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Healthcare

Everybody who is legally resident in the Netherlands, is obliged to pay for an mandatory Health Insurance for basic health care. It is possible to extend the coverage of the insurance, dependent on the insurance company.

People without residence permit normally have no right to this Health Insurance. They nevertheless have the right to treatment. A doctor is not allowed to distinguish his care according to the residence permit of his patient.

  • People who come to the Netherlands on a touristvisa, need to have a health insurance, this is called: Schengen Visum Insurance.
  • For people who travel to the Netherlands with MVV (visum for long therm stay) because they are entitled to a residence permit in the NL, OOM 1 provides travel insurance. Some undocumented migrants are able to constantly renew their travel health insurance. Be aware, this only covers new health issues, not existing needs.
  • People who had a residence permit, and are involved in proceedings to change their permit, have a duty to keep their health insurance untill the decision of the complaint authority (‘bezwaar’).2
  • People who have a residence permit in another EU country can use the EHIC-card3 as insurance in the Netherlands.
  • People who apply for a residence permit as family member of EU- citizen or as parent of an NL child have a duty to register for health insurance during the procedure. 4
  • People who are waiting for an answer on their asylum request do have a health insurance from COA, the shelter organisation for asylumseekers. 5 People who are involved in legal proceedings to obtain a regular residence permit as victim of human traficking, family member of a refugee or as a minor child with parents without income, are entitled to Rvb (see also above under Financial Assistance).6 This is an allowance issued by the COA, combined with health insurance. The allowance should be applied for within 2 weeks after the right has arisen
If you don’t have a residence permit and you are not lawfully resident, you don’t have right to the Dutch mandatory health insurance.1 However, even an undocumented migrant who has no health insurance has a right to ‘medically necessary health care’, which is operationalized as ‘appropriate and reasonable care’2, which is all the care that is necessary to keep a person in good health. A practitioner cannot refuse a patiënt only because of his residence status. If the patiënt cannot pay for him or herself, in most cases, the health care can be reimbursed by Het CAK, see here. This is valid for all care that is included in the basic health care insurance. 3  Het CAK offers reimbursement to all General Practitioners and midwifes, and to registered pharmacies, hospitals, psychologists and other healthcare providers – check on the CAK website for the list. In case of maternity care and in case of urgency, any hospital can be reimbursed. 4 If a health care provider is not yet registered, the institute can always ask for registration at CAK. Note: sometimes it is difficult to convince a doctor that he/she can offer health care. Or it might be difficult to convince the people on the admission desk of the hospital to let you in. In these cases, you might call a local support organisation (see the list here) or Dokters van de Wereld to help you. In Rotterdam, make sure that you first get an Erasmuspassport from Stichting ROS or Pauluskerk.

In acute situations, such as an accident or life threatening situation:

Call 112 for an ambulance (toll free) or go to the emergency room of the nearest hospital.
For urgent issues call your doctor during the day. Tell at the phone it’s urgent. Evenings or weekends call the Centrale Huisartsenpost. It is important that you are familiar with a doctor in your neighbourhood and your family are registered with a doctor practice. The cost depends on the care needed. If you can not pay, the doctor will be reimbursed by Het CAK (see under Health Care for Undocumented Migrants).

