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Healthcare insurance in the Netherlands: an overview

Healthcare insurance in the Netherlands: an overview

The Dutch health insurance system relies on two laws, the Zorgverzekeringswet (Zvw, healthcare insurance law) and the AWBZ (general law on exceptional medical expenses).

 Zorgverzekeringswet (Zvw, healthcare insurance law)

The first law consists of rules and regulations regarding short-term medical care, such as visits to a general practitioner, medicine prescriptions, hospital stays and midwifery services.

 AWBZ (general law on exceptional medical expenses)

The second law aims to provide exceptional and long-term medical care for the elderly, disabled or the chronically ill. For instance, elderly that are unable to take care of themselves are entitled to in-home (medical) care provided by healthcare professionals.

Healthcare costs

Healthcare in the Netherlands is primarily funded by means of taxes. Employers pay a percentage of their employee’s income (7,65 per cent in 2015) to the tax administration. In addition, employees also pay a fixed percentage of their income (9,65 per cent in 2015) to the government.

The secondary part of healthcare funding is the monthly premium that each person pays to their health insurance provider. On average, the premium for basic healthcare is approximately 92 euros per month (in 2014).

However, it is important to note that the premium can change considerably, depending on the chosen health insurance policy, level of coverage and deductible excess. You can read more about these options in the "choosing a healthcare insurance" section below.

Healthcare insurance for expats

From the moment someone obtains a residence permit and starts working in the Netherlands, he or she is obliged to obtain at least basic health insurance (basisverzekering) within four months.

 Basic health insurance

This basic health insurance plan covers the most essential medical care, such as:
- Visits and treatments from a general practitioner
- Medicine prescriptions
- Certain medical aids and healthcare programs
- Hospital care: this includes emergency medical transport, hospital stays and the necessary hospital treatments performed by doctors, surgeons and other medical professionals.
- Physiotherapy (only for some chronic conditions)
- Psychological/mental healthcare
- Dental care for children under the age of 18
- Midwifery
- Speech-language pathology
- Emergency medical care abroad (according to Dutch standards and tariffs)

 Supplementary insurance plan

Optionally, you can choose a supplementary insurance plan that, for example, covers physiotherapy, dental care (for those above the age of 18), eye care (glasses and lenses) or birth control methods.

Choosing a healthcare insurance plan

When choosing a healthcare insurance plan, it is important to look at several parameters:

 Decide your deductible excess

Everyone insured in the Netherlands has a standard, obligatory deductible excess (375 euros in 2015). This deductible amount must be paid by the insurance policy holder to the health insurance provider before the insurer will reimburse healthcare or medical costs made by the policy holder.

Not all types of medical care are subject to deductible excess. For example, the insurer will directly reimburse visits and treatments by a general practitioner.

The same applies for healthcare that is covered by the supplementary health insurance. For expats that seldom use medical care, it may be worthwhile raising the deductible excess to a maximum amount of 500 euros.

This will result in a discount on the monthly premium of around 15 to 25 euros, depending on the health insurance provider.

 Main policy types in the Netherlands

In the Netherlands it is possible to choose from three main types of basic health insurance policies:

- Naturapolis (most common policy, average premiums, limited choice policy)

Full reimbursement for medical care in hospitals and healthcare providers that have a standing agreement with the health insurance provider. Usually most hospitals and healthcare providers have an agreement with the insurer.

The reimbursement is lower (around 70 to 80 per cent) in cases when a policy holder decides to go to a hospital or healthcare provider that does not have a standing agreement with the insurer.

- Restitutiepolis (higher premiums, free choice policy)

Full reimbursement for medical care in hospitals that have a standing agreement with the health insurance provider (which is usually the case).

The reimbursement is higher compared to the naturapolis (around 90 to 100 per cent) if a policy holder decides to go to a hospital or healthcare provider that does not have a standing agreement with the insurer.

- Budgetpolis (lower premiums, minimal choice policy)

Similar to the naturapolis but slightly cheaper and offering fewer choice of healthcare providers and hospitals. Usually only hospitals in the bigger cities have a standing agreement with insurers who offer the budgetpolis.

If a policy holder is prefers to go to to a hospital or healthcare provider that does not have a standing agreement with the insurer then te reimbursement is lower compared to the naturapolis (between zero and 50 percent).

Supplementary health insurance

Besides the basic health insurance plan, you can choose a supplementary health insurance plan, which results in a higher premium.

Supplementary health insurance may be beneficial if you require specific types of healthcare that are not covered via the basic health insurance, such as: physiotherapy, extensive dental care, dietary advice or complementary healthcare like acupuncture, homeopathy and osteopathy.
 

On ZorgWijzer.nl you can compare Dutch health insurance providers. Visit the English section to compare all available health providers in the Netherlands and find the one that best suits your needs!
 

ZorgWijzer.nl

Bart

Author

Bart Koenraadt

Bart Koenraadt is owner at ZorgWijzer.nl. ZorgWijzer.nl is a comparison website for Dutch health insurances and provides detail information about the health system in the Netherlands

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xakepa 11:05 | 29 January 2018

Good to know: Regardless of the coverage you choose - according to my employer payroll - health insurance premiums are NOT a tax-deductible expense in NL; the premiums are subtracted after the tax is subtracted form your paycheck. So there is no benefit if they are paid through payroll deductions - you can decide to pay them out of pocket, even if your employer covers a part of the premium