Renowned for its stunning landscape, its canals, its culture and its relaxed atmosphere, the Netherlands is a perennial favourite with expats.

Another reason for the country’s popularity is that — thanks to its small population of only 17 million — the country has more job vacancies than it can fill. Currently expats occupy 838,000 jobs from a total of 10.2 million and the figures for 2019 reveal job vacancies of 293,800 for the 2nd quarter of 2019 across all sectors. The Netherlands is a country of opportunity.

Health care in the Netherlands

As you’d expect from an advanced western democracy, health care in the Netherlands is highly rated and the 2018  Euro health Consumer index ranked the country second in the whole of Europe. In order to access Dutch health care, you will have to sign up to the basic Dutch public health insurance or zorgverzekeringswet — otherwise known as Zvw. Monthly premiums do vary, but if you visit the zorgwijzer website you’ll see that the average price works out at about €118 per month and all the basic health care policies have a mandatory excess or eigen risico of €385 per annum. Should your costs amount to more than the excess, then you will be reimbursed by your insurance company.

Expats and health insurance

The most important thing to bear in mind is that all expats who are working in the Netherlands must sign up for health insurance within four months. Up until that time you can rely on your European Health Insurance Card (EHIC) if you’re from a country within either the EU or the EEA or Switzerland.

As signing up for Dutch basic health insurance is obligatory you will be subject to a fine of €402.24 if you haven’t selected your Dutch insurer and started to pay your premiums within the statutory four months. If you still haven’t signed up with an insurer after six months you’ll be issued with another fine from the CAK, the government department that’s responsible for implementing statutory regulations. After nine months of non-premium payment the CAK will approach your employer, sign you up with a basic health care insurer and deduct premiums from your salary on your behalf.

Expat students

Not all expat students will have to sign up to the Dutch health care insurance programme. If you’re purely in the Netherlands for study and won’t be working during this period, you can rely on your EHIC. If you come from a country outside the EU or EAA, then you can rely on health insurance plans that you may have in your country of origin. It is important that you have some type of insurance as the medical costs may prove expensive should you need to access the Netherlands health care system and have to meet the costs from your own pocket.

If you’re in any doubt about your situation, the Dutch Social Verzekeringsbank website will be able to answer your questions. The website is in English and is informative and easy to use.

Expat family members will also be expected to sign up to the Dutch health insurance programme as long as they do not have a job outside the Netherlands. If you have children under 18 the children should still be registered with an insurer, but their treatment is free, and families will not have to pay premiums to cover their children.

Expat workers from non-EU/EAA countries

Those expats who come from countries outside the EU or EAA, may not have to participate in the Dutch health insurance programme. Certain countries have a social security agreement in place with the Netherlands and it’s worth discovering if your country of origin has signed this treaty

How to register

Once you’ve started your job in the Netherlands, you’ll have to register for insurance in order to access the Dutch health care system. You can start the registration process at your local town hall where you’ll be given a BSN otherwise known as a Dutch Citizen Service number. You’ll also receive a Digi ID that allows you to access a complete range of social security services online. This number will also prove essential for getting a driving licence, paying tax as well as receiving medical treatment.

Once you have your BSN you can then register for health insurance in the Netherlands. You’ll also need to provide a letter from your employer as proof that you’re employed, evidence of your Dutch address, and your passport. You’ll then receive a health insurance chip card as proof that you’re insured. Health insurers do vary with the range of services that they cover and their annual premiums, and there are several websites where you can compare the different insurers.

With your chip card in hand, it’s a good idea to sign up with your local Dutch GP or huisarts. You don’t want to wait until you have a medical emergency to contact your preferred medical practice only to discover that it’s no longer taking any new patients.

The basics

The Dutch basic health insurance package is comprehensive, and you can expect that you will be covered for:

• Visits to the doctor
• Dental care for under-18s
• Prescriptions
• Therapies, including speech and physical therapy
• Mental health services
• Pregnancy services
• Emergency ambulance transport
• Hospital stays including essential operations
• Emergency treatment
• Blood test
• Help for denture payments
• Physiotherapy for osteo arthritis affecting hips and knees
• Treatment for ongoing conditions including dialysis and diabetes
• Essential plastic surgery including post-operative reconstruction

The Dutch government provides a comprehensive list of all that is covered under its basic health insurance scheme.