Medical support during pregnancy The midwife supports pregnant women as of three months’ pregnancy. You are free in your choice of midwife. The midwife checks the progression of the pregnancy and the health of mother and child. If you cannot pay the midwife, he or she can claim the expenses from Het CAK. In the Netherlands, in principle the child is delivered at home. If your home situation is not safe, and you prefer to deliver your child in a hospital, ask advice from the midwife. Only if the midwife has indicated that there are medical reasons why the child cannot be delivered at home hospital care can be reimbursed by Het CAK. In that case, you can go to any hospital nearby. When pregnancy is unwanted, you can get an abortion from a specialized clinic.1  Abortion has to be paid by the mother. Up to nine weeks pregnancy abortion pills are an alternative option for free.2 Note 1: pregnant women cannot travel by plane if the delivery is due within 6 weeks, untill 6 weeks after delivery. During this period, the mother has a right to ‘postponement of departure’ (article 64) and shelter in an Asylum Centre. As long as deportation is impossible, the mother can stay there with her child. See: Shelter for migrants with medical problems in an Asylum Seekers’ Centre (AZC) and: Shelter in Family Locations. Note 2: you need to obtain a birth certificate for your child and, if applicable, acknowledgement by the father. Registration of birth has to be done by a person with legal residence who was present at the delivery. This can also be the midwife. See: family law. Maternity care Maternity care [kraamzorg] helps the mother during the first days after the delivery. If you cannot pay for maternity care, the medical part of this care can be claimed from Het CAK (see Health Care). Ask the midwife at which maternity care institution you can best be registered. Infant care The infant welfare centre (consultatiebureau) vaccinates children up to the age of four years and checks their development. Ask the midwife for help with registration at the infant welfare centre. The infant welfare centre has a duty of confidentiality and will not pass on addresses to other institutions Vaccinations and check-ups by the infant welfare centre are free of charge. After registration a nurse of the GGD will come round for a heel prick (PKU test). Once the child has become 4 years of age the GGD become responsible for the vaccinations.
If you need care, you normally first consult a General Practitioner. Try to find a GP in your neighbourhood, or ask a friend for recommendations.1   If you find it difficult to contact the GP yourself, you may ask support from a support organisation for undocumented migrants in your city. The doctor might ask your home address to be able to visit you in case you need help and are unable to go to the GP yourself. This information is strictly confidential and may not be given to any other parties, except other doctors. If you have no home address, it is always best to tell the doctor this.

Most dental care for adults is not included in the Basic Health care system and therefore cannot be reimbursed by Het CAK. Only for children up to and including 18 years of age the dentist can claim part of his expenses from Het CAK (see Accessing Health Care). For adults only chirurgical care and false teeth can be reimbursed.

If the general practitioner has given you a prescription for the pharmacy, you can collect your medication there. If you are not able to pay, you can go to the pharmacy that is contracted by Het CAK (see Health Care for Undocumented Migrants). 1  You will have to pay 5,- per prescription. If you cannot pay this amount, contact the support organisation in your city. In some cities there are arrangements to help you with your contribution.
Hospital care is available if the general practitioner has referred you. If you do cannot pay the hospital, you should choose the hospital from the list of hospitals that are in partnership with Het CAK (see Health Care for Undocumented Migrants).1 Please note: for emergency care and maternal care, you don’t have to choose a hospital from the CAK list, any hospital can ask for reimbursement of the bills.
If you suffer from psychological problems, for example severe anxiety or depression, you can be helped by a psychologist or a psychiatrist. For this help you do need a referral note from the general practitioner. If you do cannot pay, the psychologist or psychiatrist can draw up a contract with Het CAK (see Health Care for Undocumented Migrants) to claim these expenses.1
Home care Home care is care by an ambulant nurse, for instance to get up or get showered. If this care is given ‘in a medical context’, it falls under the basic health insurance. If you cannot pay, this care can be reimbursed by Het CAK (see Health Care for Undocumented Migrants).1 However, home care for handicapped patients that is not health-related cannot be reimbursed by Het CAK. Long term care If Long Term Care is considered medically necessary, and if an institute is willing to offer this care to an undocumented patient, the institute can be reimbursed by Het CAK (see Health Care for Undocumented Migrants).2 This is for instance valid for care for visually impaired, nursing homes, and psychiatric hospitals. Care for handicapped To find the best suitable care for handicapped people, you can contact the client support organisation MEE.3 Also for undocumented migrants.

Care for infectious disease like TBC, HIV or a sexually transmitted disease?

The municipal health authorities (GGD) have special surgery hours for special diseases. These surgery hours can be visited free of charge. This applies to the following diseases: tuberculosis, HIV, STDs.

Note: if Tuberculosis is detected, you are entitled to stay in an Asylum Shelter during the treatment because you are not allowed to travel. See under Shelter for Migrants with Medical problems.