In the Netherlands, having health insurance is mandatory. This ensures you are covered against unexpectedly high medical costs, such as hospital stays or medications. From 2025, you can only choose between a natura policy and a combination policy; the reimbursement policy will no longer be offered by insurers.

With a 'natura' policy, you generally receive a lower reimbursement when you opt for a non-contracted healthcare provider. With a 'combinatie' policy, this reimbursement is higher, thus reducing your out-of-pocket expenses for non-contracted care. This increases your freedom of choice when selecting a healthcare provider. However, if the reimbursement from your insurer is still insufficient and hinders your access to necessary care, you may be able to invoke the 'hindrance criterion (hinderpaal criterium).' This legal criterion ensures that higher costs do not obstruct access to necessary care.

Besides the basic insurance, you can take out supplementary insurances for care not included in the basic package, such as dental care or physiotherapy. It is important to map out your healthcare needs and compare insurances based on premiums, coverage, and conditions.

People with a lower income may be eligible for healthcare allowance (zorgtoeslag)). This is a contribution from the government to keep health insurance affordable.

Summary:

1. Choose between a 'natura' policy or 'combinatie' policy, depending on your healthcare needs.
2. Compare supplementary insurances if you need additional care.
3. Pay attention to the reimbursement for non-contracted healthcare providers. The amounts are published on your insurer’s website. You can also ask your insurer's customer service about this.
4. Check if you are eligible for a healthcare allowance (zorgtoeslag).

Make a well-informed choice to ensure your health insurance fits your situation.

When choosing health insurance in the Netherlands, it's important to consider not only the insurer and the coverage offered but also the amount of your deductible. The compulsory deductible for basic insurance is €385 per year, meaning you pay the first €385 of eligible healthcare costs yourself.

Increase Your Deductible

You can choose to increase your deductible voluntarily by increments of €100, up to an additional €500, making the maximum deductible €885. Opting for a higher deductible will lower your monthly premium, which may be beneficial if you anticipate minimal healthcare expenses.

Factors to Consider Before Increasing Your Deductible

1. Your Health Status
   • Low Health Care Usage: If you're generally healthy and seldom need medical services, a higher deductible might save you money.
   • Chronic Conditions: If you have ongoing health issues or expect significant medical expenses, a higher deductible may not be advisable.
2. Your Financial Situation
   • Can you afford the higher deductible if you face unexpected medical costs?
   • Consider the financial impact of unforeseen medical issues.
3. Risk vs. Reward
   • Analyze the potential savings against the risk of higher out-of-pocket expenses.
   • Discounts for higher deductibles vary by insurer but generally range from €200 to €300 per year.

Example Scenario

If you increase your deductible by €500 to €885, thus receiving a monthly premium reduction of €20 (€240 annually), you save €240 if you have no deductible expenses within the year. However, should medical needs arise, you could be responsible for up to €885.

Advice wrt Choosing Your Deductible

• Analyze past healthcare expenditures to gauge your usual medical costs.
• Consider whether the likely savings justify the potential risk of higher expenses.
• Compare plans and discounts across different insurers, as these can vary significantly.
• Examine alternatives such as additional insurances or opting for the lowest deductible.

Every November, you will receive the new health policy for the coming year from your insurer. It's wise to review this policy thoroughly, as your healthcare needs might change and insurers often update their terms annually. Even if your personal situation remains the same, the coverage or premiums may change, possibly making your current policy less optimal.

Why Consider Switching?

• Changed Healthcare Needs: You may need more or less healthcare next year, or specific treatments that are no longer covered.
• Modified Terms: Insurers may change policy terms, which could affect the coverage of your current insurance.
• Cost Saving: Switching could potentially save you money on your premium or offer better value for money.

Choose between a Natura Policy or a Combination Policy

When selecting a new health insurance, it is important to know that there are different types of policies:

• Natura Policy: You can use healthcare providers with whom your insurer has contracts. If you choose a non-contracted provider, often only part of the costs is reimbursed.
• Combination Policy: You can use healthcare providers with whom your insurer has contracts. Choosing a non-contracted provider typically results in higher reimbursements than with a natura policy, but still only covers part of the costs.
• Reimbursement Policy: From 2025, the reimbursement policy will no longer be offered. If you had a reimbursement policy in 2024, your insurer would likely offer a transitional arrangement. In this case, it may be wise to take advantage of this arrangement.

