Healthcare
Mandatory Health Insurance
As mentioned in Legally Settling In, health insurance is mandatory in the Netherlands. You need to have a health insurance within four months of your arrival. All health insurance companies are required to provide the same basic package which is defined by the government and covers the most common medical costs.
Own Risk
Health insurance is defined in this way that there's a limit to how much you pay for your healthcare per year. This limit is called own risk or eigen risico in Dutch. The minimum own risk changes every year but it's around 400 euros per person.
For costs that are covered by the insurance, a percentage of your medical costs would be paid by your insurance company and the rest would be paid by you. Until you reach your own risk, you need to pay for all your medical costs. After that, your insurance company would pay for the rest of your medical costs.
For example the insurance company would reimburse 100% of the cost of visiting your GP, but they might only reimburse 80% of the cost of visiting a specialist and so on.
Premium and Comparison
You can compare different health insurance companies and their premiums on Independer. You can also compare prices of included packages like dental care or physiotherapy. These extra packages usually have a limit in a way that they'd save you a fixed amount of money (e.g. 100 euros) per year and after that you need to pay for the rest of your medical costs.
Some cheaper packages have a limited number of hospitals and clinics that you can visit. So it's better to read the details of the comparison thoroughly before choosing a package.
You can reduce your premium by increasing your own risk.
Getting a GP (General Practitioner)
After you've got your health insurance, you need to register with a GP, or huisarts in Dutch, that is close to your home (usually the same postal code). There are sites that list GPs in your area or use can use Google Maps to find one.
After covid it might be a bit difficult to find a GP that is accepting new patients. From what I've heard, you can try the following in case you can't find a GP:
- Ask your insurance company to help you find a GP.
- Mention the fact that you don't have a GP when you're trying to register with the GP. They might make an exception for you.
Your GP is your gate into the healthcare system. You need to visit your GP first and they would refer you to a specialist if needed.
Getting an Appointment
Just like GPs that are your gate into the healthcare system, their assistants are your gate into your GP. Usually you can get an appointment either via phone or online. You need to answer some questions about your health situation and the assistant would assess your situation and the emergency of it and would schedule an appointment for you.
Medical Emergencies
If it's a life threatening emergency, you can call 112 and ask for an ambulance. Otherwise you need to call your GP on working hours or the After Hours GP or Huisartsenpost in Dutch. You can find the number of the After Hours GP by searching for huisartsenpost <your city> on Google.
When you call them their assistant would ask you some questions about your health situation and the emergency of it and would assess your situation. Then they send your file to a doctor and the doctor would call you back and would decide if you need to visit hospital's emergency room or not.
Without a referral from your GP or the After Hours GP, you can't visit a hospital's emergency room.
Hospitals
Most specialists and labs are located in hospitals. If you're referred to a specialist or a lab, you need to visit the hospital that is mentioned in your referral. You need to register with the hospital in your first visit. You can log into the hospital's website and view your medical records and test results with your DigiD.
Pharmacies
When you register with a GP, they would also assign a pharmacy close to the GP or your home to you. When you've got a prescription from your GP, you can go to your pharmacy and get your medicine. If your specialist has prescribed you a medicine, they would either send the prescription to your local pharmacy or to the hospital's pharmacy.
Prescriptions from Outside the Netherlands
If you've got a prescription from outside the Netherlands, you need to either visit your GP and ask them to prescribe you the same medicine. If the prescription is not for you, for example in case a family member is visiting, your local pharmacy might be able to help you. Otherwise the pharmacy that's located in Amsterdam Central Station would be able to help you.
Visiting Without Registration
If you don't have insurance or you haven't registered with a GP yet, you can't visit just any GP. There are some GPs like Central Doctors that accept patients without registration. You can call them and schedule an appointment with them.
You can reimburse your medical costs from your insurance company later on when you've got your insurance.
In case of a non-registered family member visiting you, it worth a try asking your GP to help you before visiting a GP like Central Doctors.
Dental Care and Physiotherapy
Just like GP, you need to register with a dentist and a physiotherapist.
Getting Along with the Healthcare System
This section is based on my personal experience and might not be true for everyone.
Compared to my experience in Iran, the healthcare system in the Netherlands is a bit different. Back in Iran, I was privileged to live in Tehran and had easy access to a wide range of specialists and labs. I could visit a specialist without a referral from my GP and I could visit any lab that I wanted to. I could also visit a hospital's emergency room without a referral from my GP.
This system is not sustainable and equal and from the governance point of view, I understand that the Dutch government is trying to make the system more efficient, sustainable and equal and this requires more gate keeping and is more restrictive. And from the patient's point of view, it needs some getting used to.
I don't have knowledge about the performance of the healthcare system in the Netherlands compared to other countries so I can't say how much successful the government has been in making this possible.
Efficiency and sustainability comes with the cost of inconvenience on the patient side as the system might not be willing to ease up milder pains and symptoms. Back in Iran doctors tend to prescribe medicine for milder pains and symptoms. But here, they system's philosophy is to let your body do its job and only intervene when it's really necessary.
This philosophy also has the perk of being more cost effective. Nevertheless, Every system makes some trade-offs and this is one of the trade-offs that the Dutch healthcare system has made. Knowing this, I've found it easier to get along with the system.
So I've found some ways to make the experience a bit easier:
- Get your GP as involved as possible. If something doesn't feel right for a while, call your GP and ask them to help you. Even if they just prescribe Paracetamol for you, it'll be part of your medical record and would help you in the future.
- Let them know your previous medical history. This would help them to make a better decision in case you need medical help.
- Be as clear as possible about your symptoms and prepare enough details about your situation before calling your GP or the After Hours GP. This would help them to assess your situation better.
- If the issue persists, ask for a referral to a specialist. If your GP doesn't want to refer you to a specialist, you can change your GP.
- Sometimes you need to be persistent and follow up on your situation to get the help that you need.