You have four months from the day you register in the Netherlands to arrange Dutch health insurance. Miss that deadline and you'll face a €420 penalty — plus retroactive premiums dating back to your registration date.
The Dutch system isn't optional. Even if you have international coverage through your employer, you still need a Dutch policy. Here's what you actually need to do.
Why Dutch health insurance is mandatory
The Zorgverzekeringswet (Health Insurance Act) requires everyone living or working in the Netherlands to hold basic Dutch health insurance. This includes:
- Employees on a Dutch contract
- Self-employed people registered with the KvK
- Students from the EU/EEA
- Remote workers who spend more than 183 days per year in NL
The only exception: posted workers on a foreign contract for less than a year, holding an A1 certificate from their home country's social security system.
Dutch insurers can't reject you based on pre-existing conditions. They can't charge you more because you're older or have chronic illness. Everyone pays the same premium for the same policy.
Basic insurance vs. supplementary insurance
Dutch health insurance has two tiers.
Basic insurance (basisverzekering) is mandatory. It costs €135–€160 per month depending on the insurer. Coverage includes GP visits, hospital care, prescription medication, maternity care, and mental health treatment up to a defined limit.
You'll pay the first €385 of care yourself each year — that's your eigen risico (deductible). GP visits are exempt from this deductible. Everything else counts toward it.
Supplementary insurance (aanvullende verzekering) is optional. It covers things the basic plan doesn't: dental care for adults, physiotherapy beyond 20 sessions, glasses, alternative medicine, and better mental health coverage.
Supplementary plans range from €10 to €50 per month. Insurers can reject you for supplementary coverage based on your health history.
What basic insurance actually covers
Basic insurance includes:
- Unlimited GP consultations (no deductible)
- Specialist care (with GP referral)
- Hospital treatment and surgery
- Prescription drugs on the national formulary
- Maternity care (midwife, hospital birth)
- Mental health care (up to a set number of sessions, then you need supplementary)
- Medical aids like wheelchairs and hearing aids
It does not include:
- Dental care for adults (except specific jaw surgeries)
- Physiotherapy beyond the first 20 sessions per condition
- Glasses or contact lenses (unless you're under 18)
- Alternative treatments like acupuncture or chiropractic
- Cosmetic procedures
How to choose an insurer
There are roughly 25 insurers in the Netherlands. Many are sub-brands of the same parent company — Zilveren Kruis, CZ, VGZ, and Menzis cover about 90% of the market.
Premiums for identical basic coverage vary by €20–€30 per month. Use Independer.nl or Zorgwijzer.nl to compare. Both sites are in Dutch, but you can use browser translation.
Three factors matter:
- Premium — how much you pay per month.
- Policy conditions — does the insurer require you to ask permission before seeing a specialist? Some budget policies add admin hurdles.
- Supplementary offerings — if you want dental or physio coverage, check what the insurer offers in their aanvullende packages.
Most expats choose Zilveren Kruis or CZ because their apps have English interfaces and customer service operates in English.
Step-by-step: getting insured
Step 1: Register at your local gemeente (municipality) and get your BSN (citizen service number). You can't buy insurance without a BSN.
Step 2: Compare policies on Independer or go directly to an insurer's site. Applications take 10 minutes.
Step 3: Choose your start date. If you're registering in the Netherlands for the first time, set your policy start date to match your registration date.
Step 4: Add supplementary insurance if you want it. You can only add or change supplementary coverage during the annual switch period (November–December), so decide now.
Step 5: Submit your application. The insurer will send you a policy number and payment details within a week.
Watch for: Some insurers ask for a Dutch bank account. If you don't have one yet, choose an insurer that accepts SEPA transfers from any EU account. Zilveren Kruis and CZ both do this.
Paying for your insurance
Most people pay monthly via automatic direct debit. Premiums are due by the first of each month.
You'll also receive a zorgtoeslag (healthcare allowance) from the Dutch tax office if your income is below €38,000 per year. This subsidy is paid quarterly and covers up to €167 per month of your premium. You don't apply separately — the Belastingdienst calculates it based on your income tax return.
If you're self-employed or switching from a salary to freelancing, update your insurer. Your premium stays the same, but you may lose employer contributions if you had them.
Using your insurance
Register with a GP (huisarts) in your neighbourhood. The GP is your gateway to the Dutch system. You can't see a specialist without a referral.
When you visit the GP, you'll show your insurance card or policy number. The GP bills your insurer directly. You won't pay anything upfront unless the treatment counts toward your €385 deductible.
For hospital care or specialist visits, the insurer may send you a bill for the deductible portion. Pay it within 30 days or they'll send you reminders with late fees.
Prescription medication works the same way. Hand your prescription to any pharmacy. They'll bill your insurer and charge you only for the deductible portion.
If you need emergency care
Call 112 for life-threatening emergencies. For urgent but non-life-threatening issues, call your GP's after-hours line (huisartsenpost). The number is on your GP's voicemail.
Emergency care is covered under basic insurance. You'll still pay toward your deductible, but the hospital or huisartsenpost will bill your insurer directly.
Switching insurers
Every year between November 1 and December 31, you can switch to a different insurer without penalty. Your new policy starts January 1.
Cancel your old policy by December 31. Send a registered letter or use the insurer's online cancellation form. The new insurer will handle the transition.
You can't switch mid-year unless you have a life event (marriage, moving abroad, losing a job). Otherwise, you're locked in for the calendar year.
What happens if you don't get insured
The CAK (Central Administration Office) tracks uninsured residents. If you're uninsured for longer than four months, they'll fine you €420 and enrol you in a default policy at a higher premium.
You'll also owe backdated premiums from your registration date. If you registered in March but didn't buy insurance until July, you'll pay four months of premiums retroactively.
Don't skip this. The fines compound monthly.