Health and Health Insurance Overview: The Netherlands (Nederland)

Objectives

  • General intro to Dutch health insurance

  • Roadmap for getting covered when you move

  • Overview of costs (single, partner, family)

  • Extra insurance options and when they make sense

  • Options of who to talk to when you need help

  • Currency note: €1 ≈ $1.10 USD

The Netherlands (Nederland)

  • Health insurance is mandatory for all residents, including expats

  • Governed by the Zorgverzekeringswet (Zvw)

  • Not tied to employment

  • Required if staying >4 months

  • Buy a basic insurance plan (basisverzekering) from a private company

  • Designed and regulated by the government

  • Covers most essential services

Deductible (Eigen Risico):

  • First €385 ($424) per year paid by you (exceptions: GP visits, maternity care)

  • Can increase deductible to reduce monthly premium

Policy Types (Polisvormen)

  • Restitutiepolis

    • Full freedom of provider choice

    • You pay upfront, insurer reimburses

    • Broadest coverage

    • ⚠️ Discontinued starting 2025

  • Naturapolis

    • Must use contracted providers

    • Cheaper monthly premium

    • Usually insurer pays directly (no upfront payment)

    • Many expats prefer this

  • Combinatiepolis

    • Mix of natura and restitutie

    • Some services free choice, others limited

  • Budgetpolis

    • Lowest monthly premium

    • Very restricted provider network (only limited hospitals/clinics)

    • Often no coverage outside main contracted providers

    • Not recommended for people who want flexibility or travel often

What Insurance Covers

Included in Basic Insurance:

  • GP visits

  • Hospital care

  • Maternity care

  • Prescription medications

Not included unless with Supplemental Insurance (Aanvullende verzekering):

  • Adult dental

  • Glasses/contacts (vision)

  • Limited physiotherapy sessions

  • Alternative medicine treatments

Other optional extras:

  • Travel insurance

  • Additional dental

  • Expanded physiotherapy

Children under 18:

  • Free under parents’ plan

Average Costs

  • Single adult (basic insurance): €125–€150 per month

  • Couple (two adults): €250–€300 per month

  • Family (2 adults + children): €250–€300 per month (children free)

  • Deductible: €385 per year minimum (can be raised to max €885 to lower monthly costs)

Subsidy (Zorgtoeslag)

  • Government healthcare allowance via Belastingdienst

  • Helps low-income residents pay for health insurance

  • Apply via Mijn Toeslagen (DigiD required)

Eligibility:

  • 18+ years old

  • Dutch health insurance in place

  • Resident in NL

How to Get Health Insurance

  1. Register with municipality (gemeente)

  2. Obtain BSN (Burgerservicenummer)

  3. Choose and register with an insurer (zorgverzekeraar)

  4. Register with a family doctor (huisarts)

    • Central role in system

    • Required for referrals to specialists

If You Don’t Have Insurance

  • CAK (Centraal Administratie Kantoor) warning after 1 month

  • Fine: up to €528 if uninsured after 3 months

  • Insurance may be automatically assigned with direct deductions

  • Must pay retroactive premiums for months you were uninsured

Step-by-Step: Healthcare Registration

  • Obtain Dutch health insurance (mandatory within 4 months)

  • Register with a GP (huisarts) in your postcode area

  • Register with a pharmacy (apotheek)

  • Optional: register with dentist, midwife if needed

Switching Insurance

Annual Switching Period (Open Enrollment):

  • November 12 – December 31 each year

  • You can:

    • Switch insurers

    • Change basic policy (basisverzekering) with same insurer

    • Adjust deductible (eigen risico)

    • Modify supplementary packages

Special Mid-Year Situations Where You Can Switch:

  • New expat → required to get Dutch insurance

  • Lose/gain entitlement (job loss, emigration, death of partner, etc.)

  • Leaving employer collective plan

  • Turning 18 (must get own insurance)

  • Divorce (if covered under partner’s plan)

  • Leaving military service

  • Insurer changes terms mid-year (rare)

What You Can Change Mid-Year Without Switching

  • Deductible (Eigen Risico): only in special cases

  • Supplementary coverage (Aanvullende verzekering):

    • Some allow upgrades/downgrades after major life events (pregnancy, accident, job change)

    • Downgrades easier; upgrades often require medical underwriting

  • Dental insurance: follows supplementary rules

Emergency Care

  • If you were not brought by ambulance, you must call first (usually GP or urgent care line)

  • GP is the gatekeeper to:

    • Specialist care

    • Urgent care

    • Medications

    • Lab tests

Common Pitfalls for Expats

  • Delaying GP registration

  • Assuming ER is the first stop

  • Not understanding the gatekeeper role of GPs

Other Expat Considerations

  • Must cancel insurance upon emigration

  • Compare via Independer.nl or Zorgwijzer.nl

  • Consider when choosing:

    • Big city vs small city (number of GP practices)

    • Provider client ceilings (zorgplafonds)

    • Number of chronic conditions

    • Switching possible only once per year

Tips

  • Register ASAP upon arrival

  • Don’t skip supplementary insurance if you need dental, vision, or mental health

  • GP is the key to most care

  • Dutch private insurance is cheaper vs USA

  • Apply for subsidies if eligible

  • Learn Dutch health system terminology

  • Use expat community advice

Key Players

  • Huisarts (GP): first point of contact

  • Specialists: only via GP referral

  • GGD (local public health): vaccinations, infectious disease, sexual/mental health, youth care, health promotion

  • Hospitals: both public and private accessible

  • Pharmacies: linked to your GP

Childbirth & Maternity (Zwangerschap & Bevalling)

  • Pregnancy and childbirth largely covered

  • Home birth via midwife: standard, free

  • Hospital birth (medically necessary): free, no deductible

  • Voluntary hospital stay (not medically required): partially covered, expect a personal contribution unless extra coverage

  • Kraamzorg (maternity home care): up to 8 days post-delivery, standard

Best Plans and Providers

  • Restitutiepolis historically best (broad access, fewer ceilings) → discontinued 2025

Examples of Insurers historically strong in certain areas:

  • ONVZ: high reimbursements, provider freedom

  • Zorg en Zekerheid (AV-ZZ): strong for alternative therapies

  • DSW: transparent pricing, good provider choice

  • Zilveren Kruis: widely accepted, though changing coverage

  • Menzis ExtraVerzorgd: strong chronic care support

⚠️ Caution:

  • Most naturapolis policies now have zorgplafonds (care ceilings) – max patients per provider per year

  • Particularly problematic in:

    • Mental health

    • Physiotherapy

    • Dermatology

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