Health insurance in the Netherlands for foreign expats

The healthcare system in the Netherlands might be unlike anything you’ve encountered before. It isn’t free – it’s expensive, but it’s also one of the best healthcare systems in the world¹. You’ll pay for it through a combination of insurance and compulsory salary contributions. The system combines the benefits of private healthcare with the accessibility and fairness of a universal healthcare system.

To make it a bit easier to digest, the healthcare system can be broken up into three main components: mandatory health insurance, optional health insurance and tax-funded long-term social care.

Mandatory health insurance (Basisverzekering)

Every resident legally must take out basic private insurance that covers primary care. It’s important that you understand how works, as you’ll be required to organise it yourself.

Mandatory health insurance in the Netherlands is provided by one of around 40 different private healthcare companies. You must be covered by the basic level of cover. This means every private healthcare provider offers the same basic package as standard.

The premiums do vary from company to company as the government doesn’t dictate a set price. However, every insurance company is required to charge all its policyholders the same premium for the same basic package, regardless of their age or the state of their health. Insurance providers are also required to accept everyone who applies for the standard insurance package.

Anyone that can’t afford their basic healthcare cover can file for healthcare allowance with the Dutch Tax Administration (Belastingdienst) for government support to help cover some or all the cost.

Optional additional health insurance (Aaanvullende verzekering)

Health insurance providers typically offer additional health insurance for secondary care services, such as dentistry, long-term physiotherapy and vision care. This additional level of insurance is optional, but it’s fairly common for Dutch residents to take it.

You also don’t have to take additional health insurance from the same company that provides you with your basic cover if you find a better price elsewhere. As an expat, this means you’ve got the option of supplementing your mandatory basic insurance with an international health insurance plan.

With the right level of cover, this would not only cover you for additional services in the Netherlands, but it would also provide cover in your home nation, and any other country you choose to visit in between.

Long-term care - Wet langdurige zorg (Wlz)

In addition to insurance contributions, the Netherlands also has a tax-funded social care programme that covers long-term care. This is known as the Wlz (Wet langdurige zorg) system.

While your mandatory health insurance covers short-term, immediate and emergency treatments, the long-term care system is, as the name suggests, for longer term issues such as dementia, physical disabilities, chronic illnesses and other mental and physical impairments. Dutch residents can also choose to receive long-term care at home or in a healthcare institute.

All Dutch residents (aged 18 and over) pay for this through salary contributions. The amount you’ll pay will depend on your taxable income, so it’s not a fixed amount (though it is capped). This should be set up for you by your employer, who will automatically allocate a certain percentage of your salary towards your Wlz contribution.

The process for accessing the Dutch healthcare system won’t be the same for everyone. It’ll depend on things like your employment status and nationality, so it’s always worth doing plenty of research before your move. 

But, with all residents of the Netherlands required to have mandatory health insurance for primary care, it’s important to know exactly how this works. Here are a few things everyone should be aware of when moving to the Netherlands:

Registering as a Dutch resident

When moving to the Netherlands, you’ll first need to register as a resident.

To do this, you must register with the individual area where you’re planning to live. You’ll need to do this in person within the first five days of your arrival. Be sure to make an appointment in advance and find out what documentation you need to bring along. Once registered, they’ll include your details in the country’s Personal Records Database and issue you with a citizen service number (burgerservicenummer - BSN). You need this number to start a job or open a bank account in the Netherlands, as well as to register with an insurance provider.

Accessing mandatory health insurance in the Netherlands

There are around 40 private healthcare providers to choose from. While they’re all regulated by the government to ensure they offer the same basic level of cover, there’s not an official central portal, so you’ll have to shop around a bit to compare prices and any additional features. Comparison sites are available, including zorgwijzer.² You’ll usually need to choose a company yourself, but it’s worth checking with your employer to see if they have any agreements in place with a particular provider.

Along with your (burgerservicenummer) BSN, you’ll need your passport or ID as well as personal details, like your bank account number, to register. Health insurance companies aren’t allowed to refuse basic cover to anyone on the grounds of age, lifestyle or state of health, so you should be accepted as long as you have all the correct paperwork. You’ll then be responsible for paying your monthly premiums.

You’re also able to change your health insurance provider once a year. This needs to be done in time for the next calendar year, so the deadline to switch is 31^st December each year.

