The Dutch healthcare system; an explainer for expats.
Why you need to read this:
Navigating the Dutch healthcare system is an essential part of succeeding in your international adventure. Language barriers and lack of understanding of the local healthcare system negatively influence health literacy, causing unnecessarily elevated healthcare costs and health risks.
The accompanying video to this post and parts of the blog itself were created by international physiotherapy students Amelia Lynch, Griffin Gillanders, Mark Rahn and Maxim Kaster in an effort to mitigate this risk.
Their unpublished pilot study among international students in Groningen showed the videos potential for increasing understanding of the Dutch healthcare system.
If you are looking for information about how to choose your physiotherapist in the Netherlands we have a blog about that too.
Introduction
Living abroad offers many wonderful opportunities to experience and explore other countries and cultures in a way that simply travelling can never deliver. Being completely immersed in a community you gain insight into those qualities, quirks, struggles, history and cultural and traditional legacies that make the region unique.
There are also challenges to living in a foreign country however. You’ll quickly find that you miss certain cultural elements of home, you likely don’t have a ready made support network in your adopted country and even if the locals can speak your language a little (or you theirs) you may still run into language barriers. Jokes or anekdotes may be lost in translation and then there are all the practical issues. Where do you shop for what, who provides which service and what are normal prices?
One of the major issues facing expats is understanding and navigating the local healthcare system.
Health literacy was defined by Adkins et al. (2009) as the proficiency to interpret diverse forms of communication to achieve health-related goals. Bánfai-Csonka et al. (2022) emphasize that while studying abroad fosters cultural amalgamation, it also unveils challenges in communication and cultural comprehension. Similarly, Holt et al. (2020) noted that language barriers exacerbate health literacy challenges for expatriates, leading to diminished support and awareness.
A 2017 study in New York revealed that unfamiliarity with health insurance procedures deterred many from seeking essential medical care (Hosler & Kammer, 2018). The financial burden further discourages preventive care, leading to delayed diagnoses and increased costs (Xu & Borders, 2008; Yang & Hwang, 2016).
Early diagnosis, as highlighted by Garwood (2017), not only reduces treatment costs but also enhances survival rates, underscoring the economic and health benefits of proactive healthcare.
In light of this Hanze university international students Amelia Lynch, Griffin Gillanders, Mark Rahn and Maxim Kaster performed a qualitative study to uncover the perceived barriers to healthcare experienced by expatriate students in Groningen.
Their findings led them to create the video series embedded at the top of this post in an effort to help other international students navigate the Dutch healthcare system.
The Dutch healthcare system
The Dutch healthcare system is based on four primary legislative acts:
- Health Insurance Act (Zorgverzekeringswet) – Governs hospital care.
- Long-Term Care Act (Wet langdurige zorg) – Focuses on extended care types.
- Social Support Act (Wet maatschappelijke ondersteuning).
- Youth Act (Jeugdwet).
These acts form the cornerstone of the Dutch healthcare system, with the first two contributing significantly to the nation’s healthcare budget. The Long-Term Care Act operates nationally, while private health insurers are integral in implementing the Health Insurance Act, emphasizing regulated competition and public requirements.
The Social Support Act and Youth Act, mainly enforced by the Netherlands’ approximately 400 municipalities, cover other care aspects.
Health insurance in the Netherlands
There are two types of health insurance in the Netherlands:
- mandatory standard health insurance (basis verzekering)
- optional additional health insurance (aanvullende verzekering)
Mandatory health insurance in the Netherlands
In the Dutch healthcare system residents and workers in the Netherlands must secure standard health insurance, covering general practitioner visits, hospital treatments, and prescription medications. Additional insurance for non-standard expenses is optional.
Standard health insurance premiums and contributions
- A fixed nominal premium is paid to insurers.
- Low-income individuals may receive healthcare benefits.
- An income-related contribution, part of the Health Insurance Act, is also paid.
Employers directly remit this income-related contribution to the Health Insurance Fund. Children under 18 are insured free for the standard package but must be registered within four months of birth.
Deductibles in the Dutch healthcare system
- The compulsory deductible is 385 euros per person for 2023 and 2024.
- This deductible applies only to adults with Dutch health insurance.
- Deductibles are not required for GP consultations, emergency GP services, district nursing, obstetric and maternity care, certain medical aids, and services covered by supplemental insurance.
Policyholders can voluntarily increase their deductible up to 885 euros annually, reducing monthly premiums but raising total eigen risico.
Coverage Under Basic (Basis Verzekering) and Additional (Aanvullende Verzekering) Insurances
The government, with advice from Zorginstituut Nederland, defines the standard package, which all insurers must offer equally to everyone, regardless of age or health condition. The basic package includes GP services, specialist consultations, hospitalization, mental health services, medications, dental care (up to 18 years), various therapies, nutritional care, medical aids, ambulance services, and physiotherapy for chronic conditions.
Additional insurance, covering services like physiotherapy or dental care beyond the basic package, is optional and not guaranteed for acceptance by insurance companies.
Health Insurance for International Students in the Netherlands
Students from the EU, EEA, or Switzerland generally don’t require Dutch health insurance if they possess a European Health Insurance Card. However, employment or permanent residency in the Netherlands changes this requirement. Non-EU students might need private healthcare insurance, with several plans available specifically for international students. Uncertainties can be clarified through Euraxess’s form and consultation with the Social Insurance Bank (SVB).
Still have questions?
We get it, it’s a lot… feel free to drop by and we’ll happily explain it to you!
References
Yang, P. Q., & Hwang, S. H. (2016). Explaining Immigrant Health Service Utilization: A Theoretical Framework. SAGE Open, 6(2). https://doi.org/10.1177/2158244016648137
Ross Adkins, N., & Corus, C. (2009). Health literacy for improved health outcomes: Effective capital in the marketplace. Journal of Consumer Affairs, 43(2), 199–222. https://doi.org/10.1111/j.1745-6606.2009.01137.x
Hosler, A. S., & Kammer, J. R. (2018). A Comprehensive Health Profile of Guyanese Immigrants Aged 18–64 in Schenectady, New York. Journal of Immigrant and Minority Health, 20(4), 972–980. https://doi.org/10.1007/s10903-017-0613-5
Garwood, P. (2017, February 3). Early cancer diagnosis saves lives, cuts treatment costs.
Bánfai-Csonka, H., Bánfai, B., Jeges, S., & Betlehem, J. (2022). Understanding Health Literacy among University Health Science Students of Different Nationalities. International Journal of Environmental Research and Public Health, 19(18). https://doi.org/10.3390/ijerph191811758
https://english.zorginstituutnederland.nl/about-us/healthcare-in-the-netherlands
