If you live or work in the Netherlands, Dutch health insurance is not optional: almost everyone must have it, and it is one of the first things to arrange after you arrive. The system works well once you understand it, but it is different from what most expats are used to. This guide explains who needs insurance, what it costs, what is covered, how to choose a policy and how to use Dutch healthcare day to day. Figures are for 2026 unless stated otherwise.
The Short Version
- It is compulsory. Take out Dutch basic health insurance (basisverzekering) within 4 months of registering or starting work. It is backdated, so waiting does not save money.
- It costs about €157 a month on average in 2026, plus a €385 yearly deductible (eigen risico) before most care is paid for. GP visits are exempt.
- Children under 18 are insured free on a parent's policy.
- The basic package is the same at every insurer. You choose on price, freedom to pick your doctors, service and optional extras such as adult dental care.
- On a lower income? Healthcare allowance (zorgtoeslag) pays up to €129 a month towards your premium.
- You can switch every year: new premiums come out in November, and you have until 31 December to switch.
In this guide
- How Dutch health insurance works
- Who must take out Dutch health insurance?
- What it costs in 2026
- What the basic package covers
- The deductible (eigen risico) explained
- Choosing a policy
- Supplementary insurance: do you need it?
- How to take out insurance, step by step
- Healthcare allowance (zorgtoeslag)
- Using Dutch healthcare: GP, specialists and emergencies
- Healthcare abroad and on holiday
- Switching insurer
- What happens if you are not insured or do not pay
- What changes in 2027?
- Dutch health insurance terms
How Dutch Health Insurance Works
The Dutch system is a mix of private and public. Health insurers are private companies, but the government sets the rules they must follow:
- The government decides what basic insurance covers. The basic package (basispakket) is identical at every insurer, so a cheap policy covers the same treatments as an expensive one.
- Insurers must accept everyone for basic insurance, regardless of age, health or pre-existing conditions. They cannot ask health questions or refuse you.
- Everyone with the same policy pays the same premium. Your age, health and medical history make no difference.
- You pay twice, in two ways. You pay a monthly premium to your insurer yourself, and an income-related contribution goes to the healthcare fund through your payroll. If you are employed, your employer pays that contribution, not you.
- Your GP is the gatekeeper. For most care beyond the GP, such as a hospital specialist, you need a referral.
On top of basic insurance, you can buy optional supplementary insurance (aanvullende verzekering) for care that is not in the basic package, such as adult dental care or extra physiotherapy.
Who Must Take Out Dutch Health Insurance?
You must take out Dutch basic health insurance if you live in the Netherlands, or if you work in the Netherlands and pay Dutch payroll tax on your salary. Your nationality makes no difference, and neither does the 30% ruling.
- Deadline: within 4 months of the date you became obliged, usually the day you registered with your municipality or started work, whichever was first.
- It is backdated. If you take out insurance within those 4 months, cover and premium start from that date. You pay the premium for the months in between, but any care you needed in that period is covered too.
- You need a BSN (citizen service number). You get it when you register with your municipality. Take out insurance as soon as you have it.
- Every family member needs their own policy, including a partner who does not work. Children under 18 go on a parent's policy for free, but you do need to register them, including newborns within 4 months of birth.
Your International Policy Does Not Count
If you are obliged to have Dutch insurance, an international or expat health policy, travel insurance or insurance from your home country does not replace it, however good it is. You must still take out a Dutch basic policy, or you can be fined. You may want to keep your international policy for care outside the Netherlands, but check first whether you really need both.
Exceptions
Some people are not obliged to take out Dutch insurance, or are not allowed to. The most common situations:
- Posted workers: if your employer abroad sends you to the Netherlands temporarily and you remain insured in your home country (with an A1 certificate within the EU, or a certificate under a social security treaty), you usually do not need Dutch insurance.
- Students: international students who only study here generally do not need Dutch basic insurance. EU students can use their European Health Insurance Card (EHIC); non-EU students usually need private student insurance. As soon as you take a paid job or internship, even a small part-time one, you must take out Dutch basic insurance.
- Cross-border workers: if you live in another EU country and work in the Netherlands, or the other way round, the rules depend on your situation. You may need an S1 form to register with an insurer in the country where you live.
- Employees of some international organisations and conscientious objectors to insurance have separate arrangements.
Not sure whether you are obliged? The Social Insurance Bank (SVB) can assess your situation through its Wlz questionnaire. Its decision tells you whether you are insured under Dutch law, and therefore whether you need a Dutch health policy.