Accessing additional health insurance in the Netherlands 

Additional health insurance in the Netherlands covers secondary medical services like physiotherapy and dental care. This is entirely optional, but it’s very common for Dutch residents to have this additional cover.³

The process for taking out an additional, supplementary policy is similar to taking out the basic cover, though you’re not obliged to use the same insurance provider for both. One thing to keep in mind is, unlike the basic cover, insurance companies aren’t required to accept anyone who applies, so they may ask for more information about your health and even refuse to accept you as a client if they wish.

How do I get Dutch health insurance if I’m self-employed?

All Dutch residents are legally required to take out the basic level of health insurance, including freelancers, self-employed people and entrepreneurs. You’ll access health insurance the same way as you would if you were employed, but you’ll also need to register for the long-term care system (Wet langdurige zorg – Wlz).

Alongside this, you’ll need to register for social security and make salary contributions as part of your tax return. The amount you’ll pay is linked to your income, so that will be determined by the Dutch tax and social security authorities.

What about children?

If you’re the parent or guardian of any children under the age of 18, they’ll be covered by your Dutch insurance policy. They’re covered to the same level as you, so if you have additional cover with a Dutch company, your child will too.

Of course, if you choose to take out global healthcare cover as a supplement to the Dutch basic insurance, you’ll need to check the details of your policy, (but your child will still be covered under your mandatory Dutch insurance). Basic dentistry is also free for under 18s in the Netherlands, regardless of your level of cover.

European citizens

For EU or EEA citizens, your European Health Insurance Card (EHIC) entitles you to primary medical treatment on the same basis as Dutch citizens during a short visit (less than four months). This includes any temporary stay in the Netherlands during which time your employment and residency remain based in your home nation.  

However, your EHIC isn’t a long-term solution. If you’re planning on living in the Netherlands and becoming a resident, you’ll need to get a basic insurance package within four months of your arrival.

The amount you’ll pay for healthcare in the Netherlands will depend on a number of factors, including the insurance policy you select, the amount you earn and what medical services you use.

Health insurance

Health insurance premiums vary depending on the provider and the type of policy you take out. The government sets out exactly what must be covered under the plan, but they don’t dictate the pricing. As a guide, the average monthly price for the basic level of Dutch health insurance in 2023 is around €135.³

Mandatory deductible (Eigen risico)

In addition to your insurance premium, you'll also need to pay an initial deductible (or policy excess) before your insurance kicks in and starts covering your medical expenses. This is a mandatory deductible, which is set by the government. For 2023, it’s fixed at €385 per year.³ Doctor appointments are exempt from the mandatory deductible and should always be fully covered by your insurance.

The first time you receive medical care in a calendar year, you’ll pay your deductible and then the remaining amount will be covered by your health insurance. Then any further medical care you receive in the same year will be fully covered as you’ll have cleared your deductible.

You’ll only pay a deductible if you actually use medical services. So, if you go through a whole year without incurring any medical expenses, you won’t pay any deductible. Some health insurance providers will enable you to reduce your premiums by increasing your deductible amount by between €100 and €500 per year (the maximum yearly deductible is €885).³

Personal contribution (Eigen bijdrage)

A statutory personal contribution may also be attributed to certain medical products or services that incur additional fees outside of the deductible and insurance coverage. The government determines the amount you’ll pay and the types of medical care it applies to, but it includes things like hearing aids, eyeglasses, contact lenses and dentures. 

Long-term care - Wet langdurige zorg (Wlz)

As mentioned earlier, the Netherlands also has a tax-funded social care programme that’s set up to cover long-term care called the Wet langdurige zorg (Wlz) system. In 2023, the cost for this is 9.65% of your income (capped at €35.472 per month).³

Insurance and deductible payments

You’ll pay for your Dutch insurance policy through monthly premiums, for which you’ll need to set up a direct debit. Your mandatory excess (Eigen risico) will also be paid to your insurance company. You can either pre-pay this in ten monthly instalments, which will be added to your regular payments, or you can pay as you go, in which case you’ll get a separate bill. 

Insurance reimbursements

The way your insurance company reimburses you or covers your medical costs will depend on your plan. Dutch insurance companies will generally offer two types of policy: Naturapolis (in-kind policies) and Restitutiepolis (reimbursement policies).  

