Get to Know 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 look at global health systems, the Netherlands came in at No. 11. And the 2023 edition of CEOWORLD Magazine 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 other high-income countries. Out of the 11 countries in the study, the Netherlands healthcare system came in second that year. The country's healthcare system also did well in previous years, coming in at No. 5 in the 2014 report and ranking 3rd in 2017.
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All of this means that expats moving to the Netherlands don't need to worry about healthcare quality 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 important! Learning how Dutch healthcare works can help you access care when you need it.
How Does the Dutch Healthcare System Work?
The Dutch government holds the primary responsibility for the country's healthcare system. The government has improved this system several times since it began.
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 Netherlands 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 counsels government officials about health-related topics.
- The Medicines Evaluation Board (CBG) decides which medications can be used in the country.
- The National Health Care Institute gives the VWS advice about health insurance.
- The Netherlands Competition Authority oversees health care markets.
- The Health and Youth Care Inspectorate (IGJ) monitors youth healthcare services.
Netherlands Healthcare System Pros and Cons
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 has to buy basic health insurance ("basisverzekering") from private insurers. Adults choose their policy as individuals; there is no family coverage. Children aged 18 and under are covered by their parents’ insurance. Healthcare allowances help pay for mandatory insurance for those unable to afford coverage.
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.
- People with low income and net wealth can get help to pay for 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 was more than $136 billion (125 billion euros) in 2021. The demand for healthcare is projected to continue rising in coming decades, which poses a challenge to delivering quality health care.
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 of the Netherlands healthcare system 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 hard to understand for foreigners.
There is also an informational barrier that may surprise 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 need International 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 consists of 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 of public and private health insurers. Under this, employers and employees paid into "sickness funds" to cover health insurance. Anyone earning above a certain amount had to buy private health insurance instead. Costs became an issue.
In 2006, the Health Insurance Act ("Zorgverzekeringswet" or ZVW) combined the traditional public and private insurance markets into one universal social health insurance program that mandates coverage via private insurance. Besides a basic insurance package, people can sign up for additional 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 and does not enroll, they will be fined.
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 things like adult dental care. People have the right to change insurers each year.
How to Register with the Netherlands Healthcare System
While the system is highly functional, registering can still be a bit 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 some exceptions to the rule that those eligible for healthcare in the Netherlands have to pay a fine if they do not sign up for a basic plan. If a person belongs to a religious group that does not permit them to sign up for health insurance, they can set up a private savings account to cover medical expenses. And the Ministry of Defense handles healthcare for soldiers and other members of the Netherlands’ armed forces.
How to Get Care in an Emergency
Whether you’re covered by the Dutch system or not, you still might run into 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
During 2023, the average basic premium for health insurance was about $148 (135 euros) per month. Premiums may change a little 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 paid by the policyholder 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 had 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%) buys supplemental private coverage on top of the basic insurance.
The main reason to take out private insurance is to cover treatments like physiotherapy, psychiatric care and adult dental treatments. This can offer you some peace of mind knowing that you won't have to pay the full price for treatments or surgeries that are 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.
Also Read: Top International Health Insurance Companies
Healthcare for Immigrants 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 and do not do so, you will also have 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 not required to obtain 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 throughout the world. Private global medical health insurance offers other benefits as well.
Benefits of an international health insurance plan include:
- 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
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Recommended Health Insurance in The Netherlands for Non-US Expats
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Author: Sara Kettler is a content editor at International Citizens Insurance. She has lived and worked around the globe, spending time in England, Australia, France and Japan. In each new country she’s used local health insurance programs.