Health Insurance in the Netherlands [Expat Edition]

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Disclaimer: Blue Lynx is not an official health insurance representative and cannot be held liable for any misinformation. 

When you move to the Netherlands, getting on a health insurance plan is one of the first things you need to do. Whether you have just arrived or you’ve lived in the country for a few months, health insurance is a topic that needs careful consideration by everyone living and working in the Netherlands. In this article, we’ll cover:

 

Is having health insurance mandatory for expats?

Health insurance is mandatory for everyone who is moving in the Netherlands with the intention to live, work or study here for a period of 4 months or longer.

When you arrive, your first job is to register at your Gemeente (or municipality). When you register at the local municipality, you will receive your very own and unique BSN number (this is the equivalent of the Social Security Number in the US and other countries). You need it in order to apply for a health insurance plan.

That’s when you should start arranging your insurance.

If you are coming from outside the EU, EEA or Switzerland, you have 4 months to get your residence permit and take out health insurance. EU citizens with an EHIC (European Health Insurance Card) still need to purchase healthcare insurance. The EHIC gives you the right to access healthcare treatment only for emergency situations when you are temporarily in the Netherlands. But more on that down below.

In certain situations, you can opt-out from purchasing health insurance. There is the Conscientious Objectors Scheme developed by CAK which allows you to apply for an exemption from the health insurance premium if it contradicts your religious beliefs.

 

When do you not need to be insured in the Netherlands?

You don’t need to purchase Dutch health insurance if you are a foreign student coming to the Netherlands without the intention to work or be on a paid internship, you are coming to live here but you will be working for a foreign employer, or you are a foreign national working at your country’s embassy or consulate. Wondering if you need to purchase insurance during your stay in the Netherlands? See this article to learn who is and who isn’t obliged to take out basic insurance.

 

If you have 4 months, can you wait until the very last day?

Definitely not recommended. The clock starts ticking from the moment you arrive here in the Netherlands. In fact, the government will issue a warning and a fine if they find out you are not properly (or at all) covered by health insurance after the 4 months following your arrival.

There will be many things to arrange in those first months. Health care should be one of your top priorities. Even if you take out medical insurance in the third month, you will still have to pay for the previous months.

 

How does the Dutch health care system work?

The Dutch healthcare system is regulated by the government, while it is carried out by private companies. Each of these companies will offer you different packages and prices but they are bound by law to provide you with basic health insurance. It is your choice whether or not you will pay for extra coverage on top of your basic plan.

As you learned already, the government requires adults of 18 and older to be covered by a basic plan at the very least. Children get free healthcare in the Netherlands until they turn 18.

As an expat, when you register at the Gemeente and choose a health insurance provider and plan, you will start paying a monthly amount of money that corresponds with your package. This amount is called a ‘premium’. The basic/standard health insurance plan costs about €100. Besides this fee, you also pay ‘own risk’.

 

What is “own risk”?

Own risk, or eigen risico, is an amount of money that each person pays on top of their monthly ‘premium’ fee. It is also called a ‘deductible’.  For the last 5 years (2016-2020), it has been set to a minimum of €385. This is the amount you need to pay for medical bills and treatments before your insurance kicks in.

Here is how it all works:

The €100 a month (your premium fee) covers all basic health needs, such as a physiotherapist and visits to your GP. The 100 euro a month can be added on when adding extra care packages such as additional dental care or psychologists treatments. You can also lower the €100 monthly premium when you expect not to get sick. In this case, you can enlarge your own risk and thus pay less monthly. The own risk consists of the first healthcare costs you make in a year. Legally, the minimum own risk is €385. If you enlarge your own risk to be any chosen number up until €875, you will pay less money monthly. But, you will have to cover the first €875 you use of healthcare (outside of the basic package – healthcare in the basic package is always free).

Note: Once you use your own risk it is often possible to pay it in instalments, instead of the whole sum at once.

Once you have used up all of your own risk, the rest of your healthcare (if covered by your provider) will be free. This includes most healthcare, except for very specialised treatments for rare diseases and such. Please check with your healthcare provider what is and is not covered. The own risk resets every year.

To recap: You can choose to set your own risk to be anything between €385 and €885.

If you choose to have a higher own risk, you will pay a lower monthly premium.

The ‘own risk’ is subject to change every year. Once per year, the government updates what type of medical care is covered by your premium fee and what lies under ‘own risk’. Also, some medical insurance providers may share with you some information about your eigen risico for the next year.

 

The cost of health insurance in the Netherlands

Generally, it is up to you what type of health insurance package you will choose. The basic package (which has all general care that you might need) is the cheapest option but you may always opt for a more expensive one that covers more of your needs.

The best way to choose the most suitable option is to compare health insurance packages from different providers. You can use online tools like Independer and Zorgwijzer. Keep in mind – you can switch between providers only once a year before December 31st.