There are three types of basic health insurance cover, the natura polis which is where your insurer will state which health care provider is approved by them and all of your bills will be paid directly. This type of insurer can prove to be expensive as you might find that not all of your medical bills will be reimbursed.

For a few extra euros a month, you can pay for a restitutie polis which will allow you greater freedom when selecting your health care provider. You’ll pay the bill following treatment and then you can expect to be reimbursed in full by your insurer.

Some insurers offer a combination policy which might give you more flexibility when choosing your hospital or the type of treatment that you need. As policies do differ from insurer to insurer it really is a good idea to read the fine print. Some insurers also offer tempting benefits including payment for dental emergencies.

Help with medical costs

To qualify for a health insurance allowance in the Netherlands, or zorgtoeslag you’ll have to prove:

• You earn below €29,562 pa and your assets are below €114,776
• If you have a working partner, your joint income doesn’t exceed €37,885 and your assets are under €145,136

Using your DigiD visit the toeslagen page and see if you’re eligible for health care allowance in the Netherlands.

Private health insurance

Although the Dutch basic health insurance is comprehensive, certain treatments will have to be paid for from an additional insurance package, known as an aanvullende verzekeringen. These will include:

• Dental care for over-18s
• Extra maternity care
• Some forms of psychiatric care and counselling
• Complementary and alternative therapies — for example, chiropractors and homeopathy
• Some vaccinations
• Glasses
• Non-essential plastic surgery

Some private policies will allow you to access hospital treatment more quickly than with the basic Dutch health care insurance package. You may be lucky enough to have an employer who will contribute to your additional policy as part of your employee benefits — always ask at your job interview if this is the case.

The cost of your premiums will vary, often these are dependent on whether you have a pre-existing health condition, whether you’ll be travelling overseas, and if you might be making a claim on your health insurance for a medical emergency. The Ts & Cs in your additional health care package will usually answer these questions.

Visiting the doctor

If you live in Amsterdam and you’re confused about any aspect of the Dutch health care system a good place to seek advice is the Expat medical centre Amsterdam where you’ll be able to communicate with English-speaking staff and also access GPs, physiotherapists and trained psychotherapists. Based at Bloemgracht, 112, this invaluable service is also home to tourist doctors that are Amsterdam based, a useful point of reference for those using an EHIC and who are only in the Netherlands for a short space of time.

Alternatively, should you have relocated to another part of the Netherlands, this link will provide you with a comprehensive list of expat centres throughout the country.

Once you’ve registered for basic health insurance, you’ll be able to be reimbursed by your insurer even if you need to visit your local GP and your health insurance number hasn’t been confirmed. As soon as you receive your number, contact your insurer attaching a copy of your bill as your cover starts from the date that you originally applied for health insurance.

Finding your doctor

As many professionals in the Netherlands speak English, and many other languages, you’ll find that it’s easy to track down a local GP. Simply log into this website, fill in your postcode and you’ll not only be able to find your local GP, but you’ll also be able to read reviews of the service and how your fellow expats have rated the care they received. Alternatively, any town hall will be able to provide you with up to date information about GPs in your area.

It’s easy to make an appointment and access the Netherlands health care system. Once you’ve discovered the location of your local doctor, ring up and make an appointment. If you’re suffering from a minor complaint and simply want some advice, most surgeries reserve an hour first thing in the morning where you can have a phone conversation with your doctor or a health care professional. Dutch doctors also make house calls should you need a home visit.

If you need a referral to a specialist or consultant this will be made through your GP, you should always share the referral with your insurance company. After you have this document you can then contact the specialist yourself, or even ask your doctor to put you in touch with a renowned specialist that you think can help you.

Medical emergencies

In the first instance if someone is seriously ill or you feel you might need hospital treatment, try and contact your GP and they will be able to alert the hospital that you’re coming in and also give the hospital some medical details about your condition. Huisartsenpost is a useful term to Google if your doctor isn’t available but you need speedy medical help. Alternatively, you can always telephone 020 592 34 34 if you need medical advice in a hurry but don’t think you need to go to hospital. This helpline is very useful for out-of-hours emergencies and over the weekend.

If either you or a member of your family needs urgent help, then the Netherlands emergency number is 112, the operators speak many languages so don’t worry if your command of Dutch isn’t that good. All you’ll have to give is your whereabouts, the type of emergency and keep your phone line free once you’ve hung up. The average wait for a dispatcher to pick up the phone after you’ve dialled is an impressive three seconds.

