Healthcare in the Netherlands
This guide to the Dutch healthcare system explains what you need to know about mandatory Dutch health insurance, visiting a specialist or hospital, and finding Dutch doctors, dentists and pharmacies in the Netherlands.
One of the many great things about living in the Netherlands is the excellent standard of Dutch healthcare, rated as the best in Europe. The Netherlands tops the list of 35 countries in the 2015 Euro Health Consumer Index (the ‘industry standard’ of modern healthcare) for the best healthcare services – ahead of large economies such as Switzerland (2), Germany (7) and the UK (14) – and is the only country to consistently place within the top three spots since 2005. According to the report, the Netherlands excels in relatively every healthcare criterion with perhaps only waiting time being something they could slightly improve, although accessibility increased after the country opened 160 primary care centres, open 24 hours per day, 7 days per week.
The Netherlands spends around 11.2 percent of GDP on health, plus almost all Dutch doctors speak excellent English, making healthcare in the Netherlands very accessible to foreigners. In most cases, however, some form of health insurance is mandatory to stay in the Netherlands, even temporarily, and required to access Dutch healthcare services.
International health insurer Bupa Global explains the Dutch healthcare system and what you need to know as a visitor or an expat in the Netherlands.
Health insurance in the Netherlands is mandatory
Healthcare in the Netherlands is covered by four statutory forms of insurance:
- Zorgverzekeringswet (Zvw) – often called ‘basic insurance’, covers common medical care.
- Wet langdurige zorg (Wlz) – covers long-term nursing and care.
- Wet maatschappelijke ondersteuning (Wmo) – covers every day support services offered by the government, such as household help, cleaning and cooking for those who need additional care.
- Jeugdwet – covers short and long-term medical care for youth under 18 years old.
While Dutch residents and employees are automatically insured by the government for long-term nursing and care (as covered by the Wlz), everyone has to take out their own basic healthcare insurance (basisverzekering) except in a few situations.
Those under 18 do not necessarily have to take out their own health insurance in the Netherlands. They can be covered under their parents’ health insurance. This, however, does not happen automatically. Parents have to inform their insurer that they want to assign their children to their Dutch health insurance. If you don’t take out insurance, you risk a fine.
Those who wish to apply for support services (under Wmo) will first be assessed by the government to see what services family or friends can provide, before any services are assigned to the local municipality.
You can also find more information in Expatica's guide to health insurance in the Netherlands, including how to find and choose the right Dutch insurance provider.
Dutch health insurance for temporary visitors
If you are staying in the Netherlands for less than a year, your stay is usually classed as temporary and you don’t need to take out the compulsory Dutch health insurance but you will need health insurance of some kind. If you already have an international health insurance, contact the National Health Care Institute (Zorginstituut Nederland) at 020 797 8555 to see if it will be accepted – and what healthcare services it will cover – in the Netherlands.
If you hold the European Union Health Insurance Card (EHIC) you will be covered while your stay is temporary (as decided by the insurer in your home country). If your stay is not temporary or as soon as you have a residence permit, you must take out a Dutch healthcare insurance policy.
Dutch health insurance for students
Students from the European Union (EU), European Economic Area (EEA – EU plus Iceland, Liechtenstein and Norway) and Switzerland are exempt from paying health insurance – except if they are working, even part-time or as part of a paid internship. Non-working students will be given an European Union Health Insurance Card (EHIC) or an international declaration form instead.
Students from outside the EU need insurance like everyone else. Sometimes colleges and companies have a contract with a health insurer so that students and employees can enjoy discounted premiums.
What does Dutch health insurance cover?
The basic Dutch insurance package covers all costs for the most common medical care. The Dutch government decides yearly what is included in the basisverekering.
The 2016 basic health coverage in the Netherlands includes the following:
- GP consultations
- Treatments from specialists and hospital care
- Certain mental health care
- Dental care and physiotherapy up to 18 years
- Care from certain therapists, such as speech therapists
- Dietary advice
- Basic mental health services
- Stop-smoking programs
- Maternity care and midwives.
For a complete list of healthcare services included, visit the government’s website here.
You will need extra insurance if you want coverage for extensive dental treatments, physiotherapy or anything else the government considers to be your own responsibility, and it is in these additional areas that companies compete. It is possible to purchase the additional coverage (aanvullende pakket) from a different insurer than your basic insurer. This may make things more complicated when processing bills, but it can sometimes lower your overall costs, or allow you to purchase additional coverage tailored for the needs of international persons residing in the Netherlands.
For maternity care, it is worthwhile to check what your Dutch health insurance will cover – there are generally a range of helpful services for mothers-to-be. For information about pregnancy and birth in the Netherlands, see our guide to having a baby in the Netherlands.
How much does Dutch healthcare cost?
Your employer will pay 6.75 percent of your salary for you for the Zvw component, and deduct 9.65 percent from your pay for the Wlz part. The self-employed pay slightly less Zvw, at 5.65 percent.