Important Dates to Remember

• By December 31st: If you sign up for a new health insurance before this date, the new insurer usually automatically cancels your old insurance.
• Cancel Yourself: If you decide to cancel your current insurance yourself, do this by December 31st. You then have until February 1st to choose a new health insurance.

Steps for Switching

1. Analyse Your Healthcare Needs: Make a list of the healthcare you expect to need in the coming year.
2. Transitional Arrangement for Reimbursement Policy? If you had a reimbursement policy in 2024, inquire about the transitional arrangement for 2025 with your health insurance. Otherwise, continue to point 3.
3. Choose between a natura or combination policy: Decide how important the level of reimbursement is for non-contracted healthcare providers.
4. Compare Insurers: Look at different health insurers and compare premiums, coverages, and terms.
5. Check Contracts with Healthcare Providers: If you have a preference for certain doctors or hospitals, check if they are contracted under a natura policy, or consider a combination policy.
6. Consider Additional Insurances: Determine if you need additional coverages, such as for dental care, physiotherapy, or alternative medicine.
7. Finalise the New Insurance, if Desired: If you choose a new insurance, contact the new insurer. They will handle the rest. You can indicate your preference online or by phone.

When choosing health insurance, premiums, coverage, and service often play leading roles. But did you know that there are also ethical aspects worth considering? The way insurers invest their premium funds can have a significant impact on the environment and society—and ultimately on your health.

Investments and Health

Health insurers manage vast financial reserves to cover future healthcare costs. These reserves are often invested in various companies and industries. The problem arises when these investments are made in companies that perform poorly on sustainability and corporate social responsibility. Consider businesses that contribute to climate change, environmental pollution, or even weapons manufacturing.

Why is This Important?

• Climate and Environment: Companies that harm the environment indirectly contribute to health issues such as respiratory problems, cardiovascular diseases, and other conditions.
• Disease Prevention: Insurers that invest in industries causing health damage undermine their own objectives in disease prevention and health promotion.
• Social Responsibility: As policyholders, we can expect that our premiums are managed in a way that contributes to a better and healthier society.

What Can You Do?

• Research Investment Practices: Educate yourself on how your (potential) health insurer invests its financial resources. Organizations like the Fair Insurance Guide provide insights into the sustainability policies of insurers.
• Ask Questions: Do not hesitate to ask your health insurer about their investment policy and how they contribute to sustainability and social responsibility.
• Make a Conscious Choice: When switching, consider not just price and coverage, but also the ethical aspects of the insurer.

Working Together for a Healthy Future

By consciously choosing a health insurer that invests sustainably and responsibly, you contribute to positive change. You support not only your own health but also that of the community and the environment.

From 2025, the reimbursement policy (restitutiepolis) will no longer be available. This means that you will not always be reimbursed the full costs if you choose a healthcare provider who does not have contract with your insurer. In such cases, you will have to pay part of the bill yourself.

This 'personal contribution' (eigen bijdrage) arises because the reimbursement from the insurer is lower than the rate charged by the healthcare provider. This may prevent some patients from using services of non-contracted practitioners because they cannot afford the additional costs.

What can you do?
According to the hinderpaalcriterium (hindrance criterion), a low reimbursement should not limit your freedom of choice for a healthcare provider. If the personal contribution is too high and it prevents you from receiving necessary care, you can request a higher reimbursement from your insurer.

Ask your insurer to explain the hinderpaalcriterium. An example letter to try to appeal to it is available on this website. This way, you can try to obtain the care you need.

If you have to pay a personal contribution for healthcare, these costs are conditionally deductible from your income tax.

• It's important to know that there is a threshold amount for the deduction of healthcare costs. Only the portion of the costs that exceeds this threshold is deductible. The threshold amount depends on your income, as well as whether you have a fiscal partner.
• Only specific healthcare costs that are not reimbursed and do not fall under the deductible are eligible for this deduction. At the same time, you may include all your medical expenses in this calculation if they are deductible. The healthcare costs of your fiscal partner and your children up to 27 years old may also be included.
• Even if you have a low income and pay little or no tax due to the deduction of healthcare costs, it can still be beneficial to file a tax return. You may be eligible for a subsidy.

