to bring a friend or a relative to help you out with communicating your needs.

How do you find a family doctor?

If you see a specialist without a family doctor’s referral, your insurance will not cover the visit.

To find a doctor that works in your area, refer to this online directory. Note that not all family doctors might be able to accept you as their practices might be full or you may live too far away from their clinic or hospital.

Average wait time to see a doctor in the Netherlands

To see a family doctor, you should book an appointment which can often take 1–3 days, depending on availability. Seeing a specialist, however, might take you some more time––weeks or even months. However, if your condition requires immediate care, you might get access to it sooner­.

How to find a dentist

Online directories such as this one will help you find a dentist in your area. Note that in the Netherlands the government has set prices for most common dental treatments through the Dutch Healthcare Authority (NZa), although not all procedures (especially cosmetic ones) are regulated, so you do not need to worry about the price difference between most dentists.

If you have health insurance that covers oral health, note how much they cover. Dental care for adults is generally not included in the basic insurance and must be purchased through supplementary packages, which vary in coverage and what is covered depends on the specific policy you choose.

Unlike in many other countries, giving birth in the Netherlands for residents and non-Dutch nationals is treated as a natural, not a medical condition. That means, if the mother does not have any complications, the pregnancy is usually supervised by midwives instead of gynecologists.

Having a baby in the Netherlands: midwives and home-births

The person in charge of prenatal care is usually a midwife, who you should find around 8 to 10 weeks into the pregnancy. You can ask your family doctor for a recommendation, enquire with your family and friends, or search online directories or contact midwifery practices directly.

Home-births are very popular in the Netherlands. The usage of epidurals (only available in hospitals) is very low compared to other countries. If you wish to give birth in the hospital, you need to inform your midwife about it. Also, note that not all insurance policies cover hospital births, so check with your insurance provider what options you have.

After the baby is born, you will need to register the birth at a local council in a matter of three days. The birth is usually registered by the mother, the father, or the mother’s partner. If they cannot, someone present at the birth, the house owner, or the hospital director may do it. Fathers in unmarried couples can acknowledge the child before, during, or after the birth registration, with the mother’s consent. That can be done at the local council as well.

Having a baby in the Netherlands as a foreigner

If you happen to be pregnant when you arrive in the Netherlands, and you are without any insurance, you will need to pay for the procedures out of pocket. However, once you do have your insurance, you may be eligible for partial reimbursement, depending on your policy and coverage start date.

Benefits of giving birth in the Netherlands

• During the first trimester of your pregnancy, you should register for a maternity nurse (kraamverzorger), who can provide assistance for the first week of parenthood. They can be recommended to you by your midwife, but you are free to find one on your own as well.

Maternity nurses help you:

• Adjust to your new home life, which is especially useful for new parents.
• They can answer all maternity related questions, such as how to breastfeed or bathe the baby, and check on the mother’s recovery. - --- They can also help with household chores, cook meals, or take care of the older children in the family. What you want from the maternity nurse can be discussed beforehand as you get to meet her before the delivery.

The maternity nurse typically provides 49 hours of care over the next eight days after the baby is born. However, this can be adjusted, depending on your needs. Be sure to check with your health insurance whether your policy covers the costs for the nurse and if it covers it fully.

Cost of having a baby in the Netherlands

Apart from the possible expenses, most pregnancy-related costs are covered by your health insurance, but you may have to pay extra if you choose a hospital or birth center delivery without a medical indication, or for additional services such as antenatal courses, maternity packages, or pelvic physiotherapy. If you give birth in a hospital without a medical indication, you will usually need to pay a co-payment of around 350–400 EUR (approximately 385–470 USD), while hospital births required for medical reasons and home births are fully covered by basic insurance.

Citizenship and giving birth in the Netherlands

Your child will not automatically become a Dutch citizen if you give birth in the Netherlands. Whether you are a permanent resident or not will also not determine the citizenship of your child. Your baby can become Dutch if one of the parents is Dutch. This rule, however, is applicable no matter what country the child is born in.