Health Insurance in the Netherlands: A Comprehensive Guide

The Netherlands is widely recognized for having one of the most efficient and accessible healthcare systems in the world. Central to this system is health insurance, which is mandatory for all residents and plays a crucial role in ensuring equal access to high-quality medical care. Whether you're a Dutch citizen, an expatriate, or a student, understanding how health insurance works in the Netherlands is essential for navigating life in this well-organized country.

1. Overview of the Dutch Healthcare System

The Dutch healthcare system operates on a dual-level structure:

1. Basic health insurance (basisverzekering) – Mandatory for all residents and covers essential medical care.

2. Supplementary insurance (aanvullende verzekering) – Optional coverage for services not included in the basic package.

Healthcare in the Netherlands is funded through a combination of income-based contributions, monthly premiums, and government subsidies for low-income individuals.

The Dutch Ministry of Health, Welfare, and Sport (VWS) is responsible for overall health policy, while the Dutch Health Authority (NZa) supervises healthcare providers and insurers to ensure fair practices.

2. Is Health Insurance Mandatory in the Netherlands?

Yes. Health insurance is compulsory for everyone living or working in the Netherlands. This includes:

• Dutch citizens

• Expats with a residence permit

• International students with a part-time job

• Foreign workers and freelancers

People must take out basic health insurance within four months of arriving in the Netherlands or becoming eligible. Failure to do so may result in fines and retroactive premium charges.

3. What Does Basic Health Insurance Cover?

The government decides what the basic health insurance package must include each year. As of 2025, it typically covers:

• Visits to the general practitioner (GP)

• Hospital care and surgeries

• Prescription medications

• Maternity and postnatal care

• Mental healthcare (limited)

• Emergency care

• Medical care for children under 18

• Rehabilitation and physical therapy (in specific cases)

• Vaccinations and screenings

Everyone has access to the same basic care, regardless of their chosen insurance provider.

4. Choosing a Health Insurance Provider

The Netherlands has over 30 private health insurance companies, all offering the same basic coverage mandated by law. However, they differ in:

• Monthly premiums

• Contracts with healthcare providers

• Customer service quality

• Supplementary insurance options

You are free to switch insurers once a year, during the open enrollment period from November 15 to December 31. Comparison websites such as Independer.nl and Zorgwijzer.nl help people make informed decisions.

5. Monthly Premiums and Costs

As of 2025, the average monthly premium for basic health insurance is around €135 – €145. This does not include the own risk (eigen risico), which is the amount you must pay out of pocket before your insurance covers most costs.

• Mandatory deductible (eigen risico): €385 per year

• Voluntary deductible: You can increase your deductible up to €885 in exchange for lower premiums

Children under 18 are covered for free under their parents' insurance and do not pay deductibles.

6. Government Subsidies: Healthcare Allowance (Zorgtoeslag)

To ensure healthcare remains affordable, the Dutch government offers healthcare allowance (zorgtoeslag) to low and middle-income residents. This allowance is:

• Income-dependent

• Paid monthly

• Must be applied for through the Dutch Tax Office (Belastingdienst)

As of 2025, individuals earning less than €38,500 per year may be eligible for a subsidy, with the maximum monthly amount around €125.

7. Supplementary Insurance (Aanvullende Verzekering)

Basic insurance does not cover all health needs. Supplementary insurance can include:

• Dental care for adults

• Physiotherapy

• Alternative treatments (e.g., acupuncture)

• Eyeglasses and contact lenses

• Extended mental healthcare

Supplementary insurance is optional and insurers can refuse applications based on health history. Prices and coverage vary widely, so comparing policies is essential.

8. GP System and Referrals

In the Netherlands, the general practitioner (huisarts) is the first point of contact for all health issues. GPs provide:

• Routine checkups

• Treatment for common illnesses

• Referrals to specialists or hospitals

You must register with a GP near your residence. To see a specialist, you must be referred by your GP, except in emergency situations.

9. Emergency Care

Emergency healthcare is always available and covered by the basic insurance. In urgent cases, you can:

• Visit the emergency room (spoedeisende hulp)

• Call 112 for an ambulance

• Go to an after-hours GP center (huisartsenpost)

However, emergency visits may still be subject to the deductible, unless it's exempt (like care for children).

10. Health Insurance for Expats

If you move to the Netherlands for work or long-term residence, you are required to obtain Dutch health insurance within 4 months of arrival. Key points for expats:

• EU/EEA nationals with the EHIC card can use their home country's insurance temporarily.

• International students who do not work may use private international insurance.

• Those who start working or doing internships must register with a Dutch insurer.

• Private expat insurance can be used temporarily, but not as a long-term solution.

11. Health Insurance for Freelancers and Self-Employed

Self-employed individuals and freelancers must also purchase Dutch basic health insurance. They pay premiums directly and declare their income for tax and subsidy purposes.

Freelancers should:

• Compare plans carefully based on needs and deductibles

• Consider supplementary insurance for dental or physiotherapy

• Apply for zorgtoeslag if eligible

12. Common Misunderstandings

There are some myths and misunderstandings around Dutch health insurance:

• “Healthcare is free in the Netherlands.”
  False – you must pay monthly premiums and cover deductibles.

• “You can use travel insurance instead.”
  Only for short stays or specific cases. If you live or work in the Netherlands, Dutch insurance is mandatory.

• “All insurers offer the same services.”
  Basic coverage is the same, but service quality and additional policies differ.

13. How to Register for Health Insurance

The process of registering is straightforward:

1. Get a BSN (citizen service number) after registering at your municipality.

2. Choose a health insurance company.

3. Apply online or over the phone.

4. Receive confirmation and health insurance card (zorgpas).

5. Start paying monthly premiums.

You’ll also receive an insurance policy document outlining your coverage.

14. Conclusion

Health insurance in the Netherlands is a well-regulated and structured system that ensures everyone has access to high-quality care. While the process can seem complex at first, understanding the basics—mandatory coverage, premiums, deductibles, and your rights—can help you make smart decisions and avoid costly mistakes.

Whether you're a long-time resident or new to the Netherlands, staying informed about your health insurance options is not just a legal requirement — it’s also essential to your overall well-being.