Natura policy vs. Restitution policy

Some healthcare providers have deals with only select clinics and doctors. In this case, you are not allowed to choose your own medical practitioner.

A natura policy means you can choose between contracted medical practitioners. When you choose to go to a non-contracted practitioner, you will pay for a part of the treatment yourself.

A restitution policy means you will get the full treatment refunded. You also have more choice when it comes to medical practitioners. This makes the restitution policy is more expensive than a natura policy.

 

Will your employer contribute to your medical costs?

Yes. Under the Employer’s Levy Healthcare Insurance Act, your Dutch employer must contribute to the cost of health insurance for their employees. Employers are obliged to pay a percentage (6.95% in 2020) of your gross salary. This is part of the national social insurance contributions that are in place for every Dutch citizen. In addition to that, some employers are on a corporate insurance scheme which might work out cheaper to purchase. However, if you discontinue employment, you also need to change insurers.

 

How often can you change your health insurance provider?

You may switch between health insurance companies once a year, on January 1st. To do so, you need to cancel your current plan before December 31st. You have one month, or until February 1st to take out new insurance.

In certain cases, you are allowed to change your insurance company before the end of the calendar year. For example, if you are switching jobs or if you are the main insurance holder and need to cancel one of the people who are insured through your policy.

 

What if you have pre-existing health conditions?

By law, health insurers are obliged to offer you the basic health plan regardless of your pre-existing condition. What’s more, they are not allowed to charge a higher cost because of it.

 

Is a Coronavirus test covered from the basic plan?

Yes, the standard health insurance covers PCR tests. However, make sure you have sufficient symptoms and have consulted your GP first. You can also get reimbursed for some post-virus recovery costs.

 

What if you are unemployed?

Let’s say you relocate to the Netherlands because your partner found a job here but you don’t have one yet. Do you still need to pay for insurance? Yes. But you can apply for some governmental help.

If your income is low and you are not co-insured (meaning your partner’s policy isn’t covering you both), you can apply for the  Healthcare allowance (zorgtoeslag). To determine its amount, your income, as well as the one of your partner, will be calculated and based on that, you will be eligible to an allowance, which will cover part of your insurance costs. If you are in a tax partnership, your overall household income (yours and your partner’s) must be lower than €39,979 per year to qualify for the allowance.

In 2021, the zorgtoeslag can cover up €107 (or € 207 if you are with a tax partner) of your monthly medical insurance premium. Please check this section of the tax authority website regularly for up-to-date information each year.

If you have any children under the age of 18, they are automatically covered by your insurance but you need to register them under your policy.

 

Can you transfer the health insurance from your country?

If you are on a temporary residence permit and your foreign health insurance specifies that it covers you in the Netherlands, then you will be reimbursed for your health expenses here.

Yet, if you are coming to live and work here for an indefinite amount of time, you need to purchase Dutch health insurance.

 

What are the specifics for EU citizens (EHIC card)?

If you are an EU citizen, you are eligible to get a European Health Insurance Card in your own country prior to arriving in the Netherlands. The EHIC covers medical expenses in the countries that are part of the European Economic Area (EEA), Switzerland and Australia. However, it doesn’t replace Dutch health insurance. It’s used when you are just temporarily visiting and you are not working in the Netherlands.

 

Are Dental Costs Covered by Dutch Health Insurance?

Not always. Dental care is not covered in the basic health insurance package. This means that if you want your dental care costs covered, you need additional insurance. Your policy should explicitly specify that dental care is included. Make sure that you carry your medical insurance card when you visit the dentist.

 

How to Choose a Dutch Health Insurance: Our Top 3 Tips

You might be expecting us to tell you which Dutch health insurance plan is the best but we can’t give you a specific answer because everyone’s needs are different.

But what we can do is give you some tips on how to choose an insurance plan. You will want to compare and of course, align your choice with your budget and income.

 

1) Don’t focus only on the price

Price is the deciding factor for many people as even the cheapest insurance policies are not that cheap. However, one of our top pieces of advice we give to expats who are about to buy insurance for the first time is: Put customer satisfaction first.

Check the ratings of the insurers you have shortlisted, ask around for recommendations. Cheap health insurance plans often come with a lot of rules and conditions that are less customer-friendly and more complicated.

 

2) Look for easy

The last thing you need when you have a large medical bill and a health issue is an insurance company that makes it difficult to file your claims and get reimbursed.

Choose a health insurance provider that offers a user-friendly online platform for communication and general requests such as reimbursements, filing your documents, and etc.

 

3) Add extra on top of your basic plan

Some insurers allow you to add extra options to your plan on top of the mandatory basic health care plan. They come at a surcharge on top of the monthly fee. Check if your health care insurance company has additional packages that suit your needs. This way you might avoid paying too much for insurance but still have everything you need, covered by a more personalised plan.

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