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Online therapy and English-speaking mental health support in the Netherlands

How to choose between online platforms, Dutch GGZ and private therapists, and what your insurance actually pays

Last updated: April 16, 2026✓ Verified April 2026

The Dutch mental health system is structured, subsidised and gatekeeper-driven, which is very different from what many expats expect. Access to covered therapy flows through your GP, a practice mental health worker (POH-GGZ) and then into the GGZ (geestelijke gezondheidszorg) framework. Online therapy exists within this system and outside it, and the reimbursement rules differ sharply depending on which route you take. For broader context on the Dutch health system, see our Dutch healthcare in practice guide and our health insurance guide.

This guide explains how the Dutch mental health system is organised, what your basisverzekering covers, how online platforms fit in, and which route makes most sense for your situation as an expat. It pairs with our expat mental health and wellness guide for broader culture shock and wellbeing support, and our wellness routines guide for day-to-day habits.

€385

Mandatory eigen risico (2026)

60-80%

Typical reimbursement for non-contracted GGZ

~5 sessions

Typical POH-GGZ short series (no deductible)

Table of contents

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How Dutch mental health care is organised

GP as gatekeeper and POH-GGZ

The Netherlands uses a gatekeeper system where general practitioners (huisartsen) control access to specialised care. For most mental health issues, your first step is your GP. Many GP practices employ a POH-GGZ (praktijkondersteuner huisarts GGZ, a practice mental health worker) who provides short-term counselling and triage in-house. You do not need a separate referral to see the POH-GGZ at your own practice; your GP arranges this internally.

What the POH-GGZ can do

  • Clarify your situation and available options
  • Offer a short series of sessions, often around 5 sessions of 45 minutes
  • Decide with your GP whether you need referral to BGGZ or SGGZ
  • GP and POH-GGZ care is reimbursed from the basic insurance without counting towards your eigen risico deductible

Basic vs specialised mental health care

Once you move beyond the GP or POH-GGZ, Dutch mental health care splits into two tiers, both covered by the basisverzekering with a GP referral:

BGGZ (generalistische basis GGZ)

Short- to medium-term treatment for mild to moderate issues: anxiety, depression, trauma, burnout. This is the most common entry point for expats with diagnosable but not severe conditions.

Mild to moderate conditions

SGGZ (specialistische GGZ)

Specialised, longer-term care for complex or severe conditions: personality disorders, chronic trauma, severe depression, eating disorders. Requires specific indication and specialist referral.

Complex or severe conditions

Important for expats: Both BGGZ and SGGZ are covered by the basic health insurance package, but you need a GP referral and a recognised provider. Sessions count towards your annual €385 eigen risico (2026) once you exceed the GP/POH-GGZ level. For full details on how the Dutch GP and referral system works, see our Dutch healthcare in practice guide.

What your Dutch health insurance covers

Basic coverage for mental health

The basisverzekering (basic insurance) is compulsory for residents and covers mental health treatment in BGGZ and SGGZ for adults, plus stays of up to three years in a mental health institution. Treatment must be provided by a recognised mental health professional and usually requires a GP referral. Without a referral, insurers will generally not reimburse.

Eigen risico (deductible) explained

Adults aged 18 and over have a mandatory annual deductible (eigen risico) of €385 on the basic package in 2026. This means you pay the first €385 of most basic-package care yourself each calendar year. After the deductible is used up, the insurer pays, subject to policy conditions.

Type of careCovered by basic insurance?Counts towards eigen risico?
GP consultationYesNo
POH-GGZ sessions (at your GP practice)YesNo
BGGZ (contracted provider, with referral)YesYes (€385/year)
SGGZ (contracted provider, with referral)YesYes (€385/year)
Non-contracted GGZ providerPartial (60-80% of contracted rate)Yes
Private/uncontracted therapist (no GGZ framework)Usually noN/A
International online platforms (e.g. BetterHelp)Usually noN/A

Contracted vs non-contracted providers

Dutch insurers distinguish between contracted providers (zorg in natura, where the insurer pays the provider directly at near-full tariff) and non-contracted providers (where you pay the invoice yourself and claim back only a percentage). For non-contracted GGZ providers, insurers may reimburse 60-80% of their own negotiated rate, which is itself often lower than the official NZa tariff. In practice, one typical example shows that "80% of contracted rate" can translate to around 68% of the official tariff, leaving roughly a third of costs at your own expense, on top of your deductible.

Before starting therapy, always check two things: whether the provider is contracted with your specific insurer, and how your policy type (restitutie, combinatie or natura) handles non-contracted GGZ. Your insurer is legally required to tell you. See our health insurance guide for an explanation of policy types.

