Can I go to the Hospital?
In the Netherlands, if you have health complaints you first need to go to a General Practitioner (GP) first (Dutch: “huisarts”). The GP can do a lot for you. However, if you need a specialist the GP must refer you to a hospital. If you do not have health insurance, to avoid high costs the hospital must have a contract with CAK (Centraal Administratie Kantoor). You can find the hospital list on the CAK website.
Near Wageningen, there are two CAK associated hospitals: Ziekenhuis Gelderse Vallei in Ede and Ziekenhuis Rijnstate in Arnhem. However, if you need treatment that is not offered there, your GP must choose another hospital that is on the CAK list. This could be, for example, the Diakonessenhuis at Utrecht or the Radboud UMC at Nijmegen. When you go to the hospital for the first time, Vluchteling Onder Dak (VOD) will provide a letter that is needed by the hospital. Therefore, before you visit a hospital, first visit Vluchteling Onder Dak (VOD).
Hospitals contracted by CAK can get (part of) your treatment costs refunded by CAK. However, they still have to send you a bill and a formal reminder. However if you do not have insurance, you do not have to pay these costs. If you are uncertain about this, ask VOD for help during the process.
In case of accidents or life-threatening situations, there is no time to go to the GP or VOD. Only in this case, you can go straight to the hospital.
Emergency number: 112 (free call)
In case of serious complaints at night or during the weekend:
Huisartsenpost Gelderse Vallei
Tel 0318-20 08 00
Willy Brandtlaan 10, Ede.
Do I have to pay for medical care?
Tell them that your treatment is covered by the CAK scheme for “onverzekerbare vreemdelingen” (uninsured immigrant or stranger)
People without a valid residence permit cannot get a health insurance. But by Dutch law everyone who is located in The Netherlands has the right to necessary medical care, even if you are unable to pay. The healthcare provider can request a contribution from CAK for uninsured patients, provided that the care is included in the basic package of the Health Insurance Act.
- The GP can recover 80% of the non-collectable costs.
- Midwives can get all costs reimbursed
- Pharmacies and Hospitals can only recover the costs if they have a contract with CAK.
- Dentists can recover the costs for children under the age of eighteen and for care included in the basic package of the Health Insurance Act.
Hospitals in the Netherlands are not always aware of the partnership with the CAK. You can find them on the website: Het CAK
Here, one can find information about CAK for all types of care providers, together with the claim forms.
Can I go to the General Practitioner (Huisarts)?
Every GP has a duty of care. They can’t refuse to support people just because they are without residence permit or insurance. All GPs can get 80% of the non-collectable costs of uninsured patients reimbursed from CAK. For quick one-time help, you can go to any GP in Wageningen. You will have to pay a passer-by fee. However, to become a long-term patient, one needs to register at the General Practice. In Wageningen, there is a group of GPs that accept uninsured patients. Most GPs in Wageningen are familiar with the scheme for uninsurable patients.
Where can I get medicines?
Medication from the pharmacy (apotheek) is only available with a prescription from GP (Huisarts). The pharmacy must have a contract with CAK as mentioned above. The CAK website shows which pharmacies are connected to CAK.
In Wageningen the Alphega Apotheek Churchill has a contract with CAK. If you have a prescription from a GP or a specialist from a hospital, you only need to mention at Apotheek that you are uninsured. The pharmacist will ask you about your nationality. Then, you only pay a personal contribution per medicine. These costs can be reimbursed to you by VOD. This reduction of costs only applies for medicines included in the basic package of the Health Insurance Act. Self-medication such as paracetamol and vitamins are usually not covered.
Alphega Apotheek Churchill
Tel 0317 – 423723
Can I get mental health care?
You can ask your General Practitioner (GP) for an appointment with the MHC nurse, in Dutch: Praktijkondersteuner (POH). He or she can examine in a few conversations what MHC you need and make a referral.
You can receive psychological care at institutions that are connected to the CAK via a referral from your GP.
In the Wageningen region these are:
Please note: the waiting times for treatment are very long.
Can I go to the dentist?
