Finance

While I believe that the Dutch health care system is pretty good (inflexibility aside) the financial side is complicated, at least for me. I have given a short summary of how it is organised for the general practitioner (GP) below in relationship to the billing.

The prices for consultation either by phone or in person are determined by the government, specifically the NZA (Nederlandse Zorg Autoriteit, or the authority for the Dutch health care). These are determined yearly, are non negotiable and apply to all medical practioners.

All Dutch citizens are obliged by law to have a medical insurance. All the consultations done in the GP office are billed directly to the insurance company. A quarterly amount is also billed per person regardless of how often they need a doctor. Certain modules that we have contracted are included in this quarterly amount such as diabetic care. This is billed to all patients regardless of whether they actually are diabetic. The principle of solidarity is behind this arrangement. This can be very strange for people from abroad. (Option 1)

Most expats do not have a Dutch insurance and patients will get an invoice at their house address for rendered services. After paying they are then able to get this amount reimbursed from their own insurance. There is no quarterly billing. (Option 2)

If you look at a whole year both options add up to roughly the same amount. This is because even though it looks like option 1 generates more income to the GP, the consultation prices are much lower. A consultation of < 20 minutes is €9,04 versus €27,19 for option 2 (2015).

While in the past both options were possible for our expats (option 1 was billed to them at their house address) we changed our declaration services in November 2015. From now on all patients who do not have a Dutch insurance will be billed according to option 2.

I hope that this gives a good enough explanation. If there are questions in this regard please feel free to contact us.

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Huisartspraktijk Smit

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