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| Holland South Local Reference INFOrmation
Information on the Dutch national health care, with details on who benefits and where and how to register with the authorities and what contributions and benefits to expect.
The Netherlands is a full member of the European Union and forms part of the European Economic Area (EEA). All EU/EEA nationals working in the Netherlands have the same rights as Dutch nationals with regard to social security benefits. Their families and immediate dependants are entitled to join them and benefit from similar rights. For non-EU citizens the same benefits may not apply, and they are advised to take out private insurance. However, many countries, including the United States, have developed their own agreements with the Netherlands for the benefit of their nationals residing temporarily or permanently in the country. Other nationalities should check with their own benefit agency. The Social Security SystemThe public health and social security system in the Netherlands is comprehensive but expensive. The country has a high percentage of "economically inactive" citizens claiming one or more benefits. To further complicate matters, with effect from 1 January 2006 the Healthcare Insurance Act (Zorgverzekeringswet) came into force and the former two-tier public/private healthcare system has been replaced by a single system for everyone. Social security in the Netherlands falls into two categories: social welfare benefits (sociale voorzieningen) and social insurance benefits (sociale verzekeringen). There are also other benefits such as housing subsidies (not normally available to temporary residents) and educational funding which are not dealt with here.
Getting a BSN NumberThe BSN (Burgerservicenummer) number (formerly a SoFI–number) is a unique, personal number issued to everyone registered in the Gemeentelijke Basisadministratie persoonsgegevens (GBA), or the Personal Records Database of a municipality. It is required when starting a job, opening a bank account, using the health care system, applying for benefits, buying a car and announcing a change of address. Foreigners arriving in the Netherlands must register with the registration office (Dienst Burgerzaken) of the Gemeentelijke Basisadministratie persoonsgegevens (GBA). Within weeks, a new resident will receive a letter containing registration details and the BSN number.
Note: Foreign residents who have previously been issued with a SoFI number need not change this to the BSN number - this will have happened automatically. ContributionsFor employees (EU and non-EU nationals) it is their employer's responsibility to ensure that all the necessary formalities have been completed and that their staff are properly covered. The employer pays the majority of the contributions which are destined for the social insurance funds (to pay for unemployment or disability benefit) but the employee will also pay a proportion deducted directly from their salary. There is a maximum income level above which no contributions are levied and maximum amount which can be deducted – these amounts are adjusted each year. The tax office collects contributions for national insurance schemes and again the amount is income-driven with an upper limit. Self-employed people must obtain a declaration. Those who are already self-employed can get this declaration from their local tax office. If not they should visit their nearest tax office in Holland to obtain one. A separate declaration must be made for each type of business a person is involved in. The tax office will then set things up for the tax return (usually annual). There are tax-free allowances and various expenses which can be reclaimed. The tax office also set the level of National Insurance contributions. There are limited government schemes for the self-employed but on the whole a self-employed person must take responsibility for securing private health insurance (and insurance against disability). For example, there is little or no state help for self-employed women who want to take maternity leave. Benefits availableNot all the benefits which are currently paid in another EU state will continue under reciprocal arrangements. Anyone wishing to have these benefits paid while in the Netherlands should make their own enquiries well in advance of departure. EU and non-EU residents with children can apply for child benefit (Algemene Kinderbijslagwet – AKW) from the Dutch Social Insurance Information Centre (Sociale Verzekeringsbank – SVB). Qualification depends on the age and personal situation of each child and is not guaranteed. The SVB is also responsible for administering bereavement benefits (Algemene Nabestaandenwet – ANW) and carer's allowance (TOG). PensionAnyone wishing to have their pension paid in the Netherlands should visit the SVB. Anyone working or living in the Netherlands will accumulate some rights to the old age pension (Algemene Ouderdomswet - AOW) but the amount may be very small if limited time has been spent in the country. EEA regulations allow EU residents to combine contributions paid in two or more EEA countries in order to qualify for a state pension. Claiming and Payment of BenefitsWhen claiming any benefits the following will be needed:
Employees who need to claim due to incapacity or unemployment benefit must contact their employer's professional association who will make payment direct. In the event of illness employers are usually bound to pay 70 percent of wages for at least the first 12 months. The SVB will make payments of state pensions, family allowances and other benefits. Any Social Welfare benefits awarded are paid by the municipal authority in your area or in larger cities by a separate social services department. HealthcareThere have been a number of recent reforms to the Netherlands' healthcare system, and more may be on the way.
Non-residentsEU citizens who are not officially resident in the Netherlands must hold a European Health Insurance Card (EHIC) if they wish to obtain free urgent medical assistance in the Netherlands. Non-EU citizens will not normally be covered under any reciprocal scheme and should have their own international health insurance. ResidentsEU citizens with official residency status will almost certainly be required to obtain at least a basic level of health insurance from a private health insurance company. Insurers cannot refuse anyone basic cover regardless of age or medical history. It is possible that residency will be refused if there is not evidence of sufficient healthcare cover being in place. Non-EU citizens may do the same or continue to provide their own international health insurance but again this could change. The local health insurance office (zorgverzekeraar) will have the most up-to-date information. It will also provide information on local doctors (huisarts) and dentists (tandarts) and how to register with a practice. Depending on family situation and income some of the premium payable under the new arrangements may be refunded in the form of a health care allowance (zorgtoeslag) from the tax office. Again the local health insurance office can advise on the current income and benefit levels. As the name suggests, the basic cover which everyone must now have is just that. It covers general medical care, some dentistry and prescription medicine. Different types of policy exist. For example, in some cases the insurer organises and pays for all "reasonable" costs, while in others the individual arranges treatment and pays and is subsequently reimbursed by the insurer. It is wise to check with the insurer rather than assuming that something will be covered and they should always be notified of hospital admission (well in advance if possible). Employers should advise on any additional income-related contribution which they are obliged to deduct and pay this direct to the tax office. They may give advice on the different providers for healthcare insurance (some employers will already have negotiated discounts for their staff with particular providers) but will almost certainly leave it to the individual employee to arrange cover. Supplementary insurance (aanvullende verzekering) can be used to cover elective treatments including dentistry and physiotherapy. Dental treatment in particular is costly – basic insurance is unlikely to cover adults for check ups, extractions or x-rays. Alternative therapies are very popular in the Netherlands and some insurers will also cover these treatments under supplementary policies.
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