The healthcare system in the Netherlands

One of the many great things about living in the Netherlands is the excellent standard of medical care, which is ranked among the best in Europe. Though not completely free, the statutory healthcare system ensures all residents have access to primary care, no matter their income.

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How does healthcare in the Netherlands work?

The Dutch healthcare system

The Netherlands has a first-rate healthcare system (gezondheidszorg) that offers broad universal health coverage for all residents.

It consists of three separate coverage levels:

• Mandatory health insurance (basisverzekering) covers primary care (e.g., mental healthcare and emergency care)
• Optional additional health insurance (aanvullende verzekering) covers secondary care (e.g., dentists and opticians)
• Individual municipalities and tax-funded social care provide long-term care (e.g., disabilities and chronic illnesses)

The Ministry of Health, Welfare, and Sport is responsible for public healthcare in the Netherlands, offering guidance through their department National Institute for Public Health and the Environment (Rijksinstituut voor Volksgezondheid en Milieu – RIVM). Every year, the government reevaluates the primary care needs of the Dutch population to determine what will be covered by the system and what is not.

According to the nonprofit think tank Foundation for Research on Equal Opportunity (FREOPP), the Dutch healthcare system is ranked third best in the world (2020). The high quality and effectiveness of the system is perhaps why the Netherlands was named the eighth healthiest country in the world (2021). The overall life expectancy is 81.5 years old, almost one year higher than the EU average of 80.6 years.

Who can access healthcare in the Netherlands?

All residents who live in the Netherlands must get mandatory health insurance (ziektenkostenverzekering) to cover their primary care needs, including multi-year students and retirees. The government annually readjusts the coverage package, but it usually includes visits to the family doctor (huisarts), hospital visits and specialist care, pharmaceuticals, medical devices, and mental healthcare.

Although additional health insurance is optional, it is very common to have in the Netherlands. In 2022, 83.7% of the population had a supplementary insurance policy. Depending on the insurer, these add-ons cover secondary medical costs, such as dentistry, long-term physiotherapy, and vision care.

Minor children aged under 18 are covered by the insurance policy of their parents or guardians. If the parent or guardian has the highest level of coverage, the child will too. Moreover, basic dentistry (i.e., not orthodontics) is free for minors, regardless of their parent’s policy.

While having medical insurance is required by law, residents can also apply for exemption on the grounds of conscientious objection. For example, if your religion or beliefs prevent you from taking out health insurance.

Temporary visitors (i.e., non-residents) from the EU/EFTA (European Free Trade Association – Iceland, Liechtenstein, Norway, and Switzerland) can also access Dutch healthcare with a European Health Insurance Card (EHIC). Third-country citizens will need to have medical insurance as part of their visa application.

How to register for healthcare as an expat

Internationals staying in the Netherlands will first need to obtain a Citizen Service Number (burgerservicenummer – BSN). You can apply for this at your local municipality. After that, you can register for health insurance.

You are free to choose which insurance company you want to go with. For example, one with the lowest quote or one that offers the most coverage. Insurers cannot refuse your application, though, keep in mind that there are regulations regarding payment history (or more importantly, lack thereof).

To register, you’ll need to provide your:

• Passport or ID
• BSN
• Other personal details (including bank account)

Once you have been approved, you can register with a Dutch doctor. You’ll receive your EHIC, which you might need to present when you use any of the healthcare services in the Netherlands.

If you are looking for an international health insurance provider, there are also many global insurance companies operating in the Netherlands, including:

• Allianz Care
• AXA – Global Healthcare
• Cigna Global

How much is healthcare in the Netherlands?

In 2019, the Netherlands spent €97 billion on healthcare (or over €5,600 per inhabitant). This is reportedly around 10.2% of the GDP, which is slightly above the EU average of 9.9%.

Despite the impression some might have, the Dutch healthcare system is not free. Instead, it is financed by a combination of social security contributions, mandatory health insurance, and other fees. “Other fees” points to a deductible (eigen risico) that residents pay when they need primary care. This deductible means that if you go to a hospital or need a medical device, you must first pay a portion of the costs before the insurance provider pays the rest. In 2023, the ‘eigen risico’ is a total of €385 for the entire year.

The ‘eigen risico’ does not apply to visits to a family doctor, obstetric or maternity care, or district nursing (wijkverpleging). These services are completely free.

Lastly, there are some primary care needs that require a personal contribution (eigen bijdrage). This can be, for example, hearing aids or orthopedic shoes. The government annually decides which needs require this ‘eigen bijdrage’. You can visit the government website for more information.

