Deciphering the Dutch health insurance system - Part 1

Medical insurance is one of those matters that the Dutch have devoted particular thought to - meaning that the outcome is characteristically complex. It is a topic that requires some discipline to decipher, yet it is also a very important one, with considerable consequences if you fail to deal with it correctly.

Trying to read up about it requires becoming familiar with terms that even the average Dutch person will have a hard time grasping, let alone explaining to you.

In these articles, we cover the most important rules and terminology in order to help you figure out what your options and your obligations are.

Financing your insurance
All residents of the Netherlands are obligated to arrange Dutch health insurance in order to be able to legally reside in the Netherlands.

To pay for this, everyone pays a fixed contribution of approximately 1.200 euros and an income-dependent contribution. This income-dependent contribution is compensated by your employer, who pays it directly to the tax authorities.

If you are self-employed, you receive no such compensation. Instead you receive an annual preliminary assessment for the amount you owe, which is based on what the tax authorities estimate you will be earning that year. If you end up paying too much, you will be reimbursed after the final tax assessment over the year in question.

Also if you are receiving a benefit or old age pension, you pay an income-dependent contribution - whether this is compensated, depends on your social security institution or pension plan. If you are unemployed, you receive no compensation.

The government offers financial assistance (zorgtoeslag) to persons whose income lies below a certain level, to help pay the premium.

Children
Children are covered free of charge.

Acceptance obligation
All insurance companies are obligated to accept all applications, regardless of age, gender or health. The cost of a basic insurance is pretty much the same across the board; doing a little comparative shopping becomes worth your while if you are interested in additional coverage.

However, keep in mind that insurance companies are not obligated to take you on for additional coverage - in other words, they may refuse you. You can change insurance companies every year; visit Zorgplanet.nl (soon with English-language information too) or Zorgkiezer.nl to compare insurance companies and coverage.

Issues that are of interest to look at when doing comparative shopping are: the amount of the deductible (eigen risico, or "own risk"), what the coverage is if you are abroad and fall ill or otherwise require medical care, level of dental care offered, alternative therapies, etc.

Insurance in kind or restitution
When you are arranging your insurance, you will run into the terms "natura polis" or "restitutie polis." If you take out a "natura polis," your insurance will pay your medical bills directly.

However, they will only pay out these bills to medical service providers they have entered into a contract with (you are free to select your own general practitioner (GP)), which means that you must verify that such a contract exists between the medical care provider you wish to select and your insurance company before you make use of his or her services - or else run the risk of paying the bill yourself.

The "restitutie polis" is slightly more expensive, but does give you freedom of choice as to whom you wish to turn to for medical assistance. With the restitution policy, you pay the bill yourself and then submit it for compensation with your insurance company. Some insurance companies offer a combination of the two types of insurances.


This is the first part of the "Deciphering the Dutch health insurance system -  Bringing it back to simpler terms " article written by Stephanie Dijkstra, editor-in-chief of The XPat Journal - have a look at the current issue of the journal or subscribe here. This article has been based on a contribution to The Holland Handbook. For more information visit XPat Media.


Next in the series
› Deciphering the Dutch health insurance system - Part 2