Expat Living: Dutch healthcare insurance
Imagine you’re a new pilot who has trained on simulators but this is your first time 35,000 feet up. You’re pretty sure you know what you need to know, but there’s a constant possibility that you’re missing some tiny yet crucial detail that might result in disaster. At best, that’s a bit what being an immigrant is like.
Oh, and the manuals are all in a foreign language. Maybe you thought you spoke it, but then the official letters arrived. And if you’re lucky, the rest of the crew isn’t prejudiced against you, and the air traffic controller doesn’t say you’re a (censored). An unknown yet massive number of little differences might trip you up, but every day you wake to (hopefully) know that you are where you want to be. Just don’t screw anything up, because you also don’t really know the consequences.
Luckily, the internet is full of guides for every question. Confusing, contradictory, semi-applicable, undated and perhaps inaccurate guides. A bunch of them said I needed to get Dutch health insurance, right, but nobody mentioned how. I was annoyed by that, right up until I found out why.
The guides skip it because it’s incredibly easy.
The Dutch government sets a minimum coverage level everyone has to have, then sets the price insurers can charge for it. They have to accept everyone who applies. No hidden exclusions or tricky clauses in the illegible fine print, and “pre-existing condition” is not in the Dutch lexicon. If you want additional coverage there’s a normal market for that, but perhaps because the starting level is flat for everyone, there is a lot more competition by providers for the additional packages, resulting in drastically more options for customers than I ever saw in the US.
I kept waiting for someone to tell me nevermind, government is as bad as people love to say it is, even here, but nope, that’s the deal. Institutional protection and rationality for the shared good.
My deductible in the US was $5000, plus an additional $2000 of “100% coinsurance.” Here it’s 385 euros. I don’t mind the 95% reduction. My monthly premium, the monthly premium, is about 130 euro. I added dental insurance for less than 10 euro/month, and coverage outside Europe for one and a half euros per month. Yep, a buck fifty expands my coverage worldwide.
Your doctor has to be in your area, so I found one nearby taking new patients and walked over. It’s not a big fancy building that needs to be paid for with high premiums and denied claims because they’re not competing for attention, they’re providing a service. It’s a normal house on the block. The Dutch word for a General Practitioner means “house doctor” because that’s where they work. A house. Not missing an atrium, I gave them my ID. My insurance info was automatically linked in their system and I’m good to go.
The system is of course subsidized by taxes, and my Danish friend thinks it’s preposterous that we have to pay anything at all, but as I walked home under trees just starting to sprout, past smiling cyclists and carefully tended flower beds, something occurred to me.
I cannot wait to pay my taxes this year. This is a system I am delighted to support.
PS. I put “expat” in the title so more people would read this, and I’m not proud of it. What is an “expat”? Is it a “white” or wealthier immigrant, so therefore somehow different? More desirable? To me, the only reason to say “expat” instead of “immigrant” is to acknowledge that the decision to move was 100% voluntary, not compelled by economic necessity, violence, or persecution of any kind. Therefore it is a term of humility and gratitude, not pride, and certainly not superiority. Terms like immigrant, emigrant, expat, and asylee are too important to use without examination of what they mean.
