Healthcare in the Netherlands
Here’s a guide to the Dutch healthcare system, including Dutch health insurance, 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 34 nations in the 2012 Euro Health Consumer Index (the ‘industry standard’ of modern healthcare) and spends 11.9 percent of GDP on health, second only to the United States. Plus, almost all the doctors speak excellent English, making healthcare in the Netherlands very accessible to expats.
Health insurance in the Netherlands is mandatory
Healthcare in the Netherlands is covered by two statutory forms of insurance:
- Zorgverzekeringswet (Zvw), often called ‘basic insurance’, covers common medical care.
- Algemene Wet Bijzondere Ziektekosten (AWBZ) covers long-term nursing and care.
While Dutch residents are automatically insured by the government for AWBZ, everyone has to take out their own basic healthcare insurance (basisverzekering), except those under 18 who are automatically covered under their parents' premium. If you don’t take out insurance, you risk a fine.
Insurers have to offer a universal package for everyone over the age of 18 years, regardless of age or state of health – it’s illegal to refuse an application or impose special conditions.
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 insurance but you will need health insurance of some kind. If you already have an international health insurance, contact the College for Health Insurances (College voor Zorgverzekeringen) on 020 797 8555 to see if it will be accepted – and what healthcare 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.
Students from the EU/EEA/Switzerland are exempt from paying health insurance – unless they are working, even part time, or as part of a paid internship. Non-working students will be given an European Health Insurance Card (see below), 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.
You can follow this flowchart by Euraxess to determine if you need Dutch health insurance depending on your personal circumstances.
You can find more information on different aspects of the Dutch healthcare system on Expatica's healthcare page for the Netherlands.
What does Dutch health insurance cover?
The basic insurance package covers all costs for the most common medical care. Depending on your health insurance, it can include:
- GP consultations;
- Treatments from specialists and hospital care;
- Certain mental health care;
- Dental care up to 18 years;
- Care from certain therapists, such as speech therapists;
- Dieticians; and
- Maternity care.
You will need extra 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 packet) 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 7.75 percent of your salary for you for the Zvw component, and deduct 12.65 percent from your pay for the AWBZ part (up to EUR 33,363/year if you are under 65). 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 2013 amounted to around EUR 1,291 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’. This means that you have to pay the first EUR 350 (as of 2013) 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
You may be able to get help towards the cost of your insurance premiums in the form of a ‘care allowance’ (zorgtoeslag) by applying to the Dutch Tax Administration (Belastingdienst). To be eligible, you must be over 18, have a residence permit and be paying health insurance. You need to earn less than EUR 30,939/year as a single person or EUR 42,438/year as a couple. The amount 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. 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.
Your European Health Insurance Card
The Netherlands is part of an EU-wide (and Swiss) healthcare scheme. Your insurance company will give you a European 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.
Finding a doctor – and registering
First, you 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.
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).
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 send it direct. What you need to do varies from insurance company to insurance company, so check your policy for your payment conditions.
There is 24-hour healthcare coverage in the Netherlands; out of hours, you’ll usually hear a recorded message on the huisart's telephone 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).
Going to see a specialist
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.
There are lots of excellent hospitals (ziekenhuis) with high standards of care all over the Netherlands. Each hospital 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.
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.
Medications that can be bought over the counter back home may need 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, 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 over 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, you will be invited for six-monthly check-ups. 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. 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.
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.
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 on hand to help with mental health issues in the Netherlands. However, costs vary and not all will be covered by your health insurance.
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! 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.
Call 020 592 3434 for urgent medical advice from a central doctor’s service.
Useful medical phrases
Call an ambulance: Bel een ambulance
Call a doctor: Haal een dokter
I am ill: Ik ben ziek
For general details on the Dutch healthcare system, the Health Insurance Information Centre has information in English, as does the Ministry of Health, Welfare and Sport.
You can also visit Expatica's healtcare channel for information about insurance cover for different types of emergency care.
Need advice? Post your question on Expatica's free Ask the Expert service to see if we can help.
Bupa Global offers a variety of health insurance packages to expats in more than 190 countries around the world.