Reimbursement of costs

You want to obtain treatment in the Netherlands and you are insured in another EU member state. You must fulfil certain conditions in order to receive reimbursement of the costs. For this reason it is important that you always ask your health insurer in advance about which conditions apply to you for medical treatment in the Netherlands.

What should you do?

First of all you should always contact your health insurer. Your health insurer should inform you about the most favourable option for you in respect of treatment in the Netherlands: appealing to the Regulation or to the Directive (see below). In order to undergo treatment in the Netherlands on the grounds of the Regulation, your health insurer must in any case have first given you permission in advance. Your health insurer will subsequently provide you with an S2/E112 form. You can use this to show the healthcare provider in the Netherlands that you are entitled to undergo the treatment and that your health insurer will reimburse the costs. For the Directive also, your health insurer can oblige you to ask for permission in advance. If you do not, then you will be running the risk that the costs will 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 can find more information on the websites of the:

Toolbox for patients

For patients who wish to undergo treatment in another EU country the European Commission has created a toolbox. The toolbox contains relevant information on the legal framework of cross-border healthcare, but also information on practical issues concerning treatment in another EU country. The toolbox includes a Manual and several documents, such as a glossary, a checklist and FAQs. You’ll find these documents on the right-hand side of this page, under “Documents”.

The European Commission has also made a short video indicating what things demand particular attention when undergoing treatment in another EU country.
A link to the video can be found on the right-hand side of this page, under "See also".

Please note

You may not use the European Health Insurance Card (EHIC) if you are coming to the Netherlands in order to receive treatment here. The EHIC is, in fact, intended for the reimbursement of medical care that is urgently required when you are already in the Netherlands, e.g. on holiday. For more information you can contact Zilveren Kruis by phone: + 31 (0)33 445 68 70 or by e-mail: gbr@zilverenkruis.nl.

Your health insurer pays the healthcare provider for your treatment

You will receive care in accordance with European Regulation 883/2004. This generally means that you will not have to pay the costs of treatment yourself; your health insurer will do that. Your health insurer must have given you permission in advance. In that case you will receive an S2 or an E 112 form.

You will subsequently receive treatment as provided under the Zorgverzekeringswet [Zvw, Healthcare Insurance Act] (only in Dutch) or under the Wet langdurige zorg [Wlz, Long-Term Care Act] (only in Dutch). This means, among other things, that for certain forms of care (e.g. care provided by a medical specialist or in a hospital) you must have a letter of referral. There is also the possibility that you will have to pay a personal contribution to the healthcare provider for your treatment.

You first have to pay for the treatment yourself

The Directive on Cross-Border Health Care in the European Union (Directive 2011/24/EU) also provides a possibility of reimbursement for treatment in the Netherlands. However, you will first have to pay the costs of treatment yourself. Furthermore, you may also need to have the prior permission of your health insurer. In this case you have a right to care according to the conditions of your own insurance. If you fulfil the conditions, then after returning home you declare the costs to your health insurer. The health insurer will then reimburse you for costs up to the maximum of what the same treatment would have cost if you have been treated in your own country. If the costs are higher, then the difference will generally be at your expense.

Prescriptions from the Netherlands

If you were treated in the Netherlands, your healthcare provider may have prescribed medicines or medical devices for you. A pharmacist or supplier of medical devices in your own country must accept the prescription if it contains the following information:

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

More information on this subject can be found 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 can find the NZa tariffs on the website of the NZa (only in Dutch).

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, part of the costs are not determined by the government. It is therefore possible that you would pay a different price for the same treatment at different hospitals. You can obtain information about the costs of the treatment you want only from the healthcare provider or the hospital from which you want to receive treatment.
On their invoices, Dutch hospitals do not state every activity separately (for example, injections, scans, tests or examinations) but they only state combined diagnostic and treatment trajectories (‘DBC care products'). Each care product has its own code and rate.

You can read more about hospital invoices on the information card issued by the Dutch Healthcare Authority, NZa (only in Dutch): "Betalen van ziekenhuiszorg" ("Payment of hospital care" - only in Dutch). This sheet shows how Dutch hospitals draw up the bills.

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

Please note

The costs for treatment in Dutch hospitals can be high compared to the reimbursement you receive for the same treatment in your own country. Possibly you won’t get reimbursed all the costs if you first pay for the treatment yourself.