Although you must file a tax return to be able to deduct your healthcare costs, it may be financially the best choice.

Zorgtoeslag (healthcare allowance) is a government contribution that helps keep health insurance affordable. If you have Dutch health insurance and your income falls within the limits, you can receive this financial support.

Important: you can apply for healthcare allowance retrospectively, up to September 1st of the previous year. The sooner you apply, the faster you will receive the allowance.

Never pay to apply for healthcare allowance! Apply for free via the official website of the Belastingdienst (Tax Authority).

If you had a reimbursement policy in 2024 and received care from a psychiatrist without a contract with your health insurer, there might be a transitional arrangement applicable. This arrangement ensures that you still get reimbursed 100% of the NZa rate in 2025. If this situation applies to you, you should automatically receive a proposal from your health insurer explaining this. If this is not the case, or if you are unsure, please contact your health insurer for more information about the transitional arrangement.

In other cases, for non-contracted mental health care, the best health policies to choose from in 2025 are:

In Table 1, you can see the reimbursements relative to the rates set by the Dutch Health Authority.

Access to mental healthcare in the Netherlands is under significant pressure. Many people are on waiting lists for care. The causes of this issue are complex but are briefly explained here.

In the Netherlands, everyone is entitled to the same basic health insurance, regardless of age, health, or income. Health insurers are required to accept everyone and cannot charge higher premiums to people who need more care. This means that some insurers cover more patients with high healthcare needs, resulting in higher costs.

To distribute healthcare costs more fairly among insurers, a system called risk equalisation exists. Under this system, insurers receive financial compensation from the government based on the risk profile of their customers. This ensures that insurers with a higher number of sick patients are not financially disadvantaged.

In mental healthcare (GGZ), predicting healthcare costs is very difficult. A person may not require help one year but need extensive support the next. Furthermore, a small number of patients incur very high costs, while most people require little to no care. Because it is hard to predict who will need mental healthcare and how much it will cost, some insurers receive insufficient compensation for these expenses through the risk equalisation system, while others receive too much.

What are the consequences?

• Financial deficits for insurers: Insurers with many mental health patients do not receive enough funds to cover healthcare costs.
• Closure of mental healthcare departments: Due to funding shortages, some specialised mental healthcare departments are forced to close.
• Long waiting times: Patients face longer waits for treatment as insurers purchase less mental healthcare.
• Negative incentives: Insurers may be discouraged from purchasing high-quality mental healthcare or offering policies that protect against risks, fearing financial losses. This is evident in the gradual disappearance of reimbursement policies. Additionally, contracting new healthcare providers is slow, even when capacity is available on the care side.

The challenges surrounding risk equalisation in mental healthcare result in reduced access to mental health services for those who need them most.

Every year, the contractvrijepsycholoog compiles a detailed overview of the different health insurance policies and the reimbursements they offer for mental healthcare.

How Your Health Insurance Affects Reimbursement

Your choice of health insurance significantly impacts the level of reimbursement you receive, particularly when you visit a non-contracted healthcare provider. In addition, you will always need to pay your selected deductible yourself.

• Restitutiepolis: As of 2025, no insurers will offer this type of policy. If you had a reimbursement policy in 2024 and received care from a psychiatrist without a contract with your insurer, a transitional arrangement may apply, allowing you to still receive 100% of the NZa rate in 2025. Contact your insurer to confirm.
• Natura of combinatiepolis: With a 'natura' policy or 'combinatie' policy, reimbursement for care from non-contracted providers is typically between 50% and 75% of the NZa rate (see Table 1).

When choosing your health insurance, it’s important to consider your preferences for healthcare providers and the associated reimbursements. Detailed reimbursement amounts can be found in Table 1 and on your insurer’s website (see Table 2).

According to health insurers, only contracted healthcare providers meet the required quality standards. However, the quality of medical knowledge and expertise of professionals is not managed or monitored by health insurers. Medical training, specialist education, and the system for safeguarding medical expertise are entirely independent of contracts with health insurers and are legally regulated. Since a psychiatrist is a medical specialist, you can trust that the medical knowledge of a non-contracted psychiatrist is exactly the same as that of a contracted psychiatrist.