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The health system in the Netherlands works a little differently than in Germany. A golden rule is: "First, do no harm!" From this point of view, many drugs (such as antibiotics) are not prescribed and superfluous examinations are not performed. Even regular examinations can cause stress and above all, increase the chance of a measurement error. Do not worry! The Dutch health system is one of the best in Europe.¹

The family doctor (GP, general practitioner) plays an important role in the health system. He is the first point of contact for all health problems and is more fully educated than the German family doctor. He is a gatekeeper for the health services.

If you want to visit a specialist, you always need a referral from the family doctor, who belongs to the first stage (eerste lijn) in the health system. Dentists, district nurses, speech therapists, maternity wards, midwives and physiotherapists are also part of the eerste lijn group. No referral is required for this group.

Specialists (tweede lijn) are mostly found in hospitals or clinics. To consult the specialists there (or other functions within the tweede lijn), a referral is required.

However, you only get a referral if the family doctor cannot treat the complaints themselves. If you are in doubt you should just ask. The family doctor prescribes contraceptives for example. Unlike in Germany, usual preventive check-ups are often not available in Netherlands. You have to get used to this first, but this decision was a product of an informed study. There are however large-scale population surveys (bevolkingsonderzoek). You do not have to worry about this, because on a certain deadline (age-dependent) all required information is automatically delivered.

In the Netherlands, it is customary to be registered with a regular family doctor. Prescriptions are not given to the patient, but they are sent directly to a specific pharmacy near the doctor. There you can pick up his medication. In this pharmacy you are usually registered. The pharmacist knows exactly what medication someone takes and can warn about possible complications from other drugs. Neither the enrollment at a family doctor nor the registration at the pharmacy is mandatory, but offers some advantages. For example, one can avail of the emergency service outside the normal office hours of the family doctor. Furthermore, if you are enrolled in a family doctor, you have a secure contact point in case of illness. Finding a family doctor when you get sick can cause problems because family practices can refuse admission, for example, if too many people are registered in practice.

The following offers given are very helpful:
thuisarts.nl/
moetiknaardedokter.nl/

Germany and also the Netherlands have a clearly high density of physicians per 10,000 inhabitants according to WHO. In total, more than 55,000 doctors worked in health care in the Netherlands in 2017; more than ever before. ^[2a] In 2017, 11,770 family physicians, 8,515 dentists, and 3,578 pharmacists were registered or registered in the Netherlands. ^[2b]

Anyone living and working in the Netherlands is required to have Dutch health insurance. This is a so-called Basisverzekering (basic coverage insurance). You thereby insure yourself for the care from the basic package. If you are not insured, you will receive a fine. The organisations offering health insurance are private companies. There are around 40 different providers. The Ministry of Health determines which benefits each health insurance must at least assume. Rijksoverheid provides a list.

The basic insurance covers less than the health insurance in Germany, for example, not the cost of the dentist or physiotherapy. You can take out additional health insurance for these additional costs. Booking extra packages is common1. This vrijwillige aanvullende verzekering (voluntary supplementary insurance) need not be completed at the company of the basic coverage insurance.

The monthly contribution does not depend on your income, but low-income people can apply for government support, called zorgtoeslag. On January 1, health insurance can be changed, or the contract can be adjusted.

Try this comparison tool to find your next health insurance in the Netherlands.

Important: Ask before each treatment, whether there are extra costs involved. Do not be surprised!

Our tip: Ask your employer for health insurance options. It may be that you can make such a better deal.

Basic insurance for children

Even for children, basic coverage insurance must be completed. A child must be reported to a health insurer within four months after birth. This is possible for the insurer who took out his own health insurance, but this is not mandatory. The insurance is free of premium, and there is no deductible for the basic insurance of children under 18 years. The first premium is due from the first month after the child turns 18 years old. From this point on the deductible also applies and you can apply for care allowance.

On vacation in the Netherlands

Health insurance in Germany and insured in the Netherlands on holiday? You have the right of treatment with the European Health Insurance Card (EHIC), which is printed on the back of the German health insurance card. This card covers the cost of immediate medical and dental treatment, as well as medicines. Hospitalizations and operations are also paid. The decisive factor is whether the service provided is urgently necessary due to the health of the patient.

Patients should only seek treatment from doctors or hospitals that are part of the statutory health insurance system. Private medical treatments are not included. A return transport to Germany will not be accepted. Inform yourself in advance about benefits and costs. The EHIC is no substitute for travel insurance and includes many other rules. The conclusion of a travel health insurance can therefore also be useful when traveling to other EU countries. More information on this topic is available from the European Commission.

Most family doctors can perform quick test of urine or blood. If you do not feel well and need more data, your GP will send you to a lab (or hospital). There, a blood sample will be taken and appropriate examinations will be conducted. Detailed urine or stool analyzes are also carried out in the laboratory indicated by the family doctor. For ultrasound examinations and x-rays, a referral to the Polyclinic is written.

All results will be reported to the GP who will then discuss them with you and initiate any treatment or refer you to a specialist.

