Health Insurance in the Netherlands: A Comprehensive Guide

The Netherlands is widely recognized for its high-quality and accessible healthcare system. At the heart of this system lies a mandatory health insurance scheme designed to ensure that all residents have access to essential medical services. Whether you're a Dutch citizen, a long-term resident, or an expat planning to move to the Netherlands, understanding how health insurance works in this country is crucial.

This article explores the Dutch health insurance system in detail, including its structure, costs, coverage, providers, and how to choose the best insurance plan for your needs.

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1. Overview of the Dutch Healthcare System

The Dutch healthcare system operates under a model known as regulated competition. It combines public responsibilities with private execution. Health insurance is mandatory for all residents and is provided by private insurance companies that are strictly regulated by the government to ensure fairness, transparency, and accessibility.

The system is divided into two main components:

• Basic Health Insurance (Basisverzekering) – Mandatory and standardized by law.

• Supplementary Health Insurance (Aanvullende Verzekering) – Optional and varies by provider.

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2. Mandatory Basic Health Insurance

Every person living or working in the Netherlands is required by law to have basic health insurance, regardless of age or health condition. This rule applies to:

• Dutch citizens

• Expats with a residence permit

• International students (in some cases)

• Cross-border workers

The government defines what is included in the basic package. All insurance providers must offer the same basic coverage to everyone at the same price, although premiums may vary slightly depending on the insurer and chosen policy structure.

What Does the Basic Insurance Cover?

The basic health insurance package includes coverage for:

• Visits to the general practitioner (GP)

• Hospital treatment and emergency care

• Specialist care and consultations

• Maternity and obstetric care

• Mental health services

• Prescription medications (mostly generic drugs)

• Limited dental care for children under 18

• Physiotherapy for chronic conditions

• Preventive care (vaccinations, screening)

What’s Not Covered?

The basic package does not cover:

• Most adult dental care

• Physiotherapy for short-term issues

• Alternative medicine

• Glasses/contact lenses

• Cosmetic procedures

To cover these services, individuals may choose a supplementary plan.

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3. Supplementary Health Insurance

While not mandatory, supplementary insurance allows policyholders to extend their coverage. Each insurance provider offers different supplementary packages tailored to specific needs such as:

• Dental coverage

• Physiotherapy sessions

• Optical care (glasses and contact lenses)

• Alternative therapies (e.g., acupuncture)

• International medical coverage

Supplementary policies are not regulated in the same way as basic insurance, meaning insurers can refuse applicants or charge different premiums based on age and health condition.

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4. Costs of Health Insurance

Monthly Premium (Premie)

As of 2025, the average monthly premium for basic health insurance in the Netherlands ranges between €125 to €150 per person. This amount is paid directly to the insurance provider.

Deductible (Eigen risico)

In addition to the monthly premium, there is an annual deductible—known as “eigen risico”. This is the amount you must pay out-of-pocket for most medical costs before your insurance begins to cover expenses. The standard deductible in 2025 is €385.

Some services are exempt from the deductible, such as:

• GP visits

• Maternity care

• Children’s healthcare (under 18)

You can also increase your deductible voluntarily (up to a maximum of €885) to reduce your monthly premium.

Government Allowance (Zorgtoeslag)

To make health insurance more affordable, the Dutch government provides a healthcare allowance (zorgtoeslag) to low-income individuals and families. The amount depends on income and household size and can be as much as €120–€150 per month.

You can apply for zorgtoeslag through the Dutch Tax Office (Belastingdienst).

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5. Choosing a Health Insurance Provider

There are more than 30 health insurance providers in the Netherlands, including major companies like:

• Zilveren Kruis

• VGZ

• Menzis

• CZ

• DSW

• OHRA

• FBTO

All insurers offer the same basic coverage, but they differ in:

• Monthly premiums

• Service quality and customer support

• Online tools and app availability

• Supplementary packages

• Policy types (e.g., restitutie vs naturapolis)

Types of Policies

• Restitution Policy (Restitutiepolis): You can visit any healthcare provider and get reimbursed fully.

• In-kind Policy (Naturapolis): You can only visit providers contracted by your insurer. Out-of-network care may not be reimbursed or will be partially reimbursed.

• Combination Policy (Combinatiepolis): A mix of both types.

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6. Health Insurance for Children

Children under 18 are insured for free under the basic health insurance scheme, but they must still be registered with an insurer. Parents can also choose to purchase supplementary insurance for their children.

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7. Health Insurance for Expats and International Students

Expats

If you're an expat living or working in the Netherlands, you must obtain Dutch health insurance within 4 months of registering with the municipality. This applies even if you have private insurance from another country.

Failure to do so can lead to fines and back payments for missed premiums.

International Students

• EU/EEA students with a European Health Insurance Card (EHIC) may not need Dutch insurance.

• Non-EU students may require Dutch insurance if they take a part-time job or internship.

