Dutch Health System: Basisverzekering

The basiszorgverzekering is a health insurance that is compulsory for most Dutch citizens. The aim of the Dutch Health Insurance is to offer cover for necessary care, aimed at curing the patient. It ensures that the majority of Dutch citizens are covered for all basic medical costs. This system has been in force since 1 January 2006 and the Dutch government determines what falls under the basic cover and also sets a compulsory excess.

Who should have the basisverzekering depends on several factors. In general the rule that applies is; if you are insured with Social Security, then you should have a Basisverzekering as well.

Is a basiszorgverzekering compulsory for myself?

As a foreigner, it may be compulsory to purchase a 'basiszorgverzekering'. To determine whether or not you fall into this category you can contact us directly for advice.

If you're experiencing problems in finding out whether you should have the basiszorgverzekering, or basic health insurance, then you can also contact the SVB. That is short for Sociale Verzekeringsbank, the Dutch authority that determines whom in The Netherlands has social security.

What is a deductible or excess?

Deductible, also known as excess or "own risk", means that you don’t get a refund from the insurance company as long as the costs you make are lower than the deductible. An example to clarify: let’s say that there is a deductible of 200 euros per year. In January and March you need to see a doctor and the expenses are 50 euros for each treatment. You have 100 euros of expenses in total. Because this is lower than your deductible, the insurance company will extract the 100 euros of your deductible and won’t give you a refund. In August you need a surgery, which costs 400 euros. After extraction from your outstanding deductible, the insurance company will give you a refund of 300 euros.
So in other words, until you have reached the amount of your deductible, the insurance company will not provide a reimbursment.

How can I purchase a Basiszorgverzekering?

In most cases you need a residence permit, Burger Service Nummer (BSN) and registration at a local municipality to actually apply for the insurance. JoHo Insurances offers both Dutch Basisverzekering and International Expat insurances. We can help you find a health insurance suitable for your situation.

When can you amend your Basiszorgverzekering?

Prior to the 1st January of each year is it possible to amend either your basisverzekering or the type of cover. During the year it is possible to change insurers if you have changed employers and as a result you have lost your collective (group) discount.

How to amend your Basiszorgverzekering

You can amend your current basiszorgverzekering up until the 31 December of each year. Send a letter or email to your current health insurer (zorgverzekeraar). Make sure that you receive a confirmation.

Should you decide to change insurers, advising your old insurer is often automatically done by your new insurer.

What is Naturapolis or Restitutiepolis? (Contracted care providers)

There are a lot of insurance companies that offer the Basic Health Insurance (basisverzekering). In general there are two options:

1. Restitutie polis. In short this means that you can choose the health care provider that you would like to use. The premium for this kind of insurance is higher since you pay for the ability to choose. Also, because there are no contracts between your insurer and the care provider, direct billing can be more complex to arrange.
2. Natura polis. In this case you don't have a complete free choice but you pay less premium. The reason is simple, the insurance company sets deals with several health care proviceders (like hospitals, GP's, therapists) and makes agreements about the prices. This way they ensure less costs for the insurance company. It is therefor that you need to use these care providers, so you benefit from the agreed prices. If you don't use a contracted care provider, then the insurer is not obliged to give you a full refund. Obviously this rule is not applicable when it comes to emergency treatment, for example when the ambulance takes you to the nearest hospital.

Aanvullend (supplementary) Insurance

On top of your basiszorgverzekering it is also possible to purchase an aanvullend insurance to cover or offer extra cover for dental care, physiotherapy or glasses. Things that are not covered under the basiszorgverzekering.

Under the Dutch basiszorgverzekering overseas medical costs are covered up 100% from the Dutch price. If you have purchased an aanvullend (supplementary) insurance on top of your basisverzekering that offers cover for up to 200% of the Dutch price and the overseas medical costs are higher than that of the Dutch prices, then not all your costs will be insured. You will have to pay the difference yourself. A travel insurance can cover the costs that are not covered by your basiszorgverzekering. First check with your zorgverzekeraar (dutch health insurer) what medical costs are covered overseas. If you are not covered up to the cost price under your Dutch Health Insurance, you can purchase a supplementary travel insurance. Please note that a zorgverzekering does not offer overseas cover for luggage, accidents, liability, legal aid and extra expenses. This is insured under a travel insurance.

Sometimes your aanvullend insurance offers cover up to the cost price overseas. In this case it is possible to purchase a travel insurance without medical cover. This way you are not over insured and do not pay more than is necessary.

Should you have any further queries regarding the Dutch basisverzekering, aanvullende insurance or travel insurance during your stay here in the Netherlands please contact JoHo Insurances by filling out the contact & advice form