Hospitals

The standard of health care in Dutch hospitals is generally good, although waiting lists do exist for some procedures. Under the basic health care package, you will be expected to share a room with six other patients, unless you’re very seriously ill. There are three types of hospital in the Netherlands:

• Academic hospitals that are connected with Dutch universities, this is where you’ll be referred if your illness requires more specialised treatment
• General hospitals which provide a good and efficient standard of care — should any problems develop as a result of your condition you can expect to be moved to a more specialised facility
• Teaching hospitals means that you can expect to be treated by trainee doctors and nurses. Some forms of specialised treatment may be offered at these facilities. The staff are all supervised

The Dutch health care system also has numerous independent clinics. You should discuss reimbursement for treatment at a private clinic or independent treatment centre with your health insurance provider.

Children in hospital

Should your child need to be hospitalised during your stay in the Netherlands you can rest assured that they will receive the highest quality of care. There are numerous specialist children’s hospitals throughout the Netherlands, and all hospitals also have wards that cater for the needs of these young patients. Most hospitals and children’s wards have facilities for parental overnight stays.

Medicine and pharmacies

Once you’ve registered with your GP, you’ll also have to sign up with your local pharmacy or apotheek. In theory you can have your prescriptions filled by any pharmacy you wish, but if you stick with a single practice and provide them with your health insurance details, you’ll be able to ensure that communications between your GP and the chemist are easy. You can always check on registration that the pharmacy you’ve selected is listed with your insurer.

If you’re looking for an out-of-hours pharmacy, your local branch will have a list of nearby chemists and their out-of-hours services. This website is also useful when looking for an out-of-hours service. Or you can always call 020 694 8709.

New medicines are always being added to the list of medicines covered by your basic health package. The Dutch government provides a very useful website where you’ll be able to confirm if a drug that you’ve read about and think will help your condition is available under the terms of the basic package.

Mental health

The OECD has stated that ‘the Netherlands has an innovative mental health system,’ which is reassuring if you’re at all worried about moving to the Netherlands. It’s recognised that many expats who live and work in another country, often far away from their support network of friends and family, may well be in need of help with mental health issues.

In the first instance, if you find that you’re having problems coping and are suffering from anxiety or depression, pay a visit to your local GP. If your doctor believes that you need additional help in the form of counselling or visiting a specialist, you’ll be referred to a member of the Dutch Association of Mental Health and Addiction Care — the GGZ. Costs for mental health treatment are covered under your basic health care insurance package. Some expats would rather seek help from an organisation that’s more familiar with their types of problems, in which case, PsyQ might be able to help and you should see if your GP will refer you to this expat organisation.

Vaccinations

As a result of the 1957 polio epidemic the Dutch health system has always taken vaccinations very seriously. The Netherlands has a national immunisation programme in place and the 12 major diseases covered include:

• Diphtheria
• Hepatitis B
• Measles
• Mumps
• Polio
• Human papillomavirus
• Whooping cough
• Rubella
• Tetanus
• Meningococcal disease

Your child will be entitled to vaccinations from these potentially lethal diseases free of charge. Anyone who is suffering from a long-term condition such as heart disease, lung disease or is over 60 will also be entitled to a free seasonal flu vaccination. If you’re not considered to be in a high-risk category, then you will have to pay for your vaccination.

Some travel-related vaccinations will be available under your existing basic health care insurance, it’s always wise to check with your provider before you go jaunting off to some of the planet’s more far flung destinations. The National Travel Coordination Centre has an extensive list of countries that require vaccinations when travelling from the Netherlands — a right click when you’re on this Dutch website will bring up an English translation.

Complementary medicine

In common with the rest of the world the popularity of complementary medicine in the Netherlands is growing. Alternative therapies are those that are classified as ‘falling outside standard medical care’. Even though these will not be covered by your basic health care insurance; you will discover that most complementary medicine treatments can be reimbursed through your aanvullende verzekeringen. You should make sure that your chosen practitioner is on a registered list such as the Infolijn Alternatieve Geneeswijzen register. Practitioners on this list are qualified and if you want advice about the therapists and which conditions they treat you can always phone: 088 2424240. Alternative therapies often promote a feeling of well-being which is always useful when you’re living and working in a new environment.

No one ever plans to be ill, but if you’re a stranger in a new country it’s always reassuring to have a basic grasp of how a health system works, which treatments are covered by your insurance and how you can maintain your health and get the best from your new country.

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