The medical system
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Expat healthcare from AXA PPP InternationalMoving to a new country is one of the most exciting and adventurous decisions you can make in life. But along with that excitement also comes the daunting task of making sure your health is protected should anything go wrong.
Netherlands - Health
In the Netherlands, the government is not in charge of the day-to-day management of the healthcare system. Private health suppliers are responsible for the provision of services in this area. The government is responsible for the accessibility and quality of the healthcare.
If you are living in the Netherlands or you are paying income-tax in the Netherlands you are required to purchase a health insurance at a Dutch insurance company. In the past there was a difference between public and private healthcare in the Netherlands. This however has been changed and everybody is now required to purchase basic health insurance.
The basic package
The government has put together a basic package that covers about the same as the previous system. Health insurance companies are legally obliged to offer at least this basic package and can not reject anybody who is applying for it. With the basic package you are covered for the following:
- Medical care, including services by GP’s, hospitals, medical specialists and obstetricians
- Hospital stay
- Dental care (up until the age of 18 years, when 18 years or older you are only covered for specialist dental care and false teeth)
- Various medical appliances
- Various medicines
- Prenatal care
- Patient transport (e.g. ambulance)
- Paramedical care
You can decide to purchase additional insurance for circumstances not included in the basic package. However, in this case insurance companies can reject your application and they have the right to determine the price.
If you are working for a company in the Netherlands, consider purchasing a collective health insurance policy, this can be a good option as it is often cheaper. However, you are not obliged to buy such a policy when it is offered to you and your employer is not obliged to make you an offer. Ask your employer about the possibilities.
Fees of the basic package
The fees for the basic health insurance package are annually determined by the health insurance companies and are normally approximately €95 per month. Although the Ministry of Health (Ministerie van Volksgezondheid, Welzijn en Sport) determines a standard premium, the insurance companies determine the additions fee you will have to pay in the end by charging a certain rate and a no-claim charge. It is with these additional fees that the insurance companies compete with each other. There are various health insurance companies and a new law will make it easier to change between health insurance companies.
If you are required to purchase health insurance and are earning a salary, you will also pay a supplementary contribution from your income (rated 6.5% up to the first €30,000 of earnings; 4.4% for self-employed individuals).
The fees of health insurance companies can differ so it is advisable to compare the various prices. To help you with this choice, you can go to: www.kiesbeter.nl.
For some, healthcare in the Netherlands has become more expensive as a result of the changes. The Dutch government compensates these cases by offering a care grant (zorgtoeslag). The Tax Administration (belastingdienst) determines if you are eligible by examining your income. Foreigners are also entitled to this grant if they qualify.
Children under the age of 18 years do not have to pay any health insurance and are insured for free for the basic package of health care.
Basic health insurance for foreigners
The length of your stay is important in determining whether or not you are required to purchase health insurance in the Netherlands. People staying temporarily in the Netherlands are not required to purchase health insurance.
If you use Dutch medical services during your stay, make sure that you always keep all the bills, prescriptions and receipts. This can save a lot of trouble on your return to your home country. If you are an EU citizen, you should apply for a European Health Insurance Card (EHIC) through your home national health insurance agency or company. This card makes it easier to access health care in European countries and means you either do not have to pay for emergency treatment or you get healthcare charges refunding more quickly.
Foreigners becoming long-term residents in the Netherlands and/ those earning a salary in the Netherlands are required to purchase a basic insurance from a Dutch health care insurance company. Keep in mind that if you do not purchase a health insurance you may be fined.
Foreigners who settle in the Netherlands and remain receiving an income abroad are not always required to purchase a Dutch health insurance. This is determined by the length of your stay. When your stay is temporary you are not required to purchase a health insurance.
When you stay in the Netherlands is not temporary, you are required to purchase a health insurance. However, rules and regulations about the durability of your stay remain unclear. Generally you can use the following rule of thumb:
- A person who stays in the Netherlands for a period of less than one year is assumed to be on a temporary stay;
- A person who stays in the Netherlands for a period between one and three years is assumed to be on a long-term stay, but this will be accepted as temporary when the person can prove otherwise;
- A person who stays in the Netherlands for a period for more than three years is assumed to be on a long-term stay.
In all cases it will be examined whether the center of your civil and social life is in the Netherlands. This depends on your legal (e.g. residency permit), financial (income, tax duty, etc.) and social (membership of a club, family, etc.) situation.
If it is still unclear whether or not you are required to purchase basic health insurance you should contact the following institutions:
- De Belastingdienst (Tax Authorities): www.belastingdienst.nl
- Ministerie van Volksgezondheid, Welzijn en Sport (Ministry of Health): www.minvws.nl
- Sociale Verzekeringsbank (Social Insurance Bank): www.svb.nl
You can also find useful information on the Health insurance information centre website - http://www.zorgverzekering.org/eng/
For more information about the health care system and for up-to-date news on expat health, insurance and related issues in the Netherlands, check out our expat health blog at ExpatHealth.org.
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Shame on your doctor but...
sounds a bit better than america
Thank you. Your comment will be published once it has been approved by the moderators.
Choose a clinic instead of a physician?
misleading informationThank you. Your comment will be published once it has been approved by the moderators.