If you are worried that you may have an STD (Sexually Transmitted Diseases, in Dutch: SOA = seksueel overdraagbare aandoening) while in the Netherlands, there are a number of different ways in which you can be tested.
Going to your general practitioner (GP) is a good way of doing this, you can explain your situation. Together with your GP you can determine which risks you may have been exposed to and which tests would be relevant for you. The GP’s opinion is leading in this. If the GP determines that a test is not needed, that test will not be done. If you go thorough the GP for an STD test, the costs will be deducted from your ‘own-risk’ of your medical insurance.

Many people prefer not to go to their GP with such a delicate matter, and prefer to remain anonymous.

In some cases it is possible to be tested by the Public Health Department, known as the GGD in the Netherlands. The tests from the GGD are free, but there is a considerable waiting list, and these GGD tests are not made available to everyone: the GGD tests are only available to men who have sex with men, to sex-workers and people under the age of 25.

If you are not in one of these categories, but would still like to be tested anonymously, you can approach a private clinic. This is not free, but the cost will not be declared against your medical insurance ‘own-risk’, and you can remain completely anonymous. You can determine exactly what you want tested, and you can be tested quickly. You will typically receive the test results promptly. In the center of the Netherlands, in Bunnik, close to Utrecht, you can get tested at SoaZorg.nl. There is no waiting list and you get the test results within 2 working days. If you need any treatment, this can also be arranged by SoaZorg anonymously.

The medical emergency service is handled by Huisartsenpost. Call your Huisartsenpost to briefly clarify situations. In this conversation or after a callback, it is determined whether and when a visit is necessary. Only then can you go to the Huisartsenpost at the agreed time.

Life threatening situation? Call 112!

The medical care is not only very service-oriented, but it also has high availability. The family doctor is available for both urgent and non-urgent matters during office hours.

The GPs also take part in an emergency service concept, so that the availability for urgent matters is guaranteed every hour of the week. When patients decide to visit for non-urgent matters, care during urgent cases is jeopardized.

Huisartsenposten are mostly independent medical practices. Here the family doctors are usually available in the evening, at night and on weekends. You can either ask your GP for the address or find it on the internet.

Again, are unsure if you can come by? Call your Huisartsenpost to briefly clarify situations.  Are you experiencing a life threatening situation? Call 112!

Huisartsenposten in the area

Amsterdam
https://www.huisartsenpostenamsterdam.nl/

Drechtsteden (Dordrecht, Papendrecht, Sliedrecht & Zwijndrecht)
https://www.huisartsenpostdrechtsteden.nl/

Den Haag
http://www.smashaaglanden.nl/

Den Helder, Schagen & Texel
https://www.hknhuisartsen.nl/

Friesland (Leeuwarden, Dokkum, Sneek, Heerenveen and Drachten; exclusive Dutch islands!)
https://www.dokterswacht.nl/

Goeree-Overflakkee and Zuid-Zuid-Holland (Ouddorp, Dirksland, Klaaswaal, Beijerland, ...)
http://haphellegat.nl/

Groningen and surroundings
https://www.doktersdienstgroningen.nl/

Maastricht and surroundings
https://hapmaastricht.nl/

Rijnland (Leiden, Alphen aan de Rijn, Leiderdorp, ...)
https://huisartsenpostenrijnland.nl/

Rotterdam and surroundings
https://huisartsenpostenrijnmond.nl/

Schiedam, Vlaardingen & Maassluis
https://www.huisartsenpost-nwn.nl/

Utrecht and surroundings
https://www.primair-hap.nl/

Zeeland
https://www.zhco.nl/huisartsenpost/

For a better overview, visit zorgkaartnederland.nl/huisartsenpost oder ask Google.com/search?q=huisartsenpost.

Own risk

For members of a Dutch insurance applies: The family doctor is fully reimbursed. The care is not at the expense of your compulsory deductible. This also applies to the care at a huisartsenpost. The care at an emergency department/first aid takes place in a hospital. The compulsory deductible applies to this care. Have you not fully utilized your deductible? Then you pay part of the bill yourself.^[3]

Pharmacies are mostly found in residential areas, near a family doctor. Pharmacies are controlled by the government to ensure quality. Responsible is Inspectie Gezondheidszorg en Jeugd. There are significantly fewer pharmacies than in Germany. ^[4] Patiëntenfederatie Nederland provides an overview of around 1900 pharmacies on their website Zorgkaartnederland.

Many medicines are also available in drugstores in the Netherlands. The employees in the drugstore are trained in drug counselling.

Since many over-the-counter drugs are available in drugstores and even supermarkets, pharmacies are not overcrowded. Depending on the time of day, but there may be waiting times. In the many pharmacies waiting numbers have to be drawn at the entrance. Then you are called.

Pharmacy, drugstore or supermarket

Whether a drug may be sold in the pharmacy, a drugstore chain or in a supermarket depends on the approval category:

Prescription drugs are only issued in the pharmacy. This requires a recipe. Depending on the doctor, this recipe can also be digitally transmitted to the pharmacy of their choice.

