How is health insurance in the Netherlands regulated by the government?

Everyone who lives or works in the Netherlands must take out basic healthcare insurance. The national government determines what is included in this so-called basic package. This is medically necessary care to which everyone is entitled. Health insurers themselves determine what is included in supplementary insurance policies, for example for physiotherapy, orthodontics or glasses care. This is reported by the national government.

The basic insurance covers standard care from, for example, the general practitioner, pharmacy or hospital. An excess applies to most care in the basic package. A personal contribution may also apply for some components. The main features of the basic package are:

  • Basic insurance is compulsory for everyone who lives or works in the Netherlands. Also for children.
  • The basic package is the same for everyone.
  • The content of the basic package is determined by the government. This can change annually. For example, the government will remove reimbursement for vitamin D from the package in 2023 and heavier paracetamols have already been removed. The government also determines the amount of the deductible and the amount of the healthcare allowance. There is no deductible for certain care, such as general practitioner care or obstetric care. Apart from the deductible, there is also the personal contribution. The government determines for which care a personal contribution must be paid.
  • For the basic package, health insurers are obliged to accept everyone.
  • The premium of a policy is the same for everyone. Everyone with the same policy therefore pays the same, regardless of age or health.
  • Health insurers have a duty of care. This means that they must ensure that everyone receives the care they need on time and within a reasonable distance.

Everyone pays for health insurance. For example, healthy young people help pay for specialist medical care that the elderly often need. And the elderly contribute to the maternity care that is important for young mothers.

Affordable care

The government believes that competition between insurers should lead to good and affordable healthcare. With an affordable premium for policyholders. Insurers negotiate with healthcare providers about the price of the healthcare provided, which should lead to healthcare becoming more affordable.

Promising care faster in the basic package

It takes a long time for patients to benefit from innovations in healthcare. The government wants promising treatments, medical technology and medicines to be included in the basic package more quickly. Funds are made available annually to promote this.

Part of the money goes annually to the subsidy scheme Promising care faster to the patient. This scheme is intended for new care such as treatments, aids and medical technology. The purpose of the scheme is to determine through research as quickly and accurately as possible whether the new care improves your health and at what cost. This makes it easier to determine whether society benefits from the new care. The subsidy is therefore intended for research that must demonstrate the added value of the new treatment or aid.

In addition, part goes to the conditional admission of orphan drugs, conditionals and exceptionals. This is a similar scheme, but specifically aimed at medicines. This concerns medicines against rare diseases (orphan medicines) and medicines that have been conditionally admitted to the market.

By: National Care Guide

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