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All Dutch citizens over eighteen years of age are required to have health insurance; it is mandatory. The coverage provided by these policies guarantees that the policyholder—the citizen and people who work in the Netherlands—has access to basic health care services.
History of health insurance
There are many options to choose from when buying a mandatory health insurance policy. For starters, there are over thirty insurance companies that offer these kinds of policies, and there are three different kinds of insurance policies that meet legal requirements. The policy you buy determines whether or not you can go to certain hospitals and/or if you have to pay part of the hospital bill yourself.
In the Netherlands people in general believe that health care should be accessible to everybody whether you are young or old, male or female, sick or healthy. The consequence of that belief is that the cost of health care is borne by everyone who lives here. And that explains why we have lot of subsystems in place to manage the overall cost of the system.
The most important choice we’ve made is that people don’t get to request services directly from a hospital (expensive) unless they are in acute danger; everybody is registered with a general practitioner of their choice (a huisarts). That’s your first point of contact, and your huisarts will help you decide what kind of care you need and will tell you where you can obtain it.
Another “instrument” used to manage the cost of health care is the annual deductible that people have to pay out of their own pocket when they need health care (€385 in 2017).
What kind of health care?
And there is the discussion about what sort of health care needs to be accessible to everyone. For instance, there is life-saving surgery, there is post-operative recovery, and there is the private clinic for high-end rehabilitation. The general opinion in the Netherlands is that the first of these needs be accessible to everyone, whereas the last of these needs be paid partly out of your own pocket. To make sure everybody gets what fits them best, part of the cost of health care is transferred from “government paid” to a mandatory health insurance system. Under that health insurance system, people get to choose what fits them best. So if you want basic care only, you take out a policy for basic care only, but if you want the best possible health care, you buy a deluxe policy. There is one group exempted from this system, that is children up to the age of eighteen. Children up to the age of eighteen get general health care for free (meaning government paid).
The payment your employer makes for you is not shown on your payslip or anywhere else, but every employer in the Netherlands pays social contributions towards health care. This amount is based on your gross salary and will be paid by the employer to the tax authority.
If an employer fails to pay this, it will not be charged to you. Don’t worry. It is the responsibility of the employer to pay this premium, and the tax authority will issue any penalty to them.
The insurance –the Basic part of the policies
The employee part is the basic coverage and contains three categories for you to choose from:
- The first category provides coverage where the insurance company decides what hospitals you are allowed to go to, depending on your complaint (in Dutch: Budgetpolis);
- The second category is coverage where you select the doctor/hospital, but where the insurance company limits the annual budget per treatment a doctor/hospital has. There is therefore a risk that the budget a doctor/hospital has is used up, which means the client has to wait to get treatment until annual budgets are renewed (in Dutch: Naturapolis);
- The third category is coverage where the insurance company has to pay for/refund all the treatments the government requires to be covered under the mandatory basic insurance (in Dutch: Restitutiepolis or Combinatiepolis).
Note: In all categories there is a deductible of €385 (minimum) per year per person.
So, the basic cover provides access to basic health care. Personal needs differ, of course, and in addition to the basic policy, you can buy add-ons for additional coverage for physiotherapy, alternative health, or glasses or contact lenses.
Since the Dutch health care system is accessible to everyone who lives (and/or works) here, these rules apply to expatriates as well.
That means you have to select and buy one of the mandatory insurance policies just like everybody else. It is unlikely that you know which of the available policies fits your needs and what you need to do to research, select, and purchase the coverage that suits you best—it is complicated enough in one’s own country; doing it in your new country can be a real challenge.
To give you a simple and, we think, attractive solution, Payingit International offers an insurance policy via one of the top Dutch insurers, DeltaLloyd. It is totally up to you whether you elect to take it through us, but we have negotiated an employer discount on basic and additional insurance policies for people employed through us. We decided to offer only category 3 because we think this covers the health requirements of skilled employees. The discount we get means you pay a premium level (cost) for a category 3 policy that is similar to the cost of other category 2 policies.
I was directed to Payingit International when I was moving to Amsterdam. Pim was very professional and proactive from the beginning. I can recommend Payingit International's services to any expat looking for payrolling advice in the Netherlands!
Pim has been a great help, he is very knowledgeable, responsive and helpful. He has been providing excellent service from day one. He also takes time to answer any questions I might have. Overall, I’m very happy with the service.
Sudarat ChenCountry: Thailand
Payingit International has been very helpful and efficient in arranging everything between the company and me so all the parties involved are satisfied.