Cost of Dutch health insurance

In 2023, the average premium of health insurance (zorgpremie) is €1,661.40 per year (or €138,45 per month).

Around 85% of Dutch residents also get additional health insurance to cover other medical costs, including:

• Dentistry
• Long-term physiotherapy
• Glasses and vision care
• Alternative medicines
• Additional post-natal care (e.g., breastfeeding or lactation consultant)

Depending on the extra coverage, an additional health insurance policy sets you back an extra €120-960 per year (or €10-80 per month).

Discounts, allowances, and tax deductibles

You can choose to increase your ‘eigen risico’ in exchange for a discount. This is called vrijwillig eigen risico. Depending on your insurer, you can increase it by €100-500 a year. Although your premium will be discounted by up to €300 a year (or €25 a month), you do take the risk that you have to pay an ‘eigen risico’ of up to €885.

If your income is below a certain threshold, you can apply for a healthcare allowance from the Dutch tax office (Belastingdienst). This allowance is available from the day you turn 18. In 2023, these threshold levels are set at €38,520 for single individuals and €48,224 for couples. If you do not have an income but have assets, they cannot be more than €127,582 for individuals and €161,329 for couples.

Those who have exorbitant medical costs (e.g., because they’re chronically ill), can deduct it from their income tax return. You can check the rules and your eligibility on the government website.

Healthcare facilities in the Netherlands

Health centers and clinics

For non-emergency-related medical issues, your first point of contact – including getting a prescription (voorschrift) – is the family doctor. These operate from a practice (huisartsenpraktijk) and are located across every city.

The practice is usually staffed by one or more doctors, as well as doctor’s assistants and practice nurses (Praktijkondersteuner Huisartsenzorg – POH). POHs take care of a wide range of things, including preliminary mental healthcare and smear tests (uitstrijkje) if the family doctor is a man.

Usually, each center has walk-in hours or you can schedule an appointment by phone. Although some allow you to book a meeting with a specific doctor, you might not see the same person each time you visit.

Opening hours are usually from 08:00-17:30 on Monday to Friday and are closed on the weekends. If you need to see a doctor outside of walk-in hours, you can go to an out-of-hours doctor’s service (huisartsenpost). However, these often charge extra fees.

Pharmacies in the Netherlands

After you’ve been given a prescription, you can pick it up from your local pharmacy (apotheek). These are usually located close to the practice, often indicated by a sign with the Staff of Asclepius. Opening hours are usually from 08:00–17:30 (though some close during lunch hours) on Monday to Friday. Most pharmacies are closed on the weekends. In larger cities, there are also 24-hour pharmacies that are open at any time of day.

You can usually pick up your prescription the same day or the next day, depending on availability. If the pharmacy has a contract with your insurer, they will send the bill straight to the insurance company. If they are not contracted, you’ll have to pay first and claim it back later.

Some prescribed medications require a personal contribution because there is a cheaper generic brand available. Another important thing to keep in mind is that family doctors often prescribe paracetamol; you can buy a cheaper version at any supermarket or drugstore (drogisterij).

To find your nearest pharmacy, you can use any search engine or check this list of pharmacies in the Netherlands.

Hospitals in the Netherlands

If you are in an emergency and need an ambulance (ambulance), you can call the pan-European emergency number (112). For non-life-threatening emergencies (e.g., you broke your leg), you can contact your family doctor who will refer you to the nearest emergency care service (spoedeisende hulp), located inside the hospital (ziekenhuis).

The Netherlands has 113 hospitals and 147 outpatient clinics (buitenpoliklinieken). These include:

• University hospitals (Universitair Medisch Centrum – UMC)
• Children’s hospitals (kinderziekenhuis)
• General hospitals (algemeen ziekenhuis)

Patients are given a bed in a shared room with up to six beds (mixed gender). Although toiletries are usually available, you may have to bring your own.

If you prefer to have access to a private room, you should consider taking out supplementary insurance.

Healthcare professionals in the Netherlands

Dentists in the Netherlands

You can only go to a dentist (tandarts) in the Netherlands if you are registered with their practice (tandartsenpraktijk). In case of an emergency (e.g., part of your tooth broke off), you can also go to the emergency dentist (spoedtandarts). However, these charge additional fees.

Regular check-ups usually take place every year, though some will invite you for a visit every six months. Your dentist might delegate certain routine tasks to dental hygienists, dental assistants, and prevention assistants. If necessary, they may also refer you to specialized orthodontists and oral surgeons, who are usually based in hospitals.

Standard health insurance policies do not cover the cost of dental treatment unless it takes place in a hospital. Instead, you should consider taking out additional medical insurance.

