It’s not often that you’re excited to go to the doctor, but I found myself pumping my fist in triumph after mine told me to come in. After several thwarted attempts to make appointments, I was going to experience healthcare in Europe for the first time.
Healthcare is one of the most talked-about reasons to leave the United States and head to Europe, trumping work-life balance, walkability, and other social services. I get asked about it a lot, so I thought I’d write about my experience with healthcare in the Netherlands as an expat.
First I signed up for insurance, then registered for a doctor’s office in my area. After I set that up, I had access to their online portal. From there, I could make appointments for my doctor to give me a call, or send a message with a question (or two). This week I went for my first in-person visit after living here for 1.5 years. I’ll walk you through all of the steps I took before actually setting foot in a doctor’s office.
Healthcare Abroad: Choosing an Insurance Plan
The Netherlands requires health insurance for long-term residents. You get 4 months to sign up; and if you don’t, you receive a notice and later a fine. I signed up in my first month. To narrow down my choices, I used a handy health insurance comparison tool. I decided to go with Zilveren Kruis (“Silver Cross”) after comparing costs and checking if my new coworkers had good experiences with them.
Everyone’s health is different, but I found it extremely helpful to find out what other expats were signed up for. In The Netherlands you can tag on additional “a la carte” coverage for things like physical therapy, chiropractitioners, and dental care. Here’s all the nitty gritty details of my plan– feel free to skip this section if you don’t find the numbers interesting!
All The Costs
I had the choice between a low deductible (€385) and a high deductible (€885) plan. I chose the high deductible, which I generally choose as a young, healthy person with no chronic conditions and a comfortable emergency fund. The high deductible gives a savings of €131 for 6 months, or €262 per year. I chose to stick with a Basic plan.
Even the basic plan covers quite a bit: 100% at all hospitals in The Netherlands, 100% of healthcare providers when contracted (most are covered by Zilveren Kruis anyway), otherwise 75%.
I also pay €7.50 extra for ZieZo World coverage, which covers 100% of emergency care abroad, which is a nice security while I travel.
Not included in the Basic Plan: contraception (€54 per year to add ), and dental (€128 per year to add). I went to a dentist for a cleaning and without any insurance and I was charged €80. Since the recommended cleaning is once every 6 months, it makes sense to tag on dental.
The cost for 6 months of coverage is shown to the right. My bill works out to be about €91 per month.
It is noteworthy that in most of the EU, folks purchase their health insurance individually and not through their company, which means my coverage will continue unaffected whether or not I lose or change jobs. My company provides a €125 stipend for healthcare, which is included in my paycheck. That is about the right amount for the average basic healthcare plan. Since what I need costs a bit less than that, I get to pocket the difference.
Healthcare Experience #1: The Infection
The first time I contacted my doctor (huisarts in Dutch), it was because I had a nasty spider bite on my shoulder blade. At least, I thought it was a spider bite. Upon some googling, it turned out that there are no poisonous spiders in The Netherlands, but this one was itching like crazy. A day later, a man tapped me on the shoulder (the other one) to tell me it looked like an infection he had when he was a kid. I figured it was time for a professional opinion.
When something similar happened to me a couple of years ago, I didn’t want to go to a doctor. I thought it was just a burn that wasn’t healing quite right, and I knew it would be a long process to get a referral for a dermatologist. Besides, the last time I went to the dermatologist to check out a spot, it cost me $200! After months of the burn slowly worsening, I finally self-diagnosed and treated without ever going to the doctor. It turned out okay, but seeing a professional earlier would have saved me quite a bit of aggravation and pain.
This time, I found out I could log into a portal and directly send my doctor a message. I sent a photo with a note, and within a day she agreed with my new infection hypothesis. She also verified which cream to use, adding: “Sometimes this just happens to people, its nothing to worry about.” I wasn’t worried, but the reassurance was nice anyway. The infection cleared up in less than a week. I know that services like this probably exist in the U.S., but I’ve never had access to them before so the convenience was like magic to me.
Healthcare Experience #2: No Flu Shot For You
After about half a year into living in The Netherlands, I called to make an appointment for a check-up. The front desk told me “we don’t do that here.” If nothing is wrong, you don’t go to the doctor. Fine, I thought. But while still on the phone I figured I’d try to get something else done, “How about a flu shot?”
“Are you over the age of 65?”
“Well do have any risk factors?”
“So why do you want to get the flu shot?”
“I don’t want to get the flu? In the States we get them yearly,” I tried to explain.
“Well if you want one, maybe you should go back to your own country.”
Allllriiight then. So no flu shot.
