--- title: "The Dutch Healthcare System Explained for Expats | HeyDoc" description: "How healthcare actually works in the Netherlands: GPs, specialists, insurance, costs, and the quirks that catch internationals off guard." url: https://heydoc.nl/en/kennisbank/dutch-healthcare-system-explained-for-expats lang: en source: heydoc.nl generated: 2026-05-03T09:29:55.921Z --- # The Dutch Healthcare System Explained for Expats Updated1 May 2026 How healthcare actually works in the Netherlands: GPs, specialists, insurance, costs, and the quirks that catch internationals off guard. # The Dutch Healthcare System Explained for Expats The Dutch healthcare system often scores well in international comparisons, but it's also notably different from systems in the US, UK, Germany, India, or anywhere else. Some of those differences catch internationals off guard. This guide explains how it actually works, with the bits that aren't obvious from the outside. ## The basics The Netherlands has a**mixed insurance-based system**with universal coverage. Every resident is required to have basic health insurance. Insurance is provided by private insurers but heavily regulated by the government, which sets the basic package, the maximum deductible, and various consumer protections. Healthcare is delivered by independent providers — GPs, hospitals, specialists, mental health services — who contract with insurers. You generally choose your insurer and your GP; for specialists, you go where your GP refers you. The system has three main "lines" of care: - **Primary care (eerste lijn)**— GPs, midwives, physiotherapists, dentists, pharmacists, mental health practitioners (POH-GGZ) - **Secondary care (tweede lijn)**— hospitals, medical specialists, specialised mental health - **Tertiary care (derde lijn)**— academic hospitals, highly specialised treatments The unusual thing about the Dutch system is**how much happens in primary care**. GPs handle far more than in many other countries — minor surgery, contraception, mental health screening, chronic disease management, palliative care, even some advanced diagnostics like ultrasound. Around 90% of all health complaints in the Netherlands are managed entirely by GPs without referral. ## The GP gatekeeper system Your GP is your first contact for almost everything medical. Want to see a dermatologist for a rash, an orthopaedist for knee pain, a psychiatrist for depression? You go to your GP first, who decides if you need a specialist and writes a referral. Without a GP referral: - Most specialist visits aren't reimbursed by insurance - You usually can't book directly with hospital outpatient clinics - You'll pay full price out of pocket The exceptions are small but useful: dentists, dental hygienists, midwives (during pregnancy), and emergency rooms in genuine emergencies don't require referral. This system feels slow if you're used to direct specialist access. The trade-off is cost control and continuity — your GP knows your full picture and prevents fragmented care. ## Health insurance Health insurance is**legally mandatory**for everyone living or working in the Netherlands for more than four months, with a few exceptions (PhD students with a stipend rather than salary, certain diplomats, some asylum seekers initially). There are two parts: **Basisverzekering (basic insurance):** - Required for everyone - Standard package set by government — every insurer covers the same basic care - Covers GP, specialist, hospital, most prescriptions, basic mental health, maternity care, ambulance, A&E - Premium varies slightly between insurers, currently around €130–160/month - Children under 18 are insured free **Aanvullende verzekering (supplementary insurance):** - Optional - Covers things basisverzekering doesn't: extensive dental, physiotherapy beyond a basic limit, alternative medicine, glasses, etc. - Premium varies based on what you choose You choose your insurer once a year (the change window is November/December for the following year). Insurers cannot refuse you for the basic package, regardless of pre-existing conditions or age. ## The eigen risico (deductible) Every adult has an annual deductible — currently around €385 — that applies to most care**except**: - GP visits (always free) - Maternity care - Care for chronic conditions on a defined list - Children under 18 So your GP visits, including chat consultations, video calls, and in-person appointments, are completely free. The deductible kicks in when you're referred to a specialist, get certain prescription medications, have a hospital admission, or use ambulance services. This is a key cost-control feature: the system makes primary care free precisely so people use it as the first contact instead of expensive specialist or emergency care. ## What insurance covers (and doesn't) **Covered by basisverzekering:** - All GP care (chat, video, in-person, on-site diagnostics) - Most specialist care after GP referral - Hospital care - Most prescription medications (subject to deductible and a defined formulary) - Maternity care - Basic mental health and