If you want mental healthcare paid for by your Dutch basic health insurance, almost everything starts with your huisarts. For people who moved here from a system where you simply book a psychologist, this is the single most confusing part of Dutch healthcare — and the place where most people lose months.
This guide explains what the referral is for, what a valid one has to contain, and the cases where you do not need one at all.
The Huisarts Is a Gatekeeper, Not an Obstacle
In the Dutch system the huisarts (GP) controls access to specialist care. For psychological treatment reimbursed from the basisverzekering, the basic insurance everyone is legally required to hold, you need a written referral — a verwijzing — from your huisarts, a medical specialist, or a company doctor (bedrijfsarts).
Without one, an insurer will generally refuse the claim, even if the treatment itself was appropriate and the therapist properly qualified.
There is one exception: emergency care does not require a referral. If you are in crisis, you are not expected to arrange paperwork first.
Start With the POH-GGZ — Most People Don't Know It Exists
Before your huisarts refers you anywhere, they will usually offer something that surprises people new to the Netherlands: an appointment with the POH-GGZ.
The POH-GGZ is a mental health practice nurse working inside the huisarts practice. They are not a receptionist and not a stopgap — they are trained in mental health and handle a large share of the lighter and moderate complaints in this country.
Two things make this worth knowing:
- It is free. Conversations with your huisarts or the POH-GGZ are covered and, crucially, do not count towards your eigen risico.
- There is no waiting list of the kind you find in the GGZ. You are usually seen within weeks, not months.
If your difficulties are recent, situational, or moderate, several sessions with the POH-GGZ may be all you need. If they are not, the POH-GGZ is also the person most likely to push your referral through quickly, because they have already assessed you.
Being offered the POH-GGZ is not a brush-off. Treat it as a first step rather than a refusal.
What a Valid Referral Letter Contains
If you are referred onward, the letter needs specific contents or the insurer may reject it later. Check that it has:
- A date before your first session. A referral written afterwards is usually not accepted. This is the most common and most expensive mistake.
- A suspected DSM-5 classification. The letter should state what the huisarts suspects — not just "stress" or "feeling low". Reimbursement from the basic insurance requires a recognised classification, not symptoms alone.
- The destination. The letter should say whether you are being referred to generalistische basis GGZ (GB-GGZ, for lighter to moderate problems) or gespecialiseerde GGZ (S-GGZ, for severe or complex ones).
- Your huisarts's AGB code and signature. The AGB code is how insurers identify a Dutch healthcare provider.
- Your own details, matching your insurance records.
Ask for a copy for yourself. You will need to hand it to the provider you end up with, and if the first provider cannot take you, you do not want to book another huisarts appointment just to get the letter reissued.
How to Make a Ten-Minute Appointment Count
A standard Dutch huisarts consultation is about ten minutes and covers one issue. That is short if you are trying to explain something that has been building for a year, and shorter still in a second language.
What helps:
- Say at the start that you want to discuss your mental health. Do not open with the physical symptoms and hope to arrive there. If you say it when booking, the practice can schedule a double appointment.
- Be concrete about duration and function. "I have not slept properly since March and I am making mistakes at work" lands very differently from "I feel stressed". Dutch medicine is pragmatic: impact on daily functioning is what moves the decision.
- Say what you have already tried. Exercise, time off, talking to friends, a previous course of therapy in another country.
- Say plainly what you are asking for. "I would like a referral for psychological treatment" is a reasonable sentence to use. Being indirect is read as the problem being mild.
- Mention language. If you need therapy in English or Polish, say so — it changes which providers are realistic.
If Your Huisarts Says No
This happens, and it is not always wrong. Common reasons are that your huisarts thinks the POH-GGZ is the right level of care, that the complaint looks situational and likely to resolve, or simply that not enough has been said to justify a referral.
Your options, roughly in order:
- Ask what would change their mind. Usually the answer is time, or a specific worsening to watch for.
- Book a follow-up. A second appointment a few weeks later showing that nothing improved is often what produces the referral.
- Ask the POH-GGZ directly. They can advocate for a referral from inside the practice.
- Change huisarts. You are free to register with another practice, though in busy areas they may be closed to new patients.
When You Do Not Need a Referral at All
A referral is a requirement of insurance reimbursement, not of treatment. Nobody is stopping you from seeing a psychologist.
If you pay for therapy yourself, or claim from aanvullende (supplementary) insurance rather than the basic package, you can usually start without any referral at all. That is how most private practices work, including ours — you can book a first conversation directly, with no letter from anyone.
Some insurers do still ask for a referral before paying out from a supplementary package, so if reimbursement matters to you, check your policy before the first session rather than after. Our guide to therapy costs and Dutch health insurance covers how to check this, and GGZ or private practice compares the two routes properly.
If You Need Help Now
If you are in crisis, do not wait for a referral.
- 113 Zelfmoordpreventie — call 113 or 0800-0113, free, 24/7 and anonymous, or chat at 113.nl
- Your huisartsenpost — the out-of-hours GP service in your area
- 112 — if there is immediate danger to life
This guide describes the Dutch system in general terms. What your own insurance covers depends on your insurer and your policy, so always check your own terms.