Luckily the Dutch system for getting vaccinated from COVID-19 was easier than getting a flu shot. For that, you received a letter in the mail, made an appointment online, and received a QR code after receiving your shot– which could be verified by airlines, restaurants, and other businesses via an app. Also, throughout the pandemic there has always been COVID self-tests right by the check-up at my grocery store for the low price of €2.99.
A common complaint of expats here is that the most frequent response to an issue is to prescribe Paracetamol (also known as acetaminophen/Tylenol). I’ve read horror stories about husbands collapsing from a heart attack after going to the doctor the previous day and being sent home with some paracetamol. My friend had a baby recently and recounted the Dutch default of natural birth– epidurals are discouraged.
Because of the lack of yearly check-ups, the Dutch system has been criticized for the lack of preventative care. On the other hand, I’ve also heard that once you actually run into true medical emergency, then the response is efficient and high quality. My next medical issue wasn’t an emergency, so I was curious what would happen next.
Healthcare Experience #3: The Red Spot
Four years ago, I wrote about My Terrible, Horrible, No Good, Very Bad Weeks when I started a new job. While cleaning, a router fell from the closet and bonked me right on the bridge of my nose. Over time, my nose stayed noticeably a bid ruddier, as if it didn’t heal properly. My parents begged me to see a doctor, but since it didn’t hurt, I didn’t see the value in it– I figured I’d get dismissed at the doctor. I just have to accept that’s just what my nose looks like now. Mechanic The Red-Nosed Engineer. See, I’ve embraced it.
However, in the last few weeks, three separate people commented, thinking I had gotten sunburned on my nose. I just said, “No, that’s just how my nose is.” If strangers are commenting, maybe it’s about time to get it checked out, just to be sure.
Like before, I sent over a description and a photo. On the same day, she responded that I should come to the clinic. Yes! I am psyched at this point, because I finally get to see what going to the doctor in The Netherlands is really like. Would I be dismissed as a scarlet-nosed hypochondriac or might they have an answer for my vermillion vexation?
Healthcare Abroad: I’m Going to the Clinic!
First off, my doctor– just like everything else I could possibly need (groceries, restaurants, pharmacies, gyms, etc. etc.)– is within walking distance. I love this about living in Europe. It takes me five minutes to cycle there, so I am fifteen minutes early and I park my bike outside. The doctors’ office itself isn’t within a massive hospital that I have to navigate like at home, it’s a one floor building sandwiched between a cheese shop and a hair salon. The person at the front desk instructs me to wait in the waiting room, which is identical to most waiting rooms in the U.S., a circle of dismal plastic chairs.
I don’t need to do give any insurance information, it’s already in the system.
The doctor calls me in fifteen minutes after my arranged time. So far, so much like doctor’s appointments at home. However, now that we’re one-on-one, I get all of her attention. I don’t feel rushed at all. She goes through her list of questions, and then she asks to look a bit closer. Then she shares her hypothesis based on some photos she shows me. She believes it’s a mild case of rosacea, a common skin condition. She shares some of the treatment options, along with the side effects. Then she adds, “Take some time to read up on it and let me know what you think.” At the end of the visit I don’t need to check out or pay anything. I just walk out when the visit is over.
The Follow Up
That evening I read up on the options, pick out a medication to try, and send a message asking for a prescription. She calls me back the next day to make sure I understand the side effects and to answer any follow-up questions, and we agree on a treatment plan. She writes me a prescription for the pharmacy (apotheek) that is just a five minute walk from my house.
Though people say preventative medicine isn’t a priority here (because of the lack of check-ups and frequent prescribing of rest and paracetamol) I’m starting to disagree. With the ease of contacting my doctor, I managed to get treatment for two separate issues. In the U.S. I ignored both issues, not wanting to deal with finding a new doctor, getting a referral, and then paying an unspecified amount of money. Lowering the barrier to getting problems addressed in the first place enables preventative care.
Healthcare Abroad Final Thoughts
I’ve only had a couple of brushes with the Dutch healthcare system, but so far so good. I may not be vaccinated against the flu, but I’m vaxxed and boosted for COVID-19. I may not get yearly check ups, but I do feel comfortable asking questions and getting answers quickly. I’m sure care varies widely depending on the office and doctor, just like anywhere, but I’m happy with mine.
Affordable healthcare is a major draw for living and retiring in Europe. The fact that healthcare isn’t tied to your job is a fantastic layer of security, and simplifies the selection of coverage. While I hope I don’t need to visit the doctor again for a while, I’m glad I got to try out going Dutch with my healthcare.
What About You
Have you ever been to the doctor in a foreign country?
What do you do when you have a non-urgent issue you want to check with a doctor?
What are your thoughts on healthcare?
Please share in the comments below!