Compare health insurance plans with GGZ coverage

Not all basic policies handle GGZ the same way. Restitutie policies generally offer better non-contracted reimbursement than natura policies. Compare plans to find one that suits your mental health needs.

Affiliate links. No extra cost to you. See our health insurance guide for a full breakdown of policy types and GGZ coverage.

Online platforms vs Dutch GGZ vs private therapists

A. International online therapy platforms

Platforms such as BetterHelp and similar services operate outside the Dutch insurance system. They typically match you with therapists online and charge a subscription or per-session fee. Some information from these platforms suggests partial reimbursement may be possible if your insurer accepts invoices from recognised providers, but this depends entirely on your policy and the individual therapist's credentials. Dutch insurers primarily reimburse care delivered within the Dutch GGZ framework, which most international platforms do not formally belong to.

In practice, most expats using global platforms in the Netherlands treat them as out-of-pocket options and do not rely on Dutch insurance to cover them. The main appeal is speed of access, continuity across borders and the ability to choose a therapist from your home country or language.

B. Dutch GGZ providers offering online therapy

Many Dutch GGZ providers now offer video-based treatment (e-health) that is fully integrated into the insurance system. If the provider is a recognised BGGZ or SGGZ practice and you have a GP referral, online sessions are reimbursed under the same rules as in-person therapy. You still pay your eigen risico, and reimbursement percentages depend on whether the provider is contracted with your insurer.

English-speaking GGZ practices that work largely online and with internationals often advertise explicitly as such. Search for "expat psychologist Netherlands" or "English-speaking GGZ" to find these providers. Coverage varies per insurer, so always confirm before booking.

C. Private English-speaking therapists and online psychologists

There is a substantial ecosystem of private, English-speaking therapists offering online and hybrid therapy to expats across the Netherlands. They fall into two categories with very different reimbursement outcomes:

BIG-registered psychologists and psychotherapists

Eligible for reimbursement if they work under GGZ contracts and with proper GP referrals. Check the BIG-register (bigregister.nl) to verify registration status. Directories such as TherapyCounselling.nl and dedicated expat psychologist platforms list multilingual options across the country.

Potentially covered with referral + contracted provider

Coaches and uncontracted therapists

Sessions typically fall outside the basic insurance and may only be partially covered by supplementary packages (aanvullende verzekering), if at all. Many offer faster access and more flexible formats, making them popular for expats who need support now and can afford the cost.

Usually out-of-pocket; private therapy typically €80-150/session

D. Employer-provided platforms (OpenUp and similar)

Platforms such as OpenUp are contracted directly by employers as an employee benefit, not via health insurance. They offer online access to psychologists via chat, phone and video, plus webinars and self-help modules. Dutch companies and universities use these platforms to support staff wellbeing.

If your employer offers such a platform: you can often access short-term, low-threshold support in English at no personal cost. Check with your HR department or employee handbook before paying out of pocket for private therapy.

OptionInsurance coverageSpeed of accessEnglish availability
GP + POH-GGZFull (no eigen risico)Days-weeksVaries by practice
Dutch GGZ online (contracted)Basic insurance (after eigen risico)Weeks-monthsVaries; search for expat-focused
BIG-registered private therapistPartial if contractedDays-weeksMany options available
Coach / uncontracted therapistUsually noneDaysWide choice
International platform (BetterHelp etc.)Usually noneHours-daysFull
Employer platform (OpenUp etc.)Employer-funded (free to you)Hours-daysUsually full

Choosing the right option as an expat

Start with GP and POH-GGZ if...

  • You have stress, mild anxiety, short-term adjustment issues, or are unsure how serious your symptoms are
  • You want reimbursed care, are comfortable with Dutch clinical settings and can tolerate some waiting time
  • You want to preserve your eigen risico budget for other health costs that year

GP and POH-GGZ care does not count towards your annual €385 deductible. It also provides a direct connection into the BGGZ/SGGZ referral network if needed.

Seek insured GGZ therapy (online or offline) if...

  • You have a diagnosable condition (depression, anxiety disorder, trauma, eating disorders, ADHD, serious burnout) and want structured, evidence-based treatment
  • You are willing to go through the GP referral process to access subsidised care

Key steps:

  1. Register with a huisarts (GP)
  2. Get a referral letter (verwijsbrief) specifying your diagnosis and needed care level
  3. Choose a contracted provider where possible to maximise reimbursement and reduce out-of-pocket costs

Choose private or online-only therapy if...