What It Costs in 2026
| Cost | Amount in 2026 | Who pays |
|---|---|---|
| Basic insurance premium | About €157 a month on average (€1,884 a year). Cheapest and most expensive policies differ by about €500 a year. | You, to your insurer |
| Compulsory deductible (eigen risico) | €385 a year, only if you use care that falls under it | You, when you use care |
| Voluntary deductible (optional) | An extra €100 to €500 a year, in exchange for a lower premium | You, when you use care |
| Children under 18 | Free, and no deductible | Nobody |
| Income-related contribution (inkomensafhankelijke bijdrage Zvw) | 6.10% of your salary up to €79,409 for employees; 4.85% for self-employed people and pensioners | Your employer (employees), or you through your tax return (self-employed) |
| Supplementary insurance (optional) | Roughly €10 to €60 a month, depending on what you add | You, to your insurer |
For most employees, the real cost is therefore the premium, any supplementary insurance and the deductible if you need care. A healthy single person with only basic insurance pays about €1,884 a year; in a year with a hospital visit or regular prescriptions, that rises to about €2,269. Many people set aside about €32 a month for the deductible, just in case.
Want to see how health insurance fits into your total budget? Our free Cost of Living Calculator includes it automatically, next to rent, utilities and your take-home pay.
What the Basic Package Covers
The basic package covers the essential medical care most people need. Some care has limits, conditions or a personal contribution, and much of it requires a referral from your GP.
| Covered by basic insurance | Not covered (or only in specific cases) |
|---|---|
|
|
Long-term care, such as a nursing home, is not part of health insurance. It is covered by the Long-term Care Act (Wlz), which you pay for through payroll tax.
The Deductible (Eigen Risico) Explained
Every adult has a compulsory deductible of €385 a year. It works like this: when you use care that falls under the deductible, you pay the bill yourself (your insurer usually pays the provider and then sends you an invoice) until you have paid €385 in that calendar year. After that, your insurer pays for the rest of the year. On 1 January it resets.
The deductible does not apply to:
- GP visits and care organised through your GP practice, such as care for diabetes or asthma (ketenzorg)
- Children under 18
- Maternity care and pregnancy-related care (but not hospital care that is not related to the pregnancy itself)
- District nursing (wijkverpleging)
- Stop-smoking programmes and lifestyle programmes
- Consultations where your GP asks a specialist for advice (new in 2026)
- Care covered by supplementary insurance
It does apply to most other care: hospital care, specialists, prescription medicines, blood tests, mental healthcare, ambulance rides and so on.
Example: you see your GP twice (no cost to you) and are then referred to a dermatologist. The hospital charges €260. You pay that €260. Later that year you fill a prescription for €180: you pay €125 and the insurer pays €55, because you have now reached €385. Everything else that year is paid by your insurer.
Many insurers let you pay the deductible in monthly instalments instead of in one go, which helps if you get a large bill.
Choosing a Policy
Because the basic package is the same everywhere, the main thing you choose is the type of policy. It decides which doctors and hospitals you can go to without paying extra.
| Policy type | How it works | Best for |
|---|---|---|
| In-kind policy (naturapolis) | Full cover with providers your insurer has a contract with (usually most of them). With a non-contracted provider you get only part of the cost back, often 60 to 80%. | Most people. A good balance between price and choice. |
| Restitution policy (restitutiepolis) | Free choice of provider. Costs are reimbursed up to the usual market rate in the Netherlands. More expensive. | People who want a specific clinic, hospital or therapist, for example an English-speaking psychologist without a contract. |
| Combination policy (combinatiepolis) | In-kind for some care (often hospital care), restitution for other care. | A middle ground; check exactly which care has free choice. |
| Budget policy (budgetpolis, a selective in-kind policy) | The cheapest option, but with a limited list of contracted providers. Outside that list you can get much less back. | Healthy people who are happy to use the providers chosen by the insurer. |
What to look at when comparing
- Your own doctors and hospital. Check whether the hospital, GP practice, pharmacy and any therapist you use have a contract with the insurer for the policy you are considering. Insurers publish this on their websites (zorgzoeker).
- Service in English. Several large insurers offer English-language websites, apps and customer service, which helps a lot in your first year.
- Whether a voluntary deductible makes sense. Raising your deductible by up to €500 lowers your premium, but the discount is usually much smaller than the extra risk. It only pays off if you are healthy and have the money set aside. About 12% of Dutch people choose one.
- Payment options. Some insurers give a small discount if you pay the premium yearly instead of monthly.
