Understanding the Netherlands Healthcare System
The Netherlands has one of the best healthcare systems in the world, according to the Legatum Institute, a London-based think tank. In its 2023 review of global health systems, the Netherlands ranked No. 11. The 2023 edition of CEOWORLD Magazine’s Health Care Index ranked it as the 7th best healthcare system in the world.
The Commonwealth Fund’s 2021 report, Mirror, Mirror 2021: Reflecting Poorly, compared healthcare in the United States with that of other high-income countries. Out of the 11 countries in the study, the Netherlands ranked second in healthcare that year. The country’s healthcare system also performed well in previous years, ranking No. 5 in the 2014 report and 3rd in 2017.
This means that expats moving to the Netherlands don’t need to worry about the quality of healthcare anywhere in the country. Doctors and hospitals all provide care that meets high international standards.
Yet knowing how to use this great system is also essential! Learning how Dutch healthcare works can help you access care when you need it.
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How Does the Dutch Healthcare System Work?
The Dutch government is responsible for the country’s healthcare system, which has undergone several improvements since its inception.
Today’s system has three philosophical objectives:
- Everyone should have access to healthcare where possible.
- Medical insurance should be jointly supportive of those insured.
- The services that the healthcare system provides should be of the highest quality.
The Dutch government sets healthcare priorities. It also monitors the system’s access, quality, and costs. When needed, the government introduces legislative changes. The Ministry of Health, Welfare, and Sport (VWS) oversees public health in the Netherlands.
The VWS receives support from different healthcare institutions. Some operate within the VWS, while others advise the ministry and the government. These include:
- The Dutch Health Care Authority makes sure that healthcare remains accessible, affordable, and of high quality.
- The Health Council of the Netherlands is an independent advisory body that provides counsel to government officials on health-related matters.
- The Medicines Evaluation Board (CBG) decides which medications can be used in the country.
- The National Health Care Institute provides the VWS with advice on health insurance.
- The Netherlands Competition Authority oversees health care markets.
- The Health and Youth Care Inspectorate (IGJ) monitors youth healthcare services.
Pros and Cons of the Netherlands Healthcare System
Like any healthcare system, the Netherlands’ system is not a perfect fit for everyone. Yet the country aims to serve as many people as possible while still meeting budgetary goals.
Anyone living and working in the Netherlands is required to purchase basic health insurance (“basisverzekering”) from private insurers. Adults choose their policy as individuals; there is no family coverage.
Their parents’ insurance covers children under the age of 18. Healthcare allowances help cover the cost of mandatory insurance for individuals who are unable to afford it.
Pros of The Netherlands Healthcare System
One pro of the Netherlands’ healthcare system is access to care. People can always visit a primary care doctor and get prescription medication. This is possible because everyone in the country has standard health insurance.
Other pros of the system include:
- Services are of high quality, with accreditation and quality assurance programs.
- Individuals with low income and net wealth can receive assistance to cover the cost of health insurance.
- Public health facilities must meet high standards.
- Insurers must accept all applicants.
- Everyone in the same plan pays the same fee for basic insurance. Age, gender, or pre-existing conditions do not affect this.
Compared to other European nations, the Netherlands spends more on healthcare. This is true both as a percentage of its GDP and in euros per capita.
The country’s total expenditure exceeded $136 billion (approximately 125 billion euros) in 2021. The demand for healthcare is projected to continue rising in the coming decades, which poses a challenge to delivering quality healthcare.
Cons of The Netherlands Healthcare System
While there are many pros to the Netherlands’ healthcare system, it can be difficult to use. It can be especially hard for expats or foreigners living in the Netherlands. Some cons include:
- Patients have to register with a primary care physician (general practitioner).
- Visiting a specialist means getting a referral from a primary care physician.
- Most government healthcare information is only in Dutch. This makes it difficult for foreigners to understand.
There is also an informational barrier that may come as a surprise to many foreigners. The Netherlands has no national system for sharing electronic patient records. This makes it difficult for different providers to access patient information.
While the Dutch healthcare system makes sure that almost every Dutch resident has access to insurance and affordable medical care, Dutch expats’ coverage may lapse when they move out of the country. When this happens, Dutch expats require international private medical insurance.
Does The Netherlands Have Universal Healthcare?
The Netherlands does not have a single-payer healthcare system. Yet around 99.9% of the population has health coverage.
The country’s universal healthcare system comprises compulsory basic private insurance, which the government regulates. Basic insurance is mainly funded through payroll taxes and insurance premiums.
The country began its national health insurance program in 1941. The system followed the German Bismarck model, which combines public and private health insurers.
Under this, employers and employees paid into “sickness funds” to cover health insurance. Anyone earning above a certain amount was required to purchase private health insurance instead. Costs became an issue.
In 2006, the Health Insurance Act (“Zorgverzekeringswet” or ZVW) merged the traditional public and private insurance markets into a single universal social health insurance program, mandating coverage through private insurance. In addition to a basic insurance package, people can opt for supplementary coverage.
The WLZ (“Wet langdurige Zorg”) system covers long-term care for people with dementia and other mental and physical impairments. Under this system, the government assesses your situation in order to determine the necessary care.
Dutch residents pay for this through a monetary contribution from taxable income. Enrollment in this insurance plan is automatic for people living and working in the Netherlands.
How to Access and Receive Healthcare in The Netherlands
Dutch citizens and permanent residents have to obtain basic healthcare coverage. If an immigrant is eligible for coverage but does not enroll, they will be subject to a fine.