Dentists can get 80% of their costs reimbursed from CAK for children under the age of 18. Before you make an appointment, tell the dentist reception empoyee that your child falls under the CAK’s scheme for uninsurable people. It is difficult for adults to find a dentist. In case of an emergency, you can ask Vluchteling Onder DAK (VOD) to make an appointment with the dentists crisis service.
There are costs involved. In case of acute pain complaints, VOD can also make an appointment for you at the dentistry department of the Radboud University Medical Center in Nijmegen. Patients from the province of Gelderland with acute complaints can be treated for a small fee, but you do need a special referral from a GP.
The Radboud University Medical Center will only treat you if you have made an appointment via Vluchteling Onder Dak (VOD).
Infectious diseases – TB, STDs, or HIV
GGD Gelderland-Midden has a special consultation hour for HIV infection and STDs (sexually transmitted diseases). You can be tested for HIV and STDs. However, that is only possible if you fall under a risk group determined by the government. The telephone employee will first ask you a few questions to assess whether you are eligible for a test at the GGD. The GGD does not need information from your general practitioner or your insurance company. You can also have an STD treated at the GGD, but for HIV infection you cannot be treated there.
088 – 3556600 (Monday to Friday from 10 a.m. to 12:30 p.m.)
I am pregnant. Where can I get medical care?
Starting at eight weeks of pregnancy an obstetrician (midwife) guides pregnant women. She checks whether the pregnancy is going well and whether the mother and child are healthy. If you cannot pay because you do not have insurance, she can declare the costs to CAK. In Wageningen, you will find midwives at the midwifery practice, called the Bakermat.
Tel 0317 – 411971
In principle, giving birth in the Netherlands takes place at home. If you would like to give birth in the hospital, you usually have to pay for it yourself. The hospital can only declare the costs to CAK if the obstetrician says that you have medical reasons to give birth in the hospital rather than at home. You do not have to choose a hospital that has a contract with CAK, because every hospital can declare the costs for a birth.
Maternity care helps mothers the first days after giving birth. If you are unable to pay for maternity care, this can also be reimbursed by CAK. You can ask the midwife with which maternity care agency is best for you to register.
The Consultation Office (Consultatieburea) gives children up to four years of age vaccinations and monitors their development. It also provides advice on the baby’s food and drinks, care, and upbringing. Care given by the Consultation Office is free, also for undocumented migrants who do not have health insurance.
Inquiry-line Youth Health Care GGD 0-4 years: 088-3556850
Walk-in consultation hours: Monday 13.00-14.00 and Thursday 13.00-14.00
I have an unwanted pregnancy. What can I do?
If you became pregnant unintentionally, you have to make important decisions in a short time. There are specialized organizations that provide personal advice about your situation. You can ask VOD which options are available for you.
In case of unwanted pregnancy, abortion is possible up to twelve weeks gestation. Always consult a doctor first. The costs of abortion are not reimbursed. You can ask VOD which options are available for you.
Are you unsure about what to do? The GGD can support you in making a decision. You can reach the Sexual Health Department on workdays between 09.00 and 11.30 hrs. at 088 – 144 71 20. Or send an email to: firstname.lastname@example.org
Where can I get contraceptives?
For contraceptives, you can go to your GP. If you do not have a general practitioner or if you prefer to go to another place for contraception, you can also go to the midwifery clinic The Bakermat in Wageningen.
Tel 0317 – 411971
I still have an old health insurance pass. Can I use that?
No. If you still have an old pass from COA, it is better not to use it if it is no longer valid. If you do use it, the care provider may think that you are insured. But later on they will discover that you’re not. You will then receive an invoice that you must pay. If the care provider does not have a contract with CAK, they will continue to send you invoices and reminders and you may get fined.
Therefore, it is important to communicate clearly about your uninsured situation, and to check whether the healthcare provider is aware of the scheme for uninsured patients.
I have received a medical invoice that I cannot pay, what to do?
When you tell the medical provider in advance that you are uninsured and without residence permit, they can assist you better. Sometimes the provider will still send you an invoice and one or two reminders. Always call them or send a message and explain again that you cannot pay and that you are uninsured. Save the message and you can always ask VOD for help.