- Collective discounts no longer apply to basic insurance. They were abolished in 2023. Some employers still offer discounts on supplementary insurance, so ask HR.
Independent comparison websites (vergelijkingssites) let you compare policies side by side. Most are in Dutch, but your browser's translate function works well on them.
Supplementary Insurance: Do You Need It?
Supplementary insurance (aanvullende verzekering) is optional. It covers care that is not in the basic package. Common add-ons are:
- Dental insurance (tandartsverzekering): for adult check-ups, cleaning and fillings. Usually with a yearly maximum and sometimes only a percentage of the cost.
- Physiotherapy: a set number of treatments a year.
- Glasses and contact lenses, usually a contribution every 2 or 3 years.
- Care abroad and travel vaccinations, including the difference between foreign and Dutch rates.
- Alternative medicine, orthodontics for adults, and other extras.
Some tips:
- Only pay for what you will use. Add up what you expect to spend on, for example, the dentist and physio, and compare it with the extra premium. For many healthy adults, a basic dental package is the only add-on worth having.
- Insurers can refuse you for supplementary insurance or ask health questions, especially for extensive dental cover. This is not allowed for basic insurance.
- Check maximums and waiting periods. Supplementary dental insurance often reimburses only up to a set amount a year.
- Supplementary care is not affected by the deductible, but you do pay anything above the policy's maximum yourself.
How to Take Out Insurance, Step by Step
- Register with your municipality and get your BSN. See our Moving to the Netherlands Checklist for how this works.
- Open a Dutch bank account, or have a SEPA account ready. Most insurers collect the premium by direct debit.
- Choose a policy type and an insurer. Check that your hospital and any providers you use are contracted.
- Decide on extras: a voluntary deductible and any supplementary insurance.
- Apply online. Enter the date you registered or started work as the start date, so your cover is backdated. Add your partner and children if relevant.
- Receive your insurance card (zorgpas) within a few weeks. The back of the card is your European Health Insurance Card (EHIC).
- Register with a GP, a dentist and a pharmacy near your home.
- Check whether you qualify for healthcare allowance and apply with your DigiD.
Healthcare Allowance (Zorgtoeslag)
If your income is relatively low, the Tax and Customs Administration (Belastingdienst) pays a monthly allowance towards your premium.
- Maximum: €129 a month for a single person, or €246 a month for a couple together, for incomes up to about €29,500.
- Income limit: the allowance falls as your income rises and stops at an income of about €40,857 for a single person, or €51,142 for a couple's combined income.
- Other conditions: you must be 18 or older, have Dutch health insurance, have a lawful residence status, and your savings and assets must be below a set limit.
- Apply online at Mijn toeslagen with your DigiD. You can apply up to 1 September of the following year, and it is paid out from the month your insurance started.
Avoid Paying It Back
Healthcare allowance is paid in advance, based on your estimated income for the whole year. If you earn more than you expected, you will have to pay some or all of it back after the year ends. This often catches out people who arrive mid-year or start a better-paid job. Use the Belastingdienst's test calculation (proefberekening), base it on your expected income for the full calendar year, and update it in Mijn toeslagen as soon as your income changes.
Using Dutch Healthcare: GP, Specialists and Emergencies
- Your GP (huisarts) is your first stop for almost everything that is not an emergency. Register with one as soon as you have an address; many practices only take patients who live nearby, and some lists are full. If you cannot find one, your insurer's care mediation service (zorgbemiddeling) must help you.
- Specialists need a referral. Without a GP referral, your insurer will usually not pay for hospital or specialist care. Physiotherapists and dentists can be visited directly.
- Expect a conservative approach. Dutch GPs tend to wait and see, and do not prescribe antibiotics quickly. If you are worried, say so clearly and ask what the next step would be.
- Mental healthcare starts with your GP, who may help you themselves, refer you to a practice nurse for mental health (POH-GGZ, free of deductible) or to a psychologist. Waiting lists for specialised care can be long.
- Pregnant? Contact a midwife (verloskundige) directly, without a referral. Most pregnancies are handled by midwives rather than doctors.
- Evenings, nights and weekends: call the out-of-hours GP service (huisartsenpost) for your region. Save its number in your phone; you will find it on your GP's website.
- Life-threatening emergency: call 112. Go to the hospital emergency department (SEH) only in a real emergency or after a referral; otherwise call the out-of-hours GP first.
- Mental health crisis: call 113 or 0800-0113 (free, 24/7) for suicide prevention support.
