Reimbursement of costs

What should you do?

Always contact your health insurance provider first. They should tell you what is the best option for you to have treatment in the Netherlands: according to European Regulation 883/2004 (the Regulation) or to Directive 2011/24/EU (the Directive).

Treatment in the Netherlands according to the Regulation

In any case, your health insurance company must give you prior authorisation. You will then receive an S2/E112 form from your health insurance company. You will show this form to the healthcare provider in the Netherlands. This way he knows that you are entitled to the treatment and that your health insurance company pays the costs.

Treatment in the Netherlands according to the Directive

Even then, your health insurance company may require you to ask for prior authorisation. If you do not, the costs may not be reimbursed. 
Your health insurer can also provide you with information on:

• conditions for permission;
• how you will be reimbursed; and
• what else you should take into account if you want to undergo treatment in another EU country.

You'll find more information on the websites of the:

• European Union;
• European Commission; and
• EPECS (only in Dutch).

Toolbox for patients

For patients wishing to go to another EU country for medical treatment, the European Commission has made a toolbox. This toolbox has information on everything related to cross-border care. For example, European legislation on cross-border care. Or practical things to think about if you want to be treated in another EU country.

The toolbox consists of a manual and several documents. These include a glossary, a checklist and an overview of frequently asked questions and answers. You will find this information on the right of this page under “Documents”.

Video

The European Commission has also made a short video. This video shows what you need to pay attention to when you are treated in another EU country. A link to the video can be found on the right of this page.

Your health insurer pays the healthcare provider for your treatment

You will receive healthcare in accordance with the European Regulation 883/2004. This means that you usually don't have to pay the costs for the treatment yourself. That’s what your health insurance company does. But you must have been given prior authorisation for this treatment. In that case, you will receive a form S2 or E 112.

You will then receive the treatment according to the Zorgverzekeringswet [Zvw, Healthcare Insurance Act] (only in Dutch) or in the Wet langdurige zorg[Wlz, Long-Term Care Act] (only in Dutch).This means, for example, that you need to have a referral for certain care. For instance, healthcare by a medical specialist or in a hospital. Sometimes you pay your own contribution for treatment to the healthcare provider.

You first have to pay for the treatment yourself

The European Patients' Directive (Directive 2011/24/EU) also allows the treatment to be reimbursed in the Netherlands. You will have to pay the costs for the treatment upfront. And you may need prior authorisation from your health insurance company.

You are entitled to healthcare under the terms of your own insurance. Do you meet the conditions? After returning home, you'll declare the costs to your health insurance company. The health insurance company will then reimburse the costs. But only up to the amount that the treatment would have cost if you had had the same treatment in your own country. If the costs are higher, you'll run the risk that you'll have to pay the difference yourself.

Prescriptions from the Netherlands

Did you have treatment in the Netherlands? Your healthcare provider may have given you a prescription for medicines or medical devices. A pharmacist or device provider in your own country must accept the prescription if it contains the following information:

• the patient's details;
• details proving that the prescription is genuine;
• details about the healthcare provider who wrote the prescription;
• details about the medicine or medical device.

More information?

Read more on this subject on the website of the European Union.

Healthcare tariffs in the Netherlands

The Nederlandse Zorgautoriteit (NZa, Dutch Healthcare Authority) fixes healthcare tariffs in the Netherlands; these are maximum tariffs. You'll find the NZa tariffs on the website of the NZa (only in Dutch).

Report to NZa

If you think the healthcare provider charged you too much, you can report this at the NZa (only in Dutch). The NZa then checks whether the healthcare provider has complied with the rules and acts if necessary.

Hospital care

In case of hospital care, the government does not determine the entire price. So you may pay a different price at different hospitals for the same treatment. Only the healthcare provider or the hospital itself can let you know how much your reatment costs.

On their invoices, Dutch hospitals do not mention each operation separately (such as an injection, a scan or an examination). They mention diagnostic treatment combinations (‘DBC healthcare products'). Every DBC healthcare product has its own code and rate.

Hospital bills

About hospital bills you can read more on the sheet of the Dutch Healthcare Authority, NZa (only in Dutch): "Betalen van ziekenhuiszorg" ("Payment of hospital care"). You'll find this sheet on the right-hand side of this page under "Documents".

Do you wish to know what type of healthcare is covered by the DBC healthcare product shown on your invoice? Please use the DBC care product rates application on the NZa's website (only in Dutch).