It’s illegal for insurance providers to deny anyone basic coverage. Every basic insurance policy covers the same benefits.
These benefits are limited and do not include services such as adult dental care. People have the right to change their insurance provider each year.
How to Register with the Netherlands Healthcare System
Although the system is highly functional, registration can still be somewhat complex. Follow the three steps below to make sure you’re covered.
- Register for a citizen service number or BSN. You will also need this number to open a bank account or find work in the Netherlands.
- Choose and register with a local primary care physician or general practitioner, called a “huisarts.” This doctor will be your first point of contact for nearly all medical services.
- Sign up for the health insurance coverage of your choice. There is no official central insurance site, so you will need to do some research. Your employer may offer standard health insurance at a reduced rate.
There are exceptions to the rule that those eligible for healthcare in the Netherlands must pay a fine if they do not enroll in a basic plan.
If a person belongs to a religious group that prohibits them from enrolling in health insurance, they can establish a private savings account to cover medical expenses.
The Ministry of Defense provides healthcare for soldiers and other members of the Netherlands’ armed forces.
How to Get Emergency Care
Whether the Dutch system covers you or not, you may still encounter situations where you need care for urgent illnesses or injuries.
- If it’s safe to do so, you can go directly to an emergency room.
- For a medical emergency such as a heart attack, call 112.
- You can also reach emergency medical services by texting 0800 8112.
You’ll receive high-quality care in urgent situations. But if you don’t have insurance, you will be expected to pay for any medical care you receive.
What Does Basic Health Insurance Cover?
The mandatory benefits package covers the following services:
- Visits to a primary care provider or general practitioner
- Some specialist care
- Hospital care
- Some mental health treatments
- Dental care up to age 18
- Maternity care
- Dietary advice
- Services to quit smoking
- Some therapy treatments
- Prescription drugs
- Physiotherapy up to age 18
- Home nursing care
- Tests for sexually transmitted infections (STIs)
The Cost of Basic Healthcare Coverage in The Netherlands
In 2023, the average basic premium for health insurance was approximately $148 (€ 135) per month. Premiums may vary slightly depending on the insurance you choose.
Individuals are responsible for paying their monthly premiums to their selected insurance company.
Another healthcare cost in the Netherlands is the deductible excess. This is the maximum amount that the policyholder pays before health insurance kicks in.
The standard deductible in 2024 is $420 (385 euros) per year. The deductible does not apply to visits or consultations by your general practitioner.
Individuals should expect to cover the cost of the following:
- Monthly premium, or “premie”
- Deductible excess, or “eigen risico”
Some healthcare plans only cover healthcare providers that have contracts with the insurer. When those consumers seek medical services outside their plans’ contracted providers, they may have to pay a copayment.
For example, imagine you want to visit a specialist in Amsterdam who is not on your particular insurance plan.
You will have to pay a greater part of their fee than you would have if you had visited a doctor who was on the approved list of your healthcare insurer.
Supplemental Private Healthcare Insurance in the Netherlands
Additional private healthcare insurance (“aanvullende verzekering”) is also available in the Netherlands. The majority of the population (84%) purchases supplemental private coverage in addition to the basic insurance.
The primary reason for taking out private insurance is to cover treatments, including physiotherapy, psychiatric care, and adult dental care.
This can offer you peace of mind knowing that you won’t have to pay the full price for treatments or surgeries covered in your supplemental plan.
For expats, another ideal option is international health insurance, which will cover you in the Netherlands, your home country, or whatever country you choose to travel to.
Healthcare for Expats in The Netherlands
As a foreigner, if you don’t have health insurance in the Netherlands, you will have to pay for any treatment and medical costs you incur. If you are eligible to sign up for Dutch health insurance but do not do so, you will also be required to pay a fine.
You should learn about the different options available for health insurance in the Netherlands. Your options and requirements will change based on whether you are there on a short vacation, a student, a digital nomad, or have a job at a Dutch company.
Expats who are exempt from purchasing Dutch mandatory insurance include:
- Temporary visitors (4 months or less) from the EU/EEA/Switzerland.
- International students who stay in the country for less than one year and do not work are exempt from obtaining mandatory insurance.
- Expats who are not permanent residents.
One great possibility for expats is to combine Dutch basic coverage with an International Health Insurance plan. Doing this will cover you in the Netherlands and worldwide. Private global medical health insurance also offers additional benefits.
Benefits of International Health Insurance
- Worldwide coverage
- Comprehensive coverage
- Access to a wider variety of healthcare facilities and doctors
- Coverage that fits your care needs
- Coverage for accidents or unexpected medical expenses
Recommended Health Insurance in The Netherlands for Expats
Cigna Global Insurance Plan
- Flexible plans tailored to your needs and budget
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Best Health Plan with Europe-Only Coverage
IMG Global Prima Medical Insurance
- Five flexible plan levels with optional add-ons
- Choose your coverage area based on where you live or travel
- Freedom to select your healthcare provider anywhere in the world
Best Health Insurance in The Netherlands for US Citizens
BCBS Global Solutions Worldwide Premier
- Unlimited annual and lifetime coverage
- Pre-existing conditions covered with prior insurance
- For U.S. citizens abroad or foreign nationals in the U.S.
Sara Kettler is a seasoned freelance writer and Dartmouth graduate who has lived in Japan, France, the UK, and Australia. She shares insights on international relocation, including healthcare, culture, and local laws, helping readers navigate life abroad with ease.
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