How is Health Insurance
arranged in NL?
Everyone living or working in the Netherlands must have a basic health insurance package (basis ziektekostenverzekering). The national government determines what is in covered by the basic package. This package is defined as what every individual is entitled to and medically necessary but the health insurance companies can decide for themselves what is included in the additional insurance policies. Please see Rijksoverheid for official documentation.
Once you have received your VVR and BSN you can apply for your insurance. It is best to do this as soon as possible. A comparison website you can look at with a lot of information: www.independer.nl. The insurance you choose has to cover you for admittance to a sanatorium or psychiatric institution. Most have it included but just double check. Please be aware that your medical insurance will be back dated to the day you arrived in the Netherlands and that includes the costs as well. Recently we learned that for knowledge migrants they are only supposed to back date it to the date when your contract starts but the insurance companies are not always aware of this rule.
Compulsory basic insurance for everyone
The basic insurance covers the standard care of, for example, a general practitioner, hospital or pharmacy. A self-payment gap (eigen risico) applies to most of the care in the basic package and the amount is determined by the government. Excess amounts may also apply.
The main features of the basic package are:
The basic insurance is compulsory if you live or work in the Netherlands. Also for children.
The basic package is the same for everyone.
The basic package has been determined by the government. The content can change annually. The government also determines the level of the self-payment gap and the level of the health care allowance. There is no deductible for certain care, such as GP care or obstetric care. The government also determines for which care you have to pay an excess amount.
A health insurance company can not refuse you cover.
The premium of a policy is the same for everyone. Everyone with the same policy therefore pays the same regardless of age or health.
Health insurers have a duty of care. They must ensure that everyone receives the care that is needed on time and within a reasonable distance.
Voluntary additional insurance
An additional insurance covers (part of the) care that is not included in the basic package. For example extra reimbursement for a treatment at the dentist.
The main features of the supplementary insurance are:
There are different packages, all of which supplement the basic insurance. The health insurer determines the conditions and reimbursements. The government therefore has no influence on the supplementary insurance policies.
An additional insurance is not mandatory. Because there are many different packages, it is important that you tailor the additional insurance to exactly what you need. You can refuse a health insurer for additional insurance. For example, older people who need a lot of care. In practice this almost never happens.
Competition between insurers must lead to good and affordable care. With an affordable premium for insured people. Insurers negotiate with care providers about the price of care provided. In this way, care is also becoming more affordable.