In addition, you will generally have to pay monthly contributions to your health insurer, which in 2016 amount to around EUR 1,288 a year (it varies slightly from insurer to insurer). Online websites help you to compare general health insurance packages and costs from different insurers.
The insurance policy will also have an ‘excess’ (eigen risico). This means that you have to pay the first EUR 385 (as of 2016) of some treatments. You don’t pay the excess on services supplied by GPs, obstetric and post-natal care: these are completely free.
Help with costs: healthcare subsidies in the Netherlands
You may be able to get help towards the cost of your insurance premiums in the form of a ‘health allowance’ (zorgtoeslag) by applying to the Dutch Tax Administration (Belastingdienst). To be eligible, you must be 18 years or older, have a valid residence permit and be paying Dutch health insurance. You also need to earn less than EUR 27,012/year as a single person or EUR 33,765/year as a couple; these income levels are revised every year. The amount of benefit you get depends on your income.
Once you’re insured
You need to present your ID and a health insurance chip card when you use any of the health services in the Netherlands. Depending on whether your insurer has a contract with the particular provider (check your policy), you can pay at the time and be reimbursed, pass the bill onto your insurer, or do nothing as the health service provider and insurer will deal with the bill between themselves.
In addition, as the Netherlands is part of an EU-wide (and Swiss) healthcare scheme, your insurance company will give you a European Union Health Insurance Card (EHIC), which means that if you need medical treatment while you are elsewhere in the EU you don’t have to pay for it – the insurance company will. Remember to take the card with you when you travel within the EU or Switzerland.
Going to the doctor in the Netherlands
The huisarts (GPs) are responsible for gathering all your medical records and are the gatekeepers to all the other types of medical treatment, so they are the first point of contact when you have a health problem (unless it’s an emergency, of course). They can deal with routine health issues, perform standard gynaecological and paediatric examinations, and refer you onto other services, including hospitals, specialists, home midwifery and physiotherapy.
Find and register with a doctor
First you will need to register with a huisart, preferably one nearby. Almost all of them will speak English. Not all practices will be taking on new patients, however, or they may have long waiting lists. As such, it's worthwhile to register before you become ill. You can make an appointment to meet the doctor before registering, to assess their suitability for your needs.
You can find a list of local doctors by checking:
- the gemeentegids (community guide) available at the town hall;
- the Yellow Pages of the phone book under ‘Artsen – huisartsen’;
- via the Centrale Doktersdienst helpline on 020 592 3434;
- by personal recommendation – ask friends, family or even post a thread on Expatica's forum.
- Online sites listing doctors in the Netherlands (Dutch language website).
Appointments: What to expect
You normally have to make an appointment in advance and may have to wait a few days to get a slot. Appointments often run late, so expect to wait, and they only last around 15 minutes, so be succinct when you’re in front of the doctor. Many doctors have daily first-come, first-served sessions (inloop spreekuur) for short phone or drop-in consultations. These days, it’s rare for doctors to make house calls.
Dutch healthcare is generally non-interventionist in nature, so don’t expect to leave the consultation with a prescription. Dutch doctors tend not to hand out antibiotics or anti-depressants lightly. It can be important to be clear and communicate what you want; read how to talk to Dutch doctors so they will listen.
You might also see the doctor’s assistant (for blood pressure readings, urine testing, injections) or practice nurse (for monitoring chronic conditions like asthma or diabetes).
There are three possible payment options, so check your insurance policy for your payment conditions: You may have to pay the doctor at the time and use the receipt to reclaim the money from your insurer; the doctor may send you an invoice for you to pass onto the insurance company; or the doctor will invoice your insurer direct.
There is 24-hour healthcare coverage in the Netherlands; out of hours you’ll usually hear a recorded message on the doctor's answering machine telling you how to contact on-call medical services. Telephone messages are usually in Dutch, so it helps to get familiar with Dutch numbers early on. Alternatively, you can call 020 592 3434 for medical advice from a central doctor’s service (Centrale Doktersdienst) for the closest doctor on-call.
Going to see a specialist in the Netherlands
You can’t go directly to a specialist for treatment; you have to be referred by a huisarts. Most specialists work within a hospital setting – as ‘contractors’ instead of employees – rather than a specialist clinic, and waiting lists can be long.
Hospitals in the Netherlands
There are lots of excellent hospitals in the Netherlands with high standards of care all over the country. Each hospital (ziekenhuis) used to offer a range of specialisms but they are becoming more specialised.
There are different types of hospital. Those attached to universities and carrying out medical research unsurprisingly have the most advanced medical equipment and treatments, and can offer the most specialised care. Teaching hospitals, training medics and nurses also offer some specialised treatments. General hospitals deal with more routine conditions.
For information on hospital locations, see Expatica's listing of hospitals in the Netherlands.
Going to the hospital in the Netherlands
Unless it’s an emergency, you will need a referral letter from our GP. You will be asked to provide details about your medical history and lifestyle, and be registered on the hospital database.
You’ll be given a registration card (ponsplaatje) which you’ll have to show each time you visit – it’s a means of bringing up your details and passing on bills to your insurance company.
