Basic insurance
Everyone who lives or works in the Netherlands is obliged to have basic health insurance. This covers standard care provided by GPs, pharmacies and hospitals. Health insurance providers have to accept everyone who applies for basic insurance. Everyone pays a set premium to the insurer for healthcare covered by basic insurance. Children and youngsters under 18 are exempt from paying premiums. If you wish, you can take out additional insurance (see below).
The government decides what is covered by basic insurance. Not all care covered by basic insurance is fully reimbursed. You may need to pay an excess (eigen risico) and sometimes a co-payment (eigen bijdrage). You may also need to pay some of the costs yourself if you choose to go to a non-contracted care provider. You always have to pay the costs for care that is not covered by basic health insurance, unless you have additional insurance.
Discussed below are:
- Additional insurance
- Excess
- Healthcare benefit (zorgtoeslag)
- Low-cost policy
- Student health insurance
More information about health insurance is available on the website of The Netherlands Authority for Consumers and Markets (ACM).
Additional insurance
For care that’s not covered by basic health insurance, such as dental care and physiotherapy, you can take out additional insurance. Check beforehand whether the additional coverage is worth the higher premium you need to pay for additional insurance.
Excess (eigen risico)
The cost of care such as hospital treatment and prescription medication is deducted from your excess. This excess is mandatory and starts at 385 euros, which means that you have to pay the first 385 euros in healthcare costs yourself. This rule doesn’t apply to GP care. However, if you need further testing, for example x-rays or a smear test, these costs are deducted from your excess. You can opt for a higher excess in return for a lower premium.
Healthcare benefit
You may be eligible for healthcare benefit, a government contribution to help pay for health insurance. Your eligibility and the amount of healthcare benefit you receive, depends on your income. For more information and to apply for healthcare benefit, visit the Belastingdienst (Tax and Customs Administration) website. Have you finished your studies or has your income increased? Don’t forget to adjust the amount of healthcare benefit you receive, because otherwise you’ll have to pay back the amount you we’re not entitled to.
Low-cost policy
A low-cost policy is cheap, but has a number of limitations. For these policies, health insurance companies negotiate contracts with only a limited number of hospitals and healthcare providers, including GPs. That means it’s very important to check which healthcare providers are covered. If you choose to get treatment elsewhere, the costs are not fully reimbursed, which means you need to pay the difference yourself.