Which healthcare costs are reimbursed?

• Medically necessary care is reimbursed under your basic healthcare insurance policy. This includes GP and hospital visits, medication and patient transport. The Dutch government decides what is covered by basic healthcare insurance.
• NB: sometimes you need a referral from a care provider or permission from ZEM. If you do not have this, the costs will not be reimbursed. In the Netherlands, you cannot see a medical specialist at the hospital without a referral from your GP.
• In many cases, the contracted care provider claims the healthcare costs directly from ZEM. If you have received an invoice for healthcare costs, you can claim these costs through your employer.

Why are some healthcare costs not reimbursed or only reimbursed in part?

• If you choose a care provider with whom ZEM does not have a contract, you may have to pay part of the costs yourself. Visit the Care finder to see which care providers ZEM has a contract with. This website also provides more information about how to find care providers and what it means if a care provider does not have a contract with ZEM.
• For some healthcare costs, the Dutch government has determined a personal contribution. Among other things, the personal contribution applies to maternity care, certain medication and care aids. You must pay the personal contribution yourself.

Reimbursements highlighted

For you convenience, we will discuss several reimbursements in some more detail:

General practitioner care

Pharmaceutical care

Specialist medical care

Patient transport

Policy conditions

• View policy conditions in English, Polish and Romanian

Read more

• I need care
• GP in the Netherlands
• Pregnancy and childbirth