Healthcare in the Netherlands

Okay, I'll try to give this a shot. It's been a while since I got doctored at though, so please accept my apologies if I get some of this stuff hilariously wrong.

- The healthcare system is structured to provide tiered access to medical services. If you're feeling ill, you can pay a visit to your friendly local General Practitioner (Huisarts). They will hopefully after some prodding, poking, and saying aaaah, diagnose you and tell you what to do next. Usually this means writing out a receipt you can take to a pharmacy to hook you up with medication of some kind, or an introduction to a medical specialist experienced with your particular illness. If the huisarts cannot determine what ails you, they can send you to a hospital for access to more advanced diagnostic equipment. This cycle of either diagnosing an ailment and sending you off for treatment, or passing you up to the next tier continues up to the university hospitals where they can throw lots of science and expensive machines at you.

Not sure what you mean by efficient. Most patients and treatments do not escalate beyond the huisarts/pharmacy level, so pretty efficient, I guess? There is sometimes a waiting list for non-critical surgical procedures since the universities cannot teach enough students because studying medicine takes forever and ever and ever. You will be an old man before you finish the study, even if you're a woman.

- Unlike regular healthcare system described above, the public health sector does not usually get involved with individual patients. They are tasked with monitoring and improving the well-being of society as a whole, or large groups of people. They keep track of infectious diseases, monitor air pollution levels, give out vaccinations, stuff like that. If they are ever interested in you as more than a statistic you may be Patient Zero, so try to avoid that.

- Considering it is illegal not to have health insurance, I would recommend buying some. If you are too broke to pay for it, contact the Tax Office and they'll send you money to pay for it depending on your income. I think you may be able to get around it if you're only here to study for a while, but you should ask your school just in case. If you live here illegally the state will pay for your healthcare with my taxes, so please don't get sick.

Sorry about the wall of text. My english isn't very good. Hope you enjoy your stay!

Thank you for your help AHV

Aurélie

You're welcome!
By the way, I did some looking around online, and noticed the Tax Office does not provide a way to apply for healthcare grants in english. If you still want them to give you money, you'll have to find a local with some free time and ask them to do it for you. You can send them here - belastingdienst.nl/wps/wcm/connect/bldcontentnl/belastingdienst/prive/toeslagen/aanvragen_en_wijzigen/aanvragen/toeslag_2012_aanvragen to get started. Be sure to keep your BSN/sofi at hand, since you'll need them for the application.

Hi,

In order to help expats and soon-to-be expats, we would like to invite you to share your experience on this topic, with updated info on the healthcare system.

Thank you in advance,

Julie
Expat.com Team

Hi Julien,

As far as I know everyone who is moving to the Netherlands to work and/or live must register with his/her municipality. Four months after this registration date he/she must obtain the basic coverage of the national health insurance for which one pays a premium to the private insurer of one's choice plus an assessment by the national tax authority based on one's income level.

You must then find/register with a general practitioner (huisarts), generally in the part of town where you live.  The GP is the gatekeeper to all health services.  Only he/she can refer you to a medical specialist or to a medical lab for tests or x-rays (for instance).

I know that one can get a waiver from the general insurance obligation, but only on the basis of proof that the foreign-based insurance coverage you have is of a level equivalent to that under the basic coverage of the Dutch national health scheme.

Good luck.

Herman

HI Everyone,
This is a great topic for expats coming to the Netherlands and I would really appreciate knowing the RULES
of the Dutch law.
It will indeed be very helpful to new Expats that may not get help with their job/company.

IN my case, I moved and registered right away with the Insurance ''Zilveren Kruis Achmea'', as they are very well known and most locals asked were pleased. I always ask locals for their opinion.
On top of this, my employer gave 10% discount to register.

Indeed, it's easy here in the NL, but EXPENSIVE!!! You go see a doctor (huisarts) and don't have to pay.
And you can get prescription medicine and no need to pay.
But every month, the cost is HIGH!
Plus there's the amount of €360 which is called ''eigen bijdrage'' which means you have to pay that TOO, on top of your monthly fee.
This amount is deducted each time you have treatments that are not in the basic insurance coverage.
After the amount reached zero, you can still get the treatments and will not have to pay extra.

Obviously it's more complicated than that, but I cannot write the extensive pages of small letters of the guidelines and rules here.

Bottom line, you need Health Insurance and it's not cheap, but it's your health, so to me, it's important.

Thank you everyone for sharing your knowledge and expertise!!!

Rachel

on my personal expirience pretty fucked up..i dont konow why dont they just deduct it from your wages, like anywhere else. and very expensive too...needless to say if you stop paying youll end up in the fucking can !! absurd aint it??

rich country . it should be free. or at least not too expensive.

My experience is pretty much the same as the first poster's.  I also have dental coverage (which I think is far more useful) but because I have a low-premium/high-deductible plan, I still end up shelling out between 7-15 euros per visit.  When my wisdom teeth were removed by an oral surgeon it was about two months between the initial x-ray and the actual "surgery" (just local), but the total cost to me was about 20 euros.  Maybe that's a little high for Dutch people, but as an American, I think that's fantastic :-)

I actually had my first child in the Netherlands; insurance covers the midwife visits, most of the testing (the optional 12-week ultrasound is not covered) and my level of health coverage would've covered a home birth completely, but I would've had to pay for an elective hospital birth.  As it turned out, I did have a medical indication for going to the hospital--nothing too serious--so I never got a bill for that.  But the best part, by far, about having a child here is the home-help aid.  Someone actually COMES TO YOUR HOUSE and helps you clean, maybe does some light cooking, helps watch your kids if you have any, shows you how to take care of your kidlet if it's your first--and it's covered by your insurance (mostly--I think we were on the hook for 10% of the cost, but again, I have a budget policy).  Most of the post-natal care is done at home; even if you do have your child in the hospital, they kick you out as soon as you're able to sit up.   During the first week, the people who are in charge of child wellness will come by and do their tests, so you don't even have to go to the doctor's. 