Over-the-counter medications are divided into different subcategories:

• The category Uitsluitend Apotheek (UA) contains medicines that can be obtained without a prescription, but a pharmacist must explain the correct application. The pharmacist will also consider any other medications you use.
• Drugs from the Uitsluitend Apotheek en Drogist (UAD) category are over-the-counter self-care products that can be bought at the pharmacy or drugstore. The pharmacist or the drugstore * can give you advice and explanations about these medicines.
• Algemene Verkoop (AV) medications can be purchased anywhere. These are "safe" medicines in small packages such as nicotine patches, analgesics, and some heartburn inhibitors.

You have a simple illness and want to treat it yourself? Then get advice in your pharmacy.

Validity of German prescription in the Netherlands - vice versa

A prescription from your EU country is also valid in all other EU countries. But beware: A medicine that is available in your country is not always available in another country or has a different name. Also, ask your doctor to issue a foreign prescription. Reasons to buy abroad can be a trip. In some cases, medicines abroad are cheaper. Also, check with your health insurance if you have the right to a refund and how you can submit it.

Paracetmol

Ein sehr beliebtes Mittel gegen Beschwerden aller Art in den Niederlanden ist Paracetamol. Es wird in allen Lebenslagen von der Grippe bis zu Zahnschmerzen verordnet und eingenommen, auch bei einer Schwangerschaft. Ein weiteres wichtiges Kriterium für Niederländer, es ist sehr preiswert. Es ist ein günstiges Mittel, dass Schmerzen lindert, Fieber senkt und wenig Nebenwirkungen hat.

Online pharmacies

Medications can also be ordered at online pharmacies. Please note the information provided by the Rijksoverheid on this subject.

Vaccination in the Netherlands is only free for children and is carried out by the Consultatiebureau. Adult booster doses have to be paid by for personally unless an additional insurance option has been chosen to cover these costs. The same applies to vaccinations and precautionary measures against tropical diseases.

Flu vaccinations are taken under certain conditions. If you are in the target group, you will receive an invitation from your family doctor.

Most hospitals in the Netherlands have several functions:

Polyclinic
For symptoms that the family doctor cannot alleviate or cure, or which requires an in-depth examination, a referral to the Polyclinic can be made. The results are exchanged with the family doctor. Depending on the severity, the patient may go home or be hospitalized.

Hospitalized
With some illness, it is clear in advance that a stationary admission must take place. The hospital decides after consultation with your GP or specialist when the admission will take place. The room occupancy depends on a few factors and the patient has no direct influence over this.

Emergency treatment
In emergencies, medical care is provided directly through the emergency room of hospitals. After the appropriate measures have been taken, it is also decided whether the patient should be hospitalized or released for further treatment by the family doctor.

In case of emergency call 112!

Overall, hospitals in the Netherlands have a very good standard and reputation. One problem of medical care in the Netherlands however is that due to the high population density there are few places for specific therapies or diagnostics. As a result, the waiting lists are sometimes very long. Some patients seek help in neighboring countries. Please note however that not every health insurance company covers the costs of a planned treatment abroad.

Hospitals in the Netherlands are digitized. You need to register in advance and get a chip card with your basic data.

You must also assume that you will be released as soon as possible after hospitalization thus hospitals not only save costs, but also ensures that another patient can be helped quickly. More importantly, the patient will come to a familiar environment and move more through the discharge. The average recording time depending on age and disease is between 2 and 7 days. Over 89% of patients are discharged to go home while others remain either in hospitals or other facilities.^[5]

A simple overview of all hospitals in the Netherlands is offered by BRV, a professional association. Algemeen Dagblad, (AD) published in November 2018 a current Top 100 of Dutch hospitals.

References:
1 Health Consumer Powerhouse (2018). Euro Health Consumer Index 2018. Retrieved on November 14, 2020, from https://healthpowerhouse.com/ehci-2018/
2a CBS (12 juli 2019). Gezondheid, leefstijl, zorggebruik en -aanbod, doodsoorzaken; kerncijfers. Retrieved on September 25, 2019, from https://opendata.cbs.nl/statline/#/CBS/nl/dataset/81628ned/table?ts=1569439809875
2b CBS (17 april 2019). Gezondheid, leefstijl, zorggebruik en -aanbod, doodsoorzaken; vanaf 1900. Retrieved on September 25, 2019, from https://opendata.cbs.nl/statline/#/CBS/nl/dataset/81628ned/table?ts=1569439809875
3 Rijksoverheid. Wanneer moet ik naar de huisartsenpost of de spoedeisende hulppost? Retrieved on April 23, 2019, from https://www.rijksoverheid.nl/onderwerpen/eerstelijnszorg/vraag-en-antwoord/huisartsenpost-spoedeisende-hulp
4 ABDA – Bundesvereinigung Deutscher Apothekerverbände e. V.  (Mai 2018). Die Apotheke - Zahlen  Fakten Daten. Retrieved on September 18, 2019, from https://www.abda.de/fileadmin/assets/ZDF/ZDF_2018/ABDA_ZDF_2018_Brosch.pdf
5 Nederlandse Vereniging van Ziekenhuizen (NVZ) (2018). Brancherapport algemene ziekenhuizen 2018. Retrieved on November 14, 2020, from https://ziekenhuiszorgincijfers.nl/assets/uploads/NVZ-Brancherapport-2018.pdf