If you’re new to the Netherlands, you may have heard the term “eigen risico” thrown around when it comes to healthcare costs. But what exactly is eigen risico, and how does it affect you as a resident or visitor in the Netherlands? In this comprehensive guide, we’ll break down everything you need to know about eigen risico and how it works in the Dutch healthcare system.
What is Eigen Risico?
Eigen risico, or “own risk,” is a set amount of money that you are required to pay out-of-pocket for certain healthcare expenses each year. This amount is determined by the Dutch government and is currently set at €385 per year (2022).
Eigen risico applies to a wide range of healthcare expenses, including:
- Most medical treatments and procedures
- Medications prescribed by a doctor or specialist
- Hospital stays
- Mental health care
- Home nursing care
There are a few exceptions to the eigen risico rule. For example, certain preventive healthcare services, such as flu shots and cancer screenings, are not subject to eigen risico. Additionally, some medical treatments and procedures that are deemed “necessary and urgent” are also exempt from eigen risico. These exceptions are determined by the Dutch government and may change from year to year.
How Does Eigen Risico Work?
When you receive medical treatment or a prescription in the Netherlands, you will typically be required to pay your eigen risico amount upfront. This means that you will need to pay the first €385 of your healthcare expenses out-of-pocket each year. Once you reach this limit, your healthcare provider or insurer will cover the rest of the costs for the remainder of the year.
It’s important to note that eigen risico is not a deductible or copayment in the traditional sense. Instead, it is a separate amount that you are required to pay before your insurance coverage kicks in. This means that if you have a high deductible health plan, you will still need to pay your eigen risico amount in addition to your deductible before your insurance will cover the rest of your healthcare expenses.
Who Pays Eigen Risico?
In the Netherlands, eigen risico is mandatory for everyone who has Dutch health insurance. This includes Dutch citizens, residents, and expats living in the Netherlands. Visitors to the Netherlands who do not have Dutch health insurance may also be required to pay eigen risico if they receive medical treatment or a prescription while in the country.
It’s important to note that eigen risico does not apply to all forms of health insurance. For example, some international insurance plans or travel insurance policies may not cover eigen risico or may have different rules for paying out-of-pocket healthcare expenses in the Netherlands. If you have a non-Dutch insurance plan, it’s important to understand how it works in relation to eigen risico and to be prepared to pay any necessary out-of-pocket costs upfront.