Doctors and specialists

The Netherlands has a high number of doctors and nurses available. In 2021, there were 3.7 doctors and 10.7 nurses per 1,000 inhabitants, compared to the EU average of 3.9 and 8.4 respectively. An above-average share of physicians work as family doctors: 24% of all doctors are general practitioners compared with the EU average of 21%.

Family doctors are usually the first point of contact when you have a health problem. They deal with routine medical issues, perform standard gynecological and pediatric examinations, do preliminary mental health consults, and refer you to a specialist doctor (e.g., a physiotherapist or MRI specialist).

Visits to family doctors are covered by basic health insurance and do not require payment of the ‘eigen risico’. If you are referred to a specialist in a hospital, it is also covered by standard medical insurance, however, you will need to pay the ‘eigen risico’ of up to €385 annually.

Physical therapy

The Netherlands has a lot of physiotherapists that can help you with physical therapy. Basic health insurance covers nine sessions per year. That means, if you need long-term physical therapy, you should consider taking out additional insurance.

You do not need a referral from a family doctor to meet with a physiotherapist. That said, they will charge you extra if you make an appointment without one.

Your insurer has contracted a number of therapists across the country. If you go to a non-contracted physio, you will likely only get 60-80% coverage.

Specialized healthcare in the Netherlands

Children’s healthcare

Minor children under the age of 18 are insured free of charge through the policy of their parents or guardians, including for children’s dental care if their parents have additional insurance.

You can register your child with your own family doctor in the Netherlands. They offer pediatric care as well or can refer to specialist pediatricians if necessary. Your local municipality can also help you find the best available healthcare services for your child, including mental healthcare services or specialist care for children living with serious illnesses or disabilities.

The Netherlands also has a National Immunization Program. It is not mandatory to vaccinate your children by law, however, free vaccinations are available against childhood diseases such as:

• Measles, mumps, and rubella (MMR)
• Meningitis
• Polio
• Tetanus

Mental healthcare

Nearly half (48%) of Dutch residents aged 18-75 will experience some form of mental illness during their lifetime. In 2022, 26% of the population had one or more diseases. The most prevalent disorder was anxiety (15%) and depression (9%).

Mental healthcare is covered by basic health insurance with a referral from the family doctor. This includes treatments such as:

• Psychiatric treatment in a hospital or mental health institution
• Psychological counseling (e.g., psychotherapy)
• Testing for disorders (e.g., ADHD or bipolar disorder)

There are also English-speaking therapists in the Netherlands, however, not all are contracted by medical care insurers. Moreover, not all provide services that are covered by basic health insurance. Mental health services are provided through GGZ Nederland, which is the trade association for the sector.

If you have any mental health issues, you can contact your family doctor for a referral. And if you feel uncomfortable about approaching your doctor or any mental health services, you can also find easily accessible support online including treatment and tests.

Sexual and reproductive health

Anticontraception (anticonceptie) is widely available across the Netherlands.

The most popular method (2017) differs per age group:

• Women aged 18-24 most use the pill (pil) – these require a prescription from a family doctor
• Women aged 25-39 prefer condoms (condoom) – these can be bought at any drug store, pharmacy, or supermarket
• Women aged 40-49 are most likely to have an IUD (spiraaltje) – these require a prescription from a family doctor and are not covered by insurance

One in 12 sexually-active women aged 18-49 does not use contraception at all.

Emergency Contraception (morning-after pil) is available without a prescription and can be bought at any drugstore or pharmacy. Abortion until 21 weeks, or 24 weeks in some medical cases, is legal in the Netherlands. This requires a referral from a family doctor as well.

You can get a free and anonymous STD (Seksueel Overdraagbare Aandoening – SOA) test at the Municipal Health Services (Gemeentelijke Gezondheidsdienst – GGD) if you are or have one of the following:

• Under 25 years old
• A man who has sex with men
• A sex worker
• From a country where, statistically, a lot of people have STDs
• Had sex with a person from a country where, statistically, a lot of people have STDs
• Had sex with someone who has an STD
• Experiencing symptoms and complaints that could be caused by an STD

In other cases, you can contact your family doctor for a test. Although testing is covered by basic health insurance, you will likely need to pay the ‘eigen risico’.

Some fertility treatments (vruchtbaarheidsbehandelingen) are covered by standard medical insurance. You should check with your family doctor before pursuing IVF or the ROPA method.

Women’s healthcare

Although some women might have to travel a little further to get access, the overall standard of women’s healthcare in the Netherlands is pretty good. Especially in larger cities, more options are available.

