Health insurance in the Netherlands is not optional. Unlike many countries where you can choose whether to buy coverage, the Dutch system requires every legal resident to have basic health insurance — known as basisverzekering. As an expat, understanding this system is crucial because the penalties for non-compliance are steep and the deadlines are strict.
This guide covers everything you need to know: what is covered, how much it costs, how to get a subsidy, and how to choose the right insurer.
The Dutch Healthcare System in a Nutshell
The Netherlands has a regulated private insurance market. The government defines a standard benefits package that every insurer must offer at the same coverage level. Insurers compete on price, service quality, and supplementary packages — but the core coverage is identical everywhere.
This means you cannot be denied basic insurance for any reason. Pre-existing conditions, age, health status — none of it matters. Every insurer must accept you for the basisverzekering.
The system is funded through a combination of individual premiums, employer contributions (paid via payroll tax), and government subsidies for lower-income residents.
Who Must Have Health Insurance?
If you live or work in the Netherlands, you are required by law to take out Dutch basic health insurance. This applies to:
- Employees working for a Dutch company (even if you live abroad in some cases)
- Self-employed professionals (ZZP'ers) registered with the KVK
- Expats with a residence permit who are registered at a Dutch address
- Family members who are registered residents, including children over 18
Important exception: If you are posted to the Netherlands by a foreign employer for a limited period and remain insured in your home country under an EU social security agreement (via an A1/E101 certificate), you may be exempt. Verify this with the SVB (Social Insurance Bank).
The 4-Month Registration Deadline
Once you register as a resident in the Netherlands, you have 4 months to arrange your basic health insurance. This deadline starts from your registration date at the municipality, not your arrival date.
If you miss this deadline, the CAK (Central Administration Office) will send you a warning letter. If you still do not comply, they will:
- Fine you approximately €460 (as of 2026)
- Send a second fine three months later if you are still uninsured
- Eventually assign you to an insurer and deduct premiums directly from your salary or benefits
The lesson is simple: do not delay. Arrange your insurance as soon as you get your BSN.
What Does Basic Insurance (Basisverzekering) Cover?
The standard package is comprehensive and covers:
- GP (huisarts) visits — fully covered, no co-pay
- Hospital care — inpatient and outpatient treatment
- Specialist consultations — when referred by your GP
- Prescription medications — most standard medications
- Mental healthcare — both basic and specialist (with referral)
- Maternity care — pregnancy, birth, and postnatal care
- Ambulance transport
- Dental care for children under 18
What is notably not covered by basic insurance includes adult dental care, physiotherapy (first sessions), glasses and contact lenses, and alternative medicine. For these, you need supplementary insurance.
How Much Does It Cost?
Basic health insurance premiums range from approximately €130 to €160 per month in 2026, depending on the insurer and whether you choose a voluntary excess (vrijwillig eigen risico).
On top of the monthly premium, every adult has a mandatory deductible (verplicht eigen risico) of €385 per year (2026). This means you pay the first €385 of most healthcare costs out of pocket. GP visits, maternity care, and care for children under 18 are excluded from the deductible.
You can also opt for a higher voluntary deductible (up to €500 extra, for a total of €885) to lower your monthly premium. This makes sense if you are young, healthy, and rarely use healthcare beyond GP visits.
Children's Insurance
Children under 18 are covered for free. They do not pay premiums and have no deductible. You simply register them under your policy, and the government covers their costs.
Zorgtoeslag: The Healthcare Subsidy
If your income is below a certain threshold, you may be eligible for zorgtoeslag — a monthly subsidy to help pay your health insurance premium. In 2026, the approximate income limits are:
- Single person: gross annual income below approximately €38,000
- Couple (fiscal partners): combined gross income below approximately €48,000
The subsidy can be up to €120 per month, which significantly reduces your effective cost. You apply via the Belastingdienst (Tax Office) website — you will need your DigiD to log in.
Note for 30% ruling holders: Your taxable income is reduced under the 30% ruling, which may bring you below the zorgtoeslag threshold even if your gross salary is higher. Check your annual income statement (jaaropgaaf) or consult a tax advisor. Learn more in our 30% ruling guide.
Choosing an Insurer
Because the basic package is the same everywhere, choosing an insurer comes down to:
- Price — premiums vary by €15-25 per month between the cheapest and most expensive
- Customer service — especially English-language support for expats
- Supplementary packages — if you need dental, physio, or other extras
- Contracted care network — natura policies are cheaper but limit you to contracted providers; restitutie policies let you see any provider
Popular insurers among expats include Zilveren Kruis, CZ, Menzis, VGZ, and OHRA. Comparison websites like Independer.nl and Zorgwijzer.nl let you compare all options side by side (some offer English translations).
Natura vs Restitutie Policies
A natura (in-kind) policy is the standard and cheapest option. You receive care from providers contracted by your insurer. If you go outside the network, you may only receive partial reimbursement (typically 60-80%).
A restitutie (reimbursement) policy costs a bit more but allows you to visit any provider, including non-contracted ones, and receive full reimbursement. This is particularly valuable if you want to choose specific specialists or international clinics.
Supplementary Insurance (Aanvullende Verzekering)
Unlike basic insurance, supplementary insurance is optional and insurers can reject you based on health. Common add-ons include:
- Dental coverage — essential for adults since basic insurance does not cover dental care over age 18
- Physiotherapy — the basic package covers limited sessions; supplementary extends this
- Glasses and contact lenses — partial reimbursement every few years
- Alternative medicine — acupuncture, osteopathy, etc.
- Orthodontics — important if you have children who may need braces
A basic dental supplementary package typically costs €10-25 per month and covers checkups, cleanings, and simple fillings. For expats who want comprehensive coverage, a combined dental and physio package runs around €30-50 per month.
Switching Insurers
Every year, you can switch your basic health insurer during the open enrollment period: November 12 to December 31. Your new policy starts January 1 of the following year. No insurer can refuse you for basic coverage.
Supplementary insurance can be switched at the same time, but insurers can impose waiting periods or refuse supplementary coverage, so plan ahead.
Practical Tips for Expats
- Register with a GP immediately — do not wait until you are sick. GP practices in popular expat areas fill up quickly
- Always visit your GP first — the Dutch system requires a GP referral for specialists. Going directly to a specialist without a referral means your insurance will not cover it
- Keep your European Health Insurance Card (EHIC) — if you are from an EU country, your EHIC remains useful for temporary travel back home
- Check your employer benefits — some employers offer collective health insurance deals with discounted premiums
- Set up direct debit — insurers strongly prefer automatic payment from your Dutch bank account
What Happens When You Leave the Netherlands?
When you deregister from your municipality upon leaving the country, your obligation to have Dutch health insurance ends. Contact your insurer to cancel your policy from your deregistration date. You are typically entitled to a pro-rata refund of any prepaid premiums.
Make sure to arrange health insurance in your destination country before canceling your Dutch policy to avoid any coverage gaps.