Health Insurance in the Netherlands: A Comprehensive Guide

The Netherlands is internationally known for its high standard of living, efficient public services, and robust healthcare system. One of the key pillars of Dutch healthcare is mandatory health insurance, which ensures that all residents have access to essential medical services. While the healthcare system in the Netherlands is publicly regulated, it is largely delivered by private providers and financed through private health insurers. This article offers a comprehensive overview of health insurance in the Netherlands, covering its structure, costs, coverage, providers, and special considerations for residents and expats.

1. The Structure of the Dutch Healthcare System

The Dutch healthcare system is based on the principles of universal access and individual responsibility. Since the introduction of the Health Insurance Act (Zorgverzekeringswet) in 2006, all residents of the Netherlands are legally required to purchase basic health insurance (basisverzekering) from a private insurer.

There are two key components to healthcare in the Netherlands:

• Basic Health Insurance (Basisverzekering): Mandatory for all residents.

• Supplementary Insurance (Aanvullende verzekering): Optional and covers services not included in the basic package, such as dental care, physiotherapy, or alternative treatments.

Despite being offered by private companies, the basic health insurance package is standardized by the government, meaning that all insurers offer the same core coverage. However, premiums, customer service, and additional perks may vary between insurers.

2. Is Health Insurance Mandatory in the Netherlands?

Yes, health insurance is mandatory for:

• All Dutch citizens and legal residents.

• Expats living and working in the Netherlands.

• Students and interns (depending on their status and work conditions).

Failure to obtain health insurance within four months of becoming a resident can result in fines and even retroactive premium charges.

3. What Does the Basic Health Insurance Cover?

The basic package (updated annually by the Dutch government) includes:

• Visits to the general practitioner (GP)

• Hospital stays and specialist care

• Prescription medications

• Maternity care

• Mental health care

• Emergency care

• Medical aids and equipment (e.g., crutches, wheelchairs)

• Ambulance transport

Children under 18 are covered for free under their parents’ insurance, and the coverage includes vaccinations, pediatric care, and dental care up to age 18.

4. Costs of Health Insurance in the Netherlands

Health insurance in the Netherlands involves two main types of costs:

A. Monthly Premium (Premie)

As of 2025, the average monthly premium is around €135–€150 per adult, depending on the insurer and chosen policy. Premiums are paid directly to the insurer.

B. Annual Deductible (Eigen Risico)

The standard mandatory deductible is €385 per year (2025), which means you must pay the first €385 of eligible healthcare costs out of pocket before insurance kicks in.

Optional: You can increase the deductible (up to €885) in exchange for a lower monthly premium — a common choice for young, healthy individuals.

C. Zorgtoeslag (Healthcare Allowance)

To make healthcare affordable, the Dutch government provides healthcare allowance to low- and middle-income residents. This benefit can cover a large part of the monthly premium and is calculated based on income, household size, and assets.

5. Types of Policies

There are three main types of insurance policies in the Netherlands:

1. Restitutiepolis (Reimbursement Policy):

You can choose any healthcare provider, and the insurer reimburses the costs, sometimes in full.

2. Naturapolis (In-Kind Policy):

You receive care from providers contracted by your insurer. It usually has lower premiums, but you may have to pay more if you use non-contracted providers.

3. Combinatiepolis (Combination Policy):

A mix between reimbursement and in-kind models.

6. Choosing a Health Insurance Provider

There are over 40 insurers in the Netherlands, but many operate under a few larger umbrella groups. Popular insurers include:

• Zilveren Kruis

• VGZ

• CZ

• Menzis

• OHRA

• FBTO

• DSW

Each insurer offers a range of plans, varying in price, service, online tools, and customer satisfaction. Most allow annual changes, with the switch deadline being December 31st of each year.

7. Supplementary Health Insurance

While the basic insurance covers essential care, many residents purchase supplementary insurance for services like:

• Extensive dental care (especially for adults)

• Physiotherapy

• Glasses and contact lenses

• Alternative medicine

• Orthodontics

Supplementary plans are not mandatory and are not regulated by the government, so coverage and pricing vary widely.

8. Health Insurance for Expats and Foreigners

Expats who move to the Netherlands for work or long-term stay are usually required to obtain Dutch health insurance within 4 months of registration. Special cases include:

• EU/EEA citizens: May use their EHIC (European Health Insurance Card) temporarily, but must switch to Dutch insurance if working or living long-term.

• Students: May remain under their home insurance if they’re not working.

• Highly skilled migrants: Must obtain Dutch insurance immediately.

Expats often use English-friendly comparison tools like Zorgwijzer, Independer, or Zorgkiezer to compare plans and register.

9. Dental Care in the Netherlands

For adults, dental care is not included in the basic insurance (except for emergencies). You’ll need to buy supplementary dental insurance if you want regular checkups, fillings, and orthodontic care covered.

For children under 18, dental care is included in the basic package.

10. How to Apply for Health Insurance in the Netherlands

Applying for health insurance is simple and can be done online:

1. Compare plans via a comparison site.

2. Choose a provider and type of policy.

3. Register with your personal details and BSN (Citizen Service Number).

4. Set up monthly payments via direct debit.

Once enrolled, you’ll receive a health insurance card and policy documents.

11. Switching Health Insurance Providers

You can switch insurers once a year, during the open enrollment period (November 15 – December 31). Your new insurer will typically cancel your old policy for you. If you miss the deadline, you are generally locked into your current provider for another year unless there are exceptional circumstances (e.g., moving to the Netherlands, turning 18, or losing coverage through a spouse).

12. Conclusion

The Dutch health insurance system successfully combines universal coverage, regulated competition, and individual choice. While premiums and deductibles may seem high to some, the level of care, short waiting times, and access to top-quality medical services justify the cost for many residents.

Understanding your responsibilities and options when it comes to Dutch health insurance ensures peace of mind — whether you’re a citizen, expat, or student living in one of Europe’s most healthcare-advanced countries.