Every year, 800 Dutch women get cervical cancer, and one in seven women experiences breast cancer in her lifetime. Women aged 30-60 are invited to do cervical cancer checks every five years. There is also a national breast cancer screening program for women aged 50-75. Lastly, residents aged 55-75 are invited to partake in a bowel cancer screening program every 2 years.

Like most other healthcare-related things in the Netherlands, cancer screenings, pregnancies, abortions, and maternity care are arranged through the local family doctor. Either they will perform the exams themselves or refer you to a specialist. This includes gynecologists, midwives, and oncologists. Once you have a referral, all costs are covered by basic health insurance.

Most gender-affirming treatments are also covered by basic health insurance in the Netherlands. However, there are a lot of hoops to jump through. It’s recommended to consult with your family doctor and insurer before you start any treatment. Also, getting legal insurance (rechtsbijstandverzekering) with medical coverage is strongly advised.

Lastly, there are many organizations in the Netherlands that offer help and support for people facing domestic abuse or sexual violence. You can reach out to:

• Centrum Seksueel Geweld – offers professional help with sexual abuse and violence
• De Kindertelefoon – if you are a child aged 8-17 who needs a listening ear
• De Luisterlijn – if you need a listening ear
• Stop it Now – if you are a child experiencing sexual abuse
• Veilig thuis – offers free 24/7 support for domestic abuse and child abuse

If you are confronted with gender-based violence, please call the Dutch emergency services (112).

COVID-19 in the Netherlands

As of March 2023, the Dutch government has lifted all restrictions that they placed in 2020 to curb the spread of COVID-19. (Self)tests and self-isolation are no longer required. There will also not be another vaccination round.

Although COVID measures are no longer implemented, the government does recommend using common sense. If you are ill, you should call in sick and stay at home.

Long COVID support

According to researchers, one in eight Dutch people suffers from the condition known as long-COVID (long-COVID). If you live in the Netherlands and have been experiencing COVID symptoms three months after recovery or vaccination, you can contact the government-backed foundation C-support. This organization provides advice and support to people who are affected by long-term corona symptoms and provides healthcare professionals with the latest information.

You can also get support and meet other long-COVID patients at the organization PostCovidNL.

Children and young adults can also develop symptoms of long-COVID. The government advises them to reach out to their family doctor, or one of the above organizations. If they are located in or around Amsterdam, they can also the long-COVID clinic in the children’s hospital Emma Kinderziekenhuis Amsterdam UMC.

Other forms of healthcare

Alternative medicines in the Netherlands

Acupuncture, halotherapy, homeopathy, iridology, osteopathy, as well as other complementary therapies, are common forms of holistic treatments (alternatieve geneeswijzen) in the Netherlands.

Some alternative medicines are covered by additional medical insurance. Be sure to check what is in your policy before you schedule an appointment.

Community-based health and wellbeing

Some common examples of Dutch community-based health and wellbeing initiatives include community gardens and cultural and art projects. These initiatives have shared benefits for people’s physical and mental health. If you live in a house without a garden, another option is to rent an allotment garden (volkstuin).

What to do in an emergency?

If you are in a life-threatening emergency, you can call the pan-European emergency number (112). This number is free of charge and the operator speaks various languages, including Dutch and English. If you have a speech or hearing problem, call 0800 8112 and you can type a message to the emergency call center. You should write where you are, where you need help, as well as what service you need.

For less urgent situations, you can call your local family doctor or out-of-hours doctor’s service.

Other emergency numbers include:

Emergency service	Phone number
Ambulance	112
Police	112
The Red Cross (Rode Kruis)	070 445 56 78
Help with domestic abuse or violence	0800 2000
Suicide prevention line	0800 0113
Drug addiction support	0900 1995
Elderly support (Ouderenfonds)	088 344 20 00

How to make a complaint about healthcare?

If you have a conflict with a doctor or a clinic, you should contact management first. After that, you can make a complaint with the clinic’s complaints officer (klachtenfunctionaris) or the National Healthcare Report Center.

Next, if you are still unable to find a solution, you can file a lawsuit or go to a dispute resolution body (geschilleninstantie) of the clinic. You can also submit a complaint to the national Disciplinary Court for Healthcare (Tuchtcollege voor de Gezondheidszorg).

Useful resources

• Apotheek.nl – list of pharmacies in the Netherlands
• Dutch Tax Office – government website with information on the healthcare allowance for low earners
• GGZ Nederland – official website with information on mental healthcare providers
• Ministry of Health, Welfare, and Sport – government website of the ministry responsible for healthcare
• Rijksoverheid Zorgverzekering – government website with information about the Dutch healthcare system