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The Dutch healthcare system might look out of place among the social protection categories of other European countries, combining the principles of universality and liberalisation of access to care: Dutch residents must indeed take out basic health insurance, but they can do so with the private insurer of their choice. However, this solution only partially covers the costs of the insured and is generally backed up by complementary health insurance.
Since its reform in 2006, the Dutch health system has been based on the principle of compulsory and universal insurance, the implementation of which is entrusted to private and competing insurers. Each of these insurers is obliged to cover any resident who applies to them and offer them minimum health benefits set by law, in exchange for the payment of fees. This basic insurance gives them access to:
general practitioner consultations (provided by the physician chosen by each insured person)
consultations with specialists on the recommendation of the GP
prescription drugs
hospitalisation on prior referral by a doctor
maternity care
Different types of contracts can be taken out with these insurers:
Contracts in kind: only care provided by approved healthcare providers is covered, with third-party payment.
Reimbursement contracts: policyholders can consult the professional of their choice, but must pay in advance before being reimbursed.
The choice of insurer is completely free among the local offers. The basic packages are generally similar from one company to another, with an average cost of €120 per month. Although they are private, most Dutch insurance companies are non-profit organisations, which explains the homogeneity of their rates, which may however vary according to certain criteria such as the amount of the excess/deductible chosen, additional services, etc.
This compulsory basic insurance usually leaves policyholders with a remaining amount to pay (depending on the deductible chosen) and does not cover, or only partially covers, certain care (particularly dental care, physiotherapy, and contraception, among others). This is why policyholders in the Netherlands generally take out complementary health insurance, either in the form of an extension to their basic coverage or with another insurer. The prices of these complementary contracts vary greatly from one local insurer to another.
It is also possible to supplement the compulsory basic insurance with international health insurance. This is of particular interest to expatriates in the Netherlands, who can then enjoy a range of benefits tailored to their profile, including coverage for treatment in other countries.
Examples of reimbursements with MyHealth International COMFORT in relation to the cost of care in the Netherlands in the private sector*.
*Reasonable costs in the private sector, APRIL International data 01/2022
The Netherlands has an extensive network of high-quality hospitals, divided into university and teaching hospitals, which are the most advanced in terms of equipment and care offered, and general hospitals, which provide less specialised tests and procedures.
However, in order to access hospital care, insured persons must be referred by their GP or another specialist (except for emergencies).
In general, the Dutch medical culture is non-interventionist. Private general practitioners, the backbone of the health system, provide most primary care (e.g., paediatrics and gynaecology) and limit as much as possible their prescriptions for examinations and treatments, as well as their referrals to specialists.
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