Published August 2026
The Dutch system is generous on paper and slow in practice. Basic health insurance covers mental health care, the GGZ, for every adult. To use it you need a referral, a diagnosis and patience. Many expats find out the hard way that their problem is not covered. Or that the wait is longer than the problem can bear.
This post explains the insured route step by step, with the 2026 numbers, then the routes around it. It pairs with my post on the GGZ waiting list, which goes deeper on what you can do while you wait. Here I want to give you the whole map.
How the insured route works
Everything starts with your huisarts. Many practices have a POH-GGZ, a mental health nurse. They can see you for a few sessions with no deductible. If you need more, the huisarts refers you to the GGZ. A bedrijfsarts or a medical specialist can refer too. Without a referral, basic insurance pays nothing.
The referral has to name a suspected DSM-5 disorder. This is the part that catches people. Work stress, burnout, an adjustment disorder, grief, relationship problems, a life phase that feels wrong: none of these are covered by basic insurance. Depression, anxiety disorders, PTSD and similar diagnoses are. Your intake decides which side of that line you are on.
Once you are in, care is split in two. Basis GGZ is short treatment for milder problems. Gespecialiseerde GGZ is for heavier or longer ones. The basis track is usually capped, often at around twelve sessions.
What you pay: the eigen risico
Adults pay the eigen risico, the yearly deductible, before insurance pays for GGZ. In 2026 it is 385 euros, unless you chose a higher voluntary one. The deductible resets each January, so treatment that crosses the year end costs it twice. Under 18s pay nothing; their care runs through the municipality. After the deductible, contracted care is fully covered. If your therapist has no contract with your insurer, you get back less. Somewhere between half and three quarters of the official rate, depending on your policy. The rest is yours.
The wait: the 14-week norm and the real numbers
The agreed maximum, the Treeknorm, is four weeks to an intake and ten more to the start of treatment. Fourteen in all. The real figures are worse. In October 2024 there were about 109,000 places on GGZ waiting lists. In more than half of them, the total wait was already past fourteen weeks. A new dashboard built from claims data was published in July 2026. It found that just over half of people start treatment within the fourteen weeks. About four in five start within six months. In March 2026 a petition against the waits reached parliament with more than 40,000 signatures.
Language sits on top of that. An English-speaking GZ-psycholoog with a contract and an open slot is the narrowest gate of all. Your insurer's wachtlijstbemiddeling can help you find a shorter list, and it is worth using. I cover that in the GGZ waiting list post.
Not sure whether the GGZ route or private therapy fits?
A 15-minute call costs nothing. I will tell you plainly which route makes sense, including when the insured one is the better answer.
A brief conversation to see if this feels like the right fit for you. Not therapy.
Private therapy outside the insurance
The other route is care that insurance does not touch. A registered GZ-psycholoog can see you for uninsured care under an NZa rate, 36.50 euros per fifteen minutes in 2026. That is roughly 110 euros for a 45-minute session and 146 for an hour. No referral, no diagnosis, no deductible, nothing in your insurer's file. Coaches and unregistered therapists set their own fees and vary widely. Check the registration before you pay anyone.
What you buy is speed and choice. A start in days rather than months, a therapist who works in English, and no argument with an insurer about whether your problem counts.
When you should stay in the system
If you need medication, your huisarts or a psychiater is the route. If you need a formal diagnosis, for work, for the UWV or for anything official, you need a BIG-registered clinician inside the system. If your problem fits a covered diagnosis and you can wait, the insured route costs you only the deductible. That is a good deal. Put your name on a list, use the wachtlijstbemiddeling, and decide what to do in the meantime.
How I fit, and where I do not
I am a US-trained therapist working online in English with people across the Netherlands and beyond. I am a private option. I am not BIG-registered, so my sessions are not covered by Dutch basic insurance, and I do not prescribe or diagnose. What I offer is a start within days, sessions in English, and open-ended depth work with no session cap. Fees are on the fees page. If coverage is essential, an English-speaking GZ-psycholoog with a contract is the better answer, and I will say so on the call.
There is more on the Netherlands page and the Amsterdam page, and on how online therapy compares to meeting in person.
Common questions about therapy in the Netherlands
I work online, in English, with clients across the Netherlands and beyond. I offer individual therapy and couples therapy via secure video call, with no referral and no waiting list. I built the practice as an expat therapist, for people in exactly this position. Before your first session, we have a free 15-minute call to see if this feels like the right fit. If you are weighing this in more than one country, I keep a country-by-country reference on how expat mental healthcare works.
What Clients Say
“I came in thinking I knew what my issues were. I’d been over them a hundred times. But those were just the things I could already see. Aaron helped me notice what I couldn’t, and that’s where everything actually started to change.”
- M.J.
“I’d been in and out of therapy for years. Different therapists, different approaches, none of it really stuck. Aaron helped me understand more in a few months than all of them combined. And he talked to me like a normal person, not like all this weird therapy-speak.”
- S.A.
“A few years ago I suddenly developed prolonged panic attacks but couldn’t begin to understand what had caused them. Having been in therapy in the past, and being a counseling intern student, I felt I had exhausted my resources trying to figure out “What is wrong with me?” I can honestly say Aaron provides a form of counseling that is difficult to find anywhere else regarding efficacy. Not only has his approach been effective, but he also has provided me a safe space to explore aspects about myself I may not otherwise have felt able to. I cannot recommend him enough as he has helped me feel more myself than ever before.”
- K.R.