Always consult with your educational institution or IND (Immigration and Naturalisation Service) to understand your obligations.

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8. Switching Insurance Providers

You can switch insurance providers once a year, during the annual open enrollment period (November 12 to December 31). Your new policy will start on January 1 of the following year.

If you don’t switch, your policy automatically continues. You can cancel your policy through your new insurer, who will take care of the transfer.

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9. Penalties for Not Having Insurance

Failure to purchase health insurance can result in:

• Fines issued by the CAK (Central Administration Office)

• Mandatory enrollment by the government

• Back payment of missed premiums

It is not legal to live in the Netherlands without health insurance if you're required to have it.

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10. Emergency Care and Temporary Visitors

Emergency medical services in the Netherlands are available to everyone, regardless of insurance. However, uninsured individuals (e.g., tourists) may be required to pay the full cost unless covered by travel insurance or an EHIC.

For temporary stays, private travel health insurance is recommended.

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Conclusion

Health insurance in the Netherlands is a well-structured and regulated system designed to provide universal access to quality healthcare. While the mandatory nature of insurance may seem strict, it ensures that everyone receives the care they need without discrimination.

Understanding your options, rights, and responsibilities helps you make the best decision—whether you're a lifelong resident or a newcomer settling into Dutch life.

Choosing the right insurer and knowing how to use the system effectively can significantly impact both your health outcomes and financial well-being. Always compare plans, check provider networks, and consider your specific healthcare needs when selecting a policy.

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Health Insurance in Switzerland: A Complete Guide

Switzerland is renowned not only for its beautiful landscapes and strong economy but also for its efficient and high-quality healthcare system. At the core of this system lies a mandatory health insurance model that ensures universal coverage for all residents. However, the Swiss healthcare system is also one of the most expensive in the world, and navigating it requires a clear understanding of how health insurance works.

This article provides a comprehensive overview of health insurance in Switzerland, including its structure, coverage, costs, providers, and tips for choosing the right insurance plan.

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1. Overview of the Swiss Healthcare System

Switzerland follows a universal healthcare model based on mandatory private insurance. Unlike many European countries that rely on tax-funded public healthcare, Switzerland mandates that all residents purchase private health insurance from approved providers.

Healthcare in Switzerland is decentralized, meaning the country's 26 cantons are responsible for managing health services in their regions. However, the system is guided by national health laws, ensuring consistency across the country.

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2. Mandatory Health Insurance (LaMal)

What Is LaMal?

The Swiss Federal Health Insurance Law, also known as LaMal (L'Assurance Maladie), requires all Swiss residents to have basic health insurance (KVG/LAMal) from an authorized insurance provider. This insurance guarantees access to a wide range of medical services and is compulsory for:

• Swiss citizens

• Residents with a Swiss residence permit

• Foreigners working or studying in Switzerland

• Refugees and asylum seekers

Everyone must obtain health insurance within three months of arriving in Switzerland or registering as a resident.

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3. What Does Basic Health Insurance Cover?

Despite being offered by private companies, the basic health insurance package is regulated by law, meaning all providers must offer the same minimum level of benefits. It includes:

• Visits to general practitioners (GPs)

• Specialist consultations (with a GP referral)

• Hospital treatment (in general wards)

• Emergency care

• Prescription medications (as listed on the Federal Drug List)

• Maternity care (check-ups, delivery, postnatal care)

• Mental health care (within certain limits)

• Rehabilitation services

• Diagnostic tests and laboratory work

The basic plan provides extensive coverage, but not everything is included.

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4. What’s Not Covered by Basic Insurance?

Services not covered by basic health insurance include:

• Dental care for adults

• Glasses and contact lenses

• Cosmetic surgery

• Alternative therapies (unless part of a specific approved plan)

• Private or semi-private hospital rooms

• Care abroad (beyond emergency services)

To cover these services, individuals can purchase supplementary insurance.

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5. Supplementary Health Insurance

Supplementary insurance (VVG) is optional and varies significantly between insurers. These plans offer additional benefits such as:

• Dental treatment

• Alternative medicine (e.g., acupuncture, homeopathy)

• Private or semi-private hospital rooms

• Coverage for medical care abroad

• Additional maternity services

• Fitness programs and wellness benefits

Supplementary insurance is not regulated like basic insurance, so providers can refuse applicants or charge higher premiums based on health conditions and age.

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6. Costs of Health Insurance in Switzerland

Premiums

Switzerland has some of the highest health insurance premiums in the world. As of 2025, the average monthly premium for basic insurance is CHF 350 to CHF 450 per adult, but this varies based on:

• Canton of residence

• Chosen insurer

• Deductible (franchise) level

• Type of plan (HMO, Telmed, traditional)

Children and young adults (under 26) pay lower premiums.

Deductibles (Franchise)

The franchise is the amount you pay out-of-pocket each year before your insurer starts covering medical costs. You can choose between:

• CHF 300 (minimum)

• Up to CHF 