This is probably a good place to note that in the Dutch medical system, your child will almost never see a pediatrician.  They treat sick children; for well-child visits you go to the consultatiebureau and your kid is weighed and measured.  They also do the vaccinations, and if your child needs additional physical/speech/other therapy it can be arranged through that office.

I also want to add that, because I'm a freelancer and registered as a ZZP'er (entrepreneur) I get an additional discount on my coverage.  My insurance is 94 euros/month, so I don't think it's all that bad.  Zilveren Kruis offers different levels of coverage and if you want to downgrade or upgrade they're usually pretty good about it.

Seriously, I'm the last person anyone wants to listen to regarding health care in the Neverlands.

I have never been taken seriously among any of the perhaps 30 (thirty!) doctors i saw in a 90 days period.

In short:

I was sent home by a hospital when looking for an emergence treatment.. 24hs later, i called it back to say i was getting worse and, at 2 AM listed no "MAM, you were here yeasterday and there's nothign wrong with you. I can come if you want, but we're doing nothing else" - This was at Bronovo Hospital, Den Haag.

At that second terrible night, at the top a pain crisis, i was advised to take 1 pill of Amitriptilina every day (or more if feeling too much pain), but 1 single pill got me sleeping 14hs nonstop. 2 days after, i quit it. I was told doctors did not think was depressed, but somehow that could help me. They advised me at the hospital that something 'tough' could come along.

Many days after another specialist told me I should stop trying to figure out what was happening to my legs, because a lot of 'worse shit' (she did say it) happens out of the sudden to normal people. Moreover i had got some 'very expensive exams' which have not concluded anything.

A Gynecologist told me i had herpes. Founding it absurd I asked for a test and - voilà - blood exams denied it.

By the end, specialists in neurology have come to a SUPPOSED diagnosis: I'd have had an auto-immune syndrome called Guillan-Barré - which i could have died of it it was true.

At a certain point, a German doctor apologized for the Dutch crap medical system and another Indian one advised me prosecute the system (!).

Back to my home chaotic country, i was told was lactose and gluten intolerant (hilariously coeliac disease was discovered by a Dutch physician decades ago) and had too many food chemicals in my blood stream. Hard to figure out, wasn't it?

It all happened 3 years ago in Den Haag.

Here in Netherlands everybody by law needs a (privat) health insurance!
you get a basic packet which the state decides year to year what that package has to cover.  This Packages in Dutch is called "Basis Packett" its costs and contents with all insurers the same. With this base packet you have an annual cost called "eigen risico" own risk of 350 euro in 2015. The government decides every year what this cost should be. and its a cost which you have to pay yourself. no matter what arrangements you have made. The charges from the house Doctor your GP does not account towards this "eigen Risico". There are also a lot of medicines where you have to pay an amount towards the medicines, even if the Doctor has given you a prescription. Most Stomach settlers go into this categorie. And a lot of basic pain medicines. U
You might have to pay not all if you have a chronic illness, thats when you can apply for a chronic illness form. But it only makes a small difference in costs.
Were you make the difference are the extra insurances. And these depend very much on your age and activities. Are you planning to have a family, might you be at risk of an illness, are you traveling a lot.... etc. They vary widely. the best seem to be silver cruise and Delta Lloyd.  The rule is if it sounds incredible than its not true. the Gemeente offers through an insurer a package but having thoroughly researched this I have come to the conclusion that they are very bad value. In actual fact for most people their own costs towards health care are now very much higher than with their old provider.
Here is a link to an insurance comparer its ok but its  not great.
independer.nl/zorgverzekering/intro.aspx

All insurers:
independer.nl/zorgverzekering/fi/intro.aspx

Information from the Dutch Government
rijksoverheid.nl/onderwerpen/zorgverzekering

there are 2 different Insurance types. one where you can only access certain Hospitals and Doctors and another were you choose which Doctor or hospital etc you want to choose.

If you are in need of Medical Help. Make ure before any medical attention that you are aware of what costs are attached to this.
Sadly in the last 3 years we have managed to go backwards in our healthcare system to something  approaching  to a more american system. Its being commercialised, rather than cost reduced.


Needing Medical assistance in Amsterdam can be very tricky. My experience is that if they think you are not Dutch you tend to be disregarded, even if you have severe symptoms. They tend to Assume that you probably took drugs and therefore its your own fault that you are not well.
Or if its a migraine or Asthma than its nothing, this goes with their saying  You got to bite into the sour apple......
So often I hear from people that they are turned away for treatment, often they would get the information to wait. This has also happend to me and I ended up with permanent damage to my shoulder.
There is also a very big problem with the Language. A lot of Dutch people think that they speak English but their English is based on dutch words that sound english but do not have the same meaning as in english. Ihave had serious misunderstandings occurring through this.