  • You need short-term support now and can afford out-of-pocket costs (typically €80-150/session for private therapists)
  • You struggle with Dutch bureaucracy or face long GGZ waiting lists
  • You want therapy in your native language and that language is not offered in Dutch GGZ near you
  • You move frequently but want continuity with the same therapist online

Trade-off: faster and more flexible, but reimbursement is uncertain unless the therapist is BIG-registered, contracted and your insurer explicitly confirms coverage.

Expat-specific note: Burnout, culture shock, adjustment difficulties and loneliness are common mental health challenges in the Netherlands. Our expat mental health guide and burnout prevention guide cover these in detail, including signs to watch for and community support options.

Practical reimbursement checklist

Use this step-by-step checklist before starting any therapy to avoid unexpected costs.

1

Confirm your insurance policy type

Check whether you have a natura, combinatie or restitutie policy. Restitutie policies generally offer better reimbursement for non-contracted care. This is shown on your insurance card or in the app.

2

Ask your insurer two specific questions

Is this provider contracted for GGZ with my specific insurer? At what percentage do you reimburse non-contracted GGZ care? Your insurer is legally required to answer both.

3

Verify the therapist's BIG registration

Check bigregister.nl to confirm the therapist holds a valid BIG registration as a psychologist, psychotherapist or psychiatrist. Only BIG-registered professionals can be reimbursed under the GGZ framework.

4

Get a GP referral before starting insured treatment

Unless you are only using GP or POH-GGZ support, you need a formal referral letter (verwijsbrief) from your GP specifying the care level needed. Without this, insurers will not reimburse BGGZ or SGGZ treatment.

5

Budget for the eigen risico

Factor in the €385 annual mandatory deductible (2026). If you have already used your deductible for other health care earlier in the year, your therapy costs from that point onward are covered from the first invoice.

Still waiting for GGZ? If you are on a waiting list for BGGZ or SGGZ, your GP can often refer you to a wachtlijstbemiddelaar (waiting list mediator) who can help find a faster placement. Some insurers also offer waiting list mediation as a service. Ask your GP or insurer directly.

Frequently asked questions

Is online therapy covered by Dutch health insurance?

Online therapy is covered if it is delivered by a recognised GGZ provider within BGGZ or SGGZ and you have a GP referral. Many recognised providers now deliver sessions partly or fully online. International platforms such as BetterHelp and purely private therapists outside the GGZ framework are usually not covered, or only partly covered via supplementary insurance. Always confirm with your insurer before starting.

Do I have to pay the eigen risico for therapy in the Netherlands?

GP and POH-GGZ support is usually reimbursed from the basic insurance without counting towards the eigen risico. Once you move into BGGZ or SGGZ, invoices are covered by the basic package but do count towards your annual €385 mandatory deductible (2026 figure) for adults aged 18 and over.

How long are waiting lists for therapy in the Netherlands?

Waiting times vary considerably between regions and providers. Expat-focused guides and clinics consistently report waits of weeks to months for BGGZ and SGGZ, especially in large cities such as Amsterdam and The Hague. Faster access is available via private or employer-provided online therapy if you can pay out of pocket or your employer covers it through platforms such as OpenUp.

Can I get therapy in English in the Netherlands?

Yes. Many GGZ practices, private psychologists and online therapists explicitly offer English-speaking services for expats. Directories such as TherapyCounselling.nl and dedicated expat psychologist platforms list multilingual therapists across the country. Finding therapy in other languages such as Spanish, Arabic or Hindi is possible but more limited and may require private payment.

What is the difference between BGGZ and SGGZ?

BGGZ (generalistische basis GGZ) is short- to medium-term treatment for mild to moderate issues such as anxiety, depression, trauma and burnout. SGGZ (specialistische GGZ) is specialised, longer-term care for complex or severe conditions such as personality disorders and chronic trauma. Both are covered by the basic health insurance package provided you have a GP referral and a recognised provider.

What is a POH-GGZ and how do I access one?

A POH-GGZ (praktijkondersteuner huisarts GGZ) is a mental health worker based in your GP practice who provides short-term counselling and triage. They can clarify your situation, offer a short series of sessions (often around 5 sessions of 45 minutes), and decide with your GP whether you need referral to BGGZ or SGGZ. Access is through your GP. GP and POH-GGZ care usually does not count towards your annual eigen risico deductible.

Official and authoritative sources

Affiliate link disclosure: this guide contains affiliate links to health insurance providers (FBTO, ASR, Unive, Zorgkiezer). Clicking and arranging cover via these links earns us a small commission at no extra cost to you.