Many insurers have agreements in place with particular healthcare providers. With a Naturapolis policy, the insurer will deal directly with their contracted healthcare provider to cover your bills. However, these policies usually come with the condition that you’ll only receive a full reimbursement if you visit a contracted healthcare provider. If you go elsewhere, you’ll likely only receive a partial reimbursement or you’ll have to cover all of the costs yourself. 

Restitutiepolis policies, on the other hand, give you the freedom to choose any hospital, clinic or doctor you want, regardless of any agreements your insurer has with any other providers. However, in this case, you’d need to pay your medical bills in full and then request reimbursement. 

There is also another policy available, it is a combination of the Naturalis and Resitutiepolis policies – known as Combinatiepolis. This is where some of the care you receive may be covered under the Naturalis policy whilst other types of care are covered under the Restitutiepolis policy – a combination of both. 

Doctors (huisarts)

Once registered with an insurance provider, you’ll need to register with a local family doctor. This is crucial when you’re living in the Netherlands, as doctors are the first point of contact for all medical issues except emergencies. They’ll answer your questions, conduct minor examinations, run tests and generally act as gatekeepers to the rest of the healthcare system, so you won’t get very far if you’re not registered with a doctor.  

You can find a doctor online or by going to a local town hall. Once you’ve found one that you like, you’ll need to register with them, for which you’ll need your BSN and health insurance details, as well as a valid ID. Depending on the practice, you may be able to register online, but be prepared for the possibility that you may need to register in person. They may also want to have an initial consultation to discuss your medical history and any medications you’re using. 

You can usually make an appointment online or on the phone, but you should allow a few days for non-emergency appointments. 

Specialists

To see a specialist in the Netherlands, you’ll need a referral from your doctor. It’s worth noting that waiting times for certain specialists can be weeks, or even months.   Your doctor will refer you if they believe your medical situation is serious enough. 

Emergencies

The phone number for an ambulance in the Netherlands is 112, which is the EU emergency number. 

Alternatively, you can go directly to the emergency department of your nearest hospital. If you do this, however, it’s worth calling your family doctor in advance if possible. 

Pharmacies in the Netherlands

One thing you mightn’t expect is that you’ll need to register with your local pharmacy (apotheek) in the same way as you do with a doctor. As a rule, you’ll still be able to visit other pharmacies, but having a regular registered pharmacy can make the process of filling prescriptions and obtaining medication a lot more streamlined.

In some cases, it allows your doctor to email through prescriptions and you may also be able to get medications delivered to you. And, depending on your insurance scheme, you may also be able to get your medication without having to pay up front and wait for a reimbursement.

Dental care

Dentistry is privatised in the Netherlands so, for over 18s, it won’t be covered by your mandatory basic insurance policy or be covered in full. Dentists (Tandarts) often operate from a single-dentist practice, although in recent years more and more larger practices have opened up with multiple dentists working from the same location. 

As a rule, dental care is only insured when you include additional benefits to your policy, but you’ll need to register with a dentist either way. You can find details of local dental practices and prices online. Their websites will guide you as to what you’ll need to do to register, but you’ll need to provide your ID, BSM and any relevant insurance details.

As already outlined, if you become a Dutch resident, private health cover from a Dutch insurance company is mandatory. Once you have that in place, it’s not a legal requirement to take out any other form of private healthcare cover.

If you’re not a Dutch resident, then you won’t be able to take out a Dutch policy, but you’ll still need cover. If you’re an EU or EEA citizen, your EHIC will cover you for primary care for up to four months, but if you’re from elsewhere, you’ll need to make other arrangements. Healthcare services in the Netherlands can be very expensive if you need to pay for them yourself, and you may not actually be granted a visa to enter the country if you don’t have health insurance.

And, if you do become a Dutch resident, you can combine your mandatory basic coverage with our global healthcare plan to ensure you’re covered for both primary and secondary services, both in the Netherlands and throughout the world.

The Netherlands has one of the best healthcare systems in the world¹. And it manages to offer this consistently high level of care for all its residents without a traditional universal, public healthcare model.

Instead, by making it mandatory for all residents to take out private health insurance, the Netherlands has effectively combined the quality, availability and efficiency of private healthcare with the accessibility and fairness of a universal system.

As a result, the standard of care for critical illnesses is exceptionally high, with modern facilities, state-of-the-art equipment, and highly qualified, well-trained medical professionals. The efficiency of the system means that waiting times for appointments are often relatively short compared to other countries.