Understanding Health Insurance in the Netherlands: A Comprehensive Guide

The Netherlands is known for its high-quality healthcare system, which consistently ranks among the best in the world. However, unlike some countries with fully state-funded healthcare, the Dutch healthcare system is based on a mandatory health insurance model. This article will provide a detailed look at how health insurance works in the Netherlands, who needs it, what it covers, the costs involved, and tips for navigating the system effectively.

1. Overview of the Dutch Healthcare System

The Dutch healthcare system combines public and private elements. It is regulated by the government but primarily delivered by private providers. The core principle is universal access to healthcare through mandatory insurance, ensuring that all residents have equal access to necessary medical services.

The system is primarily funded through private health insurance premiums and income-based contributions. Every resident is required by law to purchase a basic health insurance package from a private insurance company. The government ensures that all companies offer the same basic coverage and that premiums are fair and accessible to everyone.

2. Who Needs Health Insurance?

Mandatory for Residents and Workers:

If you are living or working in the Netherlands, you are legally required to have Dutch health insurance, regardless of your nationality. This includes:

• Dutch citizens

• EU/EEA nationals residing in the Netherlands

• Expats with residence permits

• Foreign workers on Dutch payrolls

• International students in certain situations

Exceptions:

• Tourists

• Temporary visitors

• Certain international students with valid foreign insurance

Failing to obtain Dutch health insurance within 4 months of registering with the municipality can result in fines from the Dutch government.

3. The Basic Health Insurance (Basisverzekering)

The basic package is mandatory and standardized by the Dutch government. It covers all necessary medical care such as:

• Visits to general practitioners (GPs)

• Specialist care and hospital services

• Prescription medications

• Emergency services and ambulance transport

• Maternity care

• Mental healthcare (up to a certain number of sessions)

• Certain preventive care and vaccinations

While the coverage is the same across all insurers, premiums, customer service, and additional offerings vary, giving consumers the freedom to choose a plan that suits their needs.

4. Additional Insurance (Aanvullende Verzekering)

While the basic package covers essential care, many people choose to take out supplementary insurance for services not covered by the standard package. These may include:

• Dental care (for adults)

• Physiotherapy

• Glasses and contact lenses

• Alternative medicine (e.g., acupuncture)

• Extensive mental healthcare

• Travel vaccinations

Supplementary insurance is optional and varies significantly between providers. Insurers may also reject applications for additional coverage based on medical history.

5. Cost of Health Insurance

The cost of health insurance in the Netherlands consists of three main parts:

1. Monthly Premiums:
Each insured person pays a monthly premium to their health insurer. In 2025, the average premium for the basic package is around €140 to €160 per month. Children under 18 are insured for free under their parents' policy.

2. Compulsory Deductible (Eigen risico):
This is the amount you must pay out-of-pocket for certain medical costs each year before your insurance kicks in. In 2025, the deductible is set at €385. GP visits, maternity care, and children's healthcare are exempt from this deductible.

3. Income-Based Contribution:
In addition to the monthly premium, employees pay a contribution based on income, which is usually handled by the employer. Self-employed individuals and pensioners pay this contribution directly.

6. Health Insurance Allowance (Zorgtoeslag)

To make health insurance affordable, the Dutch government offers a healthcare allowance (zorgtoeslag) to low and middle-income residents. The amount depends on:

• Income

• Assets

• Living situation (single or with partner)

In 2025, eligible individuals may receive up to €127 per month, and couples may receive more. Applications are submitted through the Belastingdienst (Dutch tax authority) website.

7. Choosing a Health Insurance Provider

There are dozens of health insurance companies in the Netherlands, including well-known names like Zilveren Kruis, VGZ, Menzis, CZ, and OHRA. All offer the basic package but differ in:

• Premiums

• Additional coverage

• Customer service

• Access to preferred hospitals or specialists

Types of Policies:

• Restitutiepolis (Reimbursement Policy): Offers the most flexibility; you can visit any healthcare provider.

• Naturapolis (In-Kind Policy): Lower premium, but only covers care from contracted providers.

• Combinatiepolis (Combination Policy): A mix of the two.

Before choosing a provider, it's important to compare policies using Dutch comparison websites like Independer.nl or Zorgwijzer.nl.

8. Registering for Health Insurance

To register for Dutch health insurance, you need:

• A BSN (Burger Service Nummer) – personal citizen service number

• A Dutch address

• Proof of residency or employment

You can sign up directly on the insurance company’s website or through a comparison tool. Most insurers offer English-language support for expats.

Important: You must sign up within 4 months of arriving or registering in the Netherlands, or risk government penalties.

9. Accessing Healthcare in the Netherlands

Once insured, you’ll receive a health insurance card. The first point of contact for any health concern is the huisarts (GP). You must register with a GP in your area, who will refer you to specialists if needed.

Hospitals typically don’t accept walk-in patients for non-emergency care. Always go through your GP first unless it’s an emergency.

10. Special Considerations for Expats

Expats often face unique challenges when navigating the Dutch healthcare system. Key tips include:

• Understand your entitlements: Not everything is covered automatically.

• Choose English-friendly providers: Many Dutch doctors speak English, but it's helpful to confirm beforehand.

• Keep track of deductible usage: This can help plan your expenses for the year.

• Update your policy annually: You can switch providers once a year (before December 31) for the following year.