Healthcare Abroad and on Holiday
- Emergency care abroad is covered by basic insurance worldwide, but only up to what the same care would cost in the Netherlands. In countries where care is expensive, such as the US, Switzerland or Japan, that can leave a big gap.
- Within the EU, EEA and Switzerland, show your EHIC (the back of your insurance card) at public healthcare providers.
- Travel insurance or a supplementary policy with cover abroad fills the gap above Dutch rates, and also covers repatriation, which basic insurance does not.
- Planned treatment abroad, including in your home country, needs approval from your insurer in advance.
- Leaving the Netherlands for good? Deregister with your municipality and then cancel your health insurance. You can cancel from the date you deregister.
Switching Insurer
You can switch health insurer once a year, effective 1 January:
- By 12 November insurers publish their premiums and conditions for the next year. Your current insurer must tell you what changes for you.
- Until 31 December you can take out a new policy. Your new insurer cancels the old one for you.
- If you cancel yourself before 1 January, you have until 1 February to take out a new policy, which then starts on 1 January.
- Supplementary insurance can be with a different insurer from your basic insurance, although many insurers only sell supplementary cover together with their own basic policy.
Outside this period you can only switch in special situations, such as when you start a job with a collective arrangement, or if your insurer changes its conditions for the worse.
What Happens If You Are Not Insured or Do Not Pay
The government compares population records with insurers' records, so not being insured is noticed.
- Not insured: the CAK (the government agency that enforces the rules) sends a letter asking you to take out insurance within 3 months. If you do not, you get a fine of €529.74 (2026). After another 3 months, a second fine follows. If you are still not insured, the CAK takes out a policy for you and withholds the premium, at 110% of the standard premium (€172.70 a month in 2026), directly from your salary for 12 months.
- Taking out insurance late: if you take out insurance more than 4 months after you became obliged, you will still have to pay the premium back to that date, and the insurer can add a surcharge.
- Not paying your premium: after 6 months of arrears, your insurer reports you to the CAK. You then pay the higher premium of €172.70 a month to the CAK, often withheld from your salary, until the debt is cleared.
If you have trouble paying, contact your insurer early. They must offer you a payment plan.
What Changes in 2027?
The 2027 budget, presented on 15 September 2026, includes these plans. They still need parliamentary approval, and each insurer sets its own premium.
- Higher premiums: the average premium is expected to rise by about €12.50 to around €169 a month.
- Higher deductible: the compulsory deductible goes up from €385 to €400. A larger increase of €60 on top of that has been postponed to 2028.
- Higher healthcare allowance: the maximum for a single person is expected to rise to about €140 a month.
- Shingles vaccination: free for people who turn 60 in 2027.
Insurers announce their 2027 premiums by 12 November 2026: a good moment to check whether your policy still suits you.
Dutch Health Insurance Terms
| Dutch | English |
|---|---|
| Zorgverzekering | Health insurance |
| Basisverzekering | Basic (compulsory) health insurance |
| Aanvullende verzekering | Supplementary insurance |
| Eigen risico | Deductible |
| Eigen bijdrage | Personal contribution (a fixed part of the cost you always pay) |
| Zorgverzekeraar | Health insurer |
| Zorgpas | Health insurance card |
| Zorgtoeslag | Healthcare allowance |
| Huisarts | GP (family doctor) |
| Verwijzing | Referral |
| Huisartsenpost | Out-of-hours GP service |
| Gecontracteerde zorg | Care from a provider contracted by your insurer |
| Polisvoorwaarden | Policy conditions |
Official Sources
- Government.nl: when do I need to take out health insurance if I come to live in the Netherlands?
- Zorginstituut Nederland: compulsory deductible (eigen risico)
- Rijksoverheid: changes to the basic package in 2026
- Belastingdienst: healthcare allowance 2026
- Rijksoverheid: what happens if you are not insured?
- Rijksoverheid: switching health insurer
- SVB: Wlz assessment and exemptions
- Rijksoverheid: healthcare plans for 2027
Figures were checked on 4 October 2026. Premiums vary by insurer and policy, and the 2027 changes still need parliamentary approval. This is general information, not personal insurance, medical or tax advice. Always check the policy conditions (polisvoorwaarden) of the insurer you choose.
Settling In to the Netherlands?
See how health insurance fits into your monthly budget with the free Cost of Living Calculator, and work through the rest of your arrival with our Moving to the Netherlands Checklist. If you need help choosing insurance or sorting out allowances and taxes, ExpatNL can put you in touch with trusted English-speaking specialists. Get in touch with us.