If you are admitted as an in-patient – and unless it’s an emergency, this could take months from your initial appointment – you may find yourself in a shared room or ward of up to six beds (mixed sex). You’ll probably have a TV and phone line but there will be a charge. Bring your own clothes and toiletries. Strictly enforced visiting hours vary from hospital to hospital. If you prefer access to private rooms, you may consider taking out private insurance.
Pharmacies: drogist and apotheek
A drogist sells non-prescription medications, toiletries, cosmetics and baby essentials; an apotheek sells prescription-only drugs as well as over-the-counter meds, vitamins, baby items, homeopathic products and medical equipment for home use, and can also advise on medications and minor ailments.
There will always be an apotheek open 24 hours somewhere in the area. To find the closest out-of-hours pharmacy, you can:
- check the list displayed in the pharmacy window;
- call 020 694 8709;
- look under ‘medische diensten’ (medical assistance) in one of the free local newspapers;
- visit this online list of pharmacies (in Dutch) – just click on zoek een apotheek and enter your postcode to find the nearest one.
If you have a consultation with a huisarts (GP), you can sometimes collect your medicine right away from the apotheek as they’re often connected electronically. If the pharmacy has a contract with your insurer you won’t have to pay for your prescription at the time; if they do not, you’ll have to pay and claim it back. Your insurance company may also specify which types or brands are covered by your policy, and which are not. If your medicine is not covered, it can be worth to check if a cheaper generic brand is available.
In some cases, medications that can be bought over the counter back home may require a prescription in the Netherlands, plus medicines in the Netherlands might not be the same as you’re used to back home. If you’re taking medication prescribed in another country, bring it to your consultation to show the pharmacist or doctor first.
Visiting the dentist
You need to register with a tandarts (dentist). You can find one in the same way as you would find a doctor (through the community guide, Yellow Pages or a personal recommendation) – there are more than 9,000 of them. Traditionally, Dutch dentists have worked in single-dentist practices (and around 60 percent still do) but the developing trend is for dentists to work together in group practices.
Once registered with a dentist, you will usually be invited for check-ups every six months. Your dentist may delegate certain routine tasks to dental hygienists, dental assistants and prevention assistants, and refer onwards if necessary to specialised orthodontists and oral surgeons, who are usually based in hospitals.
To find a dentist out of hours, call the surgery and a voice mail will direct you to an emergency service.
You may have to take out additional insurance to cover the cost of dental treatment (check what your policy offers); under 18s are automatically covered under the basic Dutch health insurance package. Read more about dental care in the Netherlands.
Alternative treatments and therapies
Homeopathy, acupuncture, chiropractic, osteopathy, traditional Chinese medicine and other complementary therapies are widely used. The different types of therapy are grouped together in associations and you’ll find a list of regulated practitioners (in Dutch only) at the Association of Alternative Medicine.
Dutch health insurers now cover many alternative therapies, so check what different insurers offer if you require alternate therapies or treatments.
There are lots of good English-speaking counselors, psychologists, psychiatrists and alternative practitioners to help with mental health issues in the Netherlands. However, costs vary and not all will be covered by your health insurance.
What the 2016 basic Dutch insurance covers are psychiatric treatments, psychological care and the first three years of residence in a mental health institution.
In an emergency
Go to the spoedeisende hulp or eerste hulp bij ongelukken (EHBO) department of your local hospital for medical emergencies or first aid.
Call 112 for urgent medical help if you think that a person’s life may be at risk. The operator will answer in Dutch but will be fluent in several languages, including English. Explain what has happened and an operator will pass you onto the correct service: ambulance, fire and police all use the same number. Don’t hang up – although your number will appear on the operator’s screen so if you are cut off, the operator can call you back. The 112 number is toll-free.
If you have a speech or hearing problem, call 0800 8112 and you can type a message to the emergency call centre. You should write where you are, where the help is needed and the service you need.
Call 020 694 8709 for pharmacies open outside normal working hours. You can also call 020 592 3434 for urgent medical advice from a central doctor’s service.
Make sure you note down this list of emergency numbers for expats in the Netherlands.
Useful Dutch medical phrases
Find more phrases in our guide to Dutch medical terms.
- I have an emergency: Ik heb een noodgeval
- Call an ambulance: Bel een ambulance
- Call a doctor: Haal een dokter
- I am ill: Ik ben ziek
- I feel unwell: Ik voel me niet lekker
- I have a headache/stomache: Ik heb hoofdpijn/buikpijn
- I have an itch: Ik heb jeuk
- I feel dizzy: Ik voel me duizelig
- I need a doctor: Ik heb een dokter nodig
- I am allergic to...: Ik heb allergisch voor…
- Help!: Hulp!
You can also visit Expatica's healthcare channel for more information about Dutch healthcare services and insurance cover and read about how to decide between local and expat health insurances.
Expatica / Updated by Bupa Global
Need advice? Post your question on Expatica's free Ask the Expert service to see if we can help.
Bupa Global offers international health insurance to expats in more than 190 countries worldwide.
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