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.
The basic package
The government decides on what the standard package covers. 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
- Community nursing services
- Primary and secondary mental health care including treatment by a psychologist or psychiatric treatment
- Physiotherapy up to the age of 18
- Dental care until the age of 18.
- Various medical appliances
- Various prescription medicines
- Prenatal care
- Patient transport (e.g. ambulance)
- Paramedical care
- Up to three session with a dietician
- Up to three IVF treatments
- Smoking cessation programmes
- Speech therapy
You can decide to purchase additional insurance if you need extra medical care which is 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.
Many companies in the Netherlands arrange collective health insurance agreements with insurance companies offering their employees a small discount. If you are working for a company in the Netherlands, consider purchasing a collective health insurance policy, as it is often cheaper than purchasing one for yourself. However, you are not obliged to buy such a policy when it is offered to you. 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 €100 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 it is possible to change health insurers at the end of each year. If you want to switch health insurers you will have to terminate your current insurance by written cancellation notice before the first of January.
Besides paying a premium to your insurer, you also have to pay a supplementary contribution from your income. The percentage that’s been deducted from your income is laid down in the Healthcare Insurance Act (ZVW) and is also known as the ZVW contribution. (The percentage is 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 .
Over the years healthcare in the Netherlands has become more expensive. The Dutch government compensates those who can’t afford healthcare 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 less than a year 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 the bills, prescriptions and receipts. This can save you 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 refunded.
Foreigners becoming long-term residents in the Netherlands and those earning a salary in the Netherlands are required to purchase basic insurance from a Dutch healthcare insurance company. Keep in mind that if you do not purchase a health insurance you may be fined.
When your stay in the Netherlands is not temporary, you are required to purchase 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.
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