Dutch medical insurance, things expats need to know
Depending on where in the world you’re from, this will shape your expectations about health insurance. Coming from the UK, for example, I was used to a system where the only time it was necessary for me to reach into my pocket to pay a medical bill, was if I had any work carried out at the Dentists. Beyond that in the UK we’ve been pretty spoilt by the national health system. It’s definitely not perfect. It can take up to a year to see specialists in certain fields, and the system itself is under strain. Doctors, who feel that they are struggling to survive on a six figure income, no longer do emergency calls out of hours. This has led to emergency wards being overloaded with patients when Doctors surgeries are closed.
In the US, historically they’ve had a pretty brutal insurance system. which has historically been based along the lines of, if you can’t afford insurance, well too bad. This led to over two million Americans without medical coverage.
In spite of bitter opposition by the Republican party and the health insurance lobby, The affordable care act (Obamacare) is attempting to provide medical coverage to all, and has led to a fall in the number of people without medical coverage. Obamacare has also outlawed insurance companies refusing to insure new patients or cover the costs of medical coverage for pre-existing conditions. Even people that previously were insured, were often shocked to be refused coverage for cancer treatment, due to what insurance companies referred to as pre-existing conditions. This could include, depression, back pain, or even forgetting to mention that you once saw a doctor to look at a spot somewhere on your body.
The Dutch health insurance system
The Dutch health system is provided by the Government in partnership with private insurance providers. It’s mandatory for all residents of the Netherlands to be covered by a Dutch based health insurance policy. As an expat, be sceptical about health insurance offerings from organisations that are outside of the country. A simple tip here is that if your insurance company doesn’t have a website that ends with .nl, you really should think twice before taking out medical coverage with them.
The standard health insurance offering provided in the Netherlands is the basisverzekering, which is part of a revised health insurance act that has taken effect in the Netherlands since 2006. Basisverzekering costs vary, but typically are somewhere in the regions of around 100 Euros a month. The basic coverage as defined in Dutch law includes:
• Visits to Doctors
• Short term hospital stays
• Limited Dental care (over 18 years old)
• Transport to hospitals (Ambulances etc)
• midwife services
• pre and post natal care
• physio, dietician etc
Pre-screening of patients for pre-existing conditions, is not allowed, and medical insurance providers must accept all patients. Long term medical care is funded by the Dutch government out of taxes.
So Dutch insurance covers everything right?
Absolutely not. Expats need to be aware, that insurance policies in the Netherlands are always provided in legal Dutch, which is difficult enough for native speakers to decipher, let alone expats. It’s important to be aware, that the insurance providers have been lobbying the government to remove certain treatments from the basisverzekering. This has led to some providers offering cheaper deals for the basisverzekering, by excluding some types of treatments. It’s important to tread very carefully when choosing an insurance policy. Never assume that everything is covered by your insurance provider.
A couple of tips:
• Medical insurance policies are always valid for a calendar year. So if you sign a policy in June, you’ll be covered until the end of the year. It’s only possible to change your insurance provider in December for the following year.
• Always call the insurance provider, and have them explain to you in English the key items covered by the policy
• Some providers have contracts only with particular hospitals, so it’s important that if you do need treatment, to make sure that the hospital you’ll be visiting has a contract with your insurer
• The basisverzekering doesn’t cover a lot of dental work for adults, including orthodontic treatment. For this it’s necessary to take out an aanvullende verzekering
The aanvullende verzekering, is an additional insurance that’s advisable to take out to cover dental treatment. Typically these are offered in increments. For example 250, 500 and 750 euros worth of coverage annually, which is then added to your monthly insurance premium. It’s important to note, that even with this coverage, that the insurance companies may still decline to cover certain dental treatments. My advice here is to always call and check with your insurance company, prior to undergoing dental treatment. This should avoid any nasty financial surprises.
It’s worth noting that 90% of health insurance policies in the Netherlands are with four companies. Doctors in the Netherlands have complained about the contracts that they have with these organisations. A common complaint by expats, is the short amount of time that they get to spend with GP’s. Some of this is related to the pressure that Doctors are put under by insurance companies to limit the time spent per patients, which in turn reduces the costs to the insurance providers.
At Lassus Tandartsen, each patient is treated as an individual, and the specialists will decide the appropriate time required depending on the treatment. For this reason, you may receive a bill directly from Fa-med, an organisation that deals with billing on behalf of many dental practices. It may also be possible for them to claim the cost of treatment directly from your insurer. Please note however, that this only applies to Dutch insurance companies. International insurance policy holders, will be billed directly, and will need to reclaim the costs from their insurer.
We hope that you’ve found this brief guide to the Dutch health insurance system useful. If you have any questions about your insurance policy, it’s always worth talking to your provider, as only they know exactly what’s covered in your policy. You can also talk to Lassus Tandartsen, if you have any questions about the treatments on offer.
For major treatments above € 250, a plan will be provided with an indication of costs that you can discuss with your insurer. Lassus Tandartsen always strive to provide as much information as possible to their clients.