POH-GGZ - Cancer screening programmes - Ambulance and emergency care - Physiotherapy in limited cases (chronic conditions, post-op) **Not covered (or only partially):** - Most adult dentistry — usually need supplementary insurance - Extensive physiotherapy — limited to specific conditions and amounts - Glasses and contact lenses for adults - Travel vaccinations (often partially covered by supplementary) - Alternative medicine (homeopathy, acupuncture) - Cosmetic procedures ## Mental health care Mental health is integrated into the primary care system to a degree that surprises some internationals. Many GP practices have a**POH-GGZ**— a mental health practitioner who provides short-term counselling for mild to moderate complaints, fully covered, without separate referral. For more severe issues (significant depression, anxiety disorders, trauma, eating disorders), the GP refers to: - **Generalistische basis-GGZ**— short-term specialised treatment, typically 5–8 sessions - **Specialistische GGZ**— longer-term treatment with psychologists, psychiatrists, and clinics Mental health treatment is covered by basisverzekering (after deductible). Waiting lists are unfortunately often long for non-acute treatment — months in some regions. For urgent mental health needs, your GP can usually arrange faster access. ## After-hours care Most GP practices are open Monday–Friday, roughly 8:00–17:00. Outside those hours: - **Huisartsenpost (HAP)**— the after-hours GP service, open evenings, nights and weekends. Phone first; they triage and either advise, schedule a visit, or send a doctor to you. In Leiden: 088 427 47 00. - **Spoedeisende Hulp (SEH)**— the hospital emergency department, for genuine emergencies only. Going there for non-urgent issues isn't covered and you'll pay out of pocket. - **112**— for life-threatening emergencies (just like 911 in the US or 999 in the UK). For non-urgent questions outside office hours, your own GP's portal or chat can also be used — but responses come during office hours. ## Pharmacy and prescriptions Prescriptions are filled at*apotheken*(pharmacies). Each adult typically registers with one pharmacy that holds your medication record and coordinates with your GP. Refills are usually requested via your GP, often digitally. Important quirk:**paracetamol, ibuprofen, naproxen and other common over-the-counter painkillers are sold in supermarkets and drugstores in small packs**. Larger packs are at pharmacies. You don't need a prescription for these. ## Cultural quirks worth knowing **Watchful waiting is normal.**Dutch primary care is conservative. Most viral illnesses, minor injuries, and self-limiting complaints are managed with reassurance, rest and over-the-counter medication. Antibiotics are given only when clearly indicated. This catches some internationals off guard but is genuinely evidence-based. **Direct communication.**Dutch GPs tend to be direct, sometimes blunt. They'll tell you if they think a complaint doesn't require a specialist or if your concern doesn't match the medical evidence. This isn't dismissiveness — it's a different communication style. **Short consultations, focused agenda.**Standard GP appointments are 10 minutes for one issue. If you have multiple things, ask for a longer appointment when booking. **Follow-up is digital.**Test results, prescription requests, and routine questions increasingly go via portals and chat. This is convenient but assumes some digital literacy. **House visits exist.**GPs do home visits for patients who genuinely can't come to the practice — usually elderly, immobile, or acutely ill. You can request one, but the GP decides medical necessity. ## Tips for new arrivals 1. **Register with a GP within your first month**, before you're sick. 2. **Get your insurance sorted**— basisverzekering is mandatory and you have four months from arrival to enrol. 3. **Save your home country medical records**in a folder. Bring them to your first GP visit. 4. **Learn the after-hours number**of your local huisartsenpost. 5. **Don't expect everything to work like home.**It often won't, and that's not always worse. ## For Leiden specifically GP capacity in Leiden is tight — many practices have patient stops. Practices that explicitly take internationals include Praktijk Boshuizen (Leiden-Noord), Roodenburg, and Wendel-van Heezik (Lammenschans area). [HeyDoc](https://heydoc.nl/en)is a digital-first English-speaking GP practice on Lammenschansweg, currently accepting new patients without a waitlist. We're particularly oriented toward internationals familiar with chat-and-video healthcare from systems like Kry, Babylon or Push Doctor. --- *This guide is general information, not personal medical or insurance advice. For specific questions about your situation, contact a GP practice or your health insurer directly.* --- Written by**HeyDoc**· HeyDoc GP practice, Leiden. This article is general information and does not replace a personal consultation. Questions?[Register with HeyDoc](https://heydoc.nl/patient-worden?lang=en)or[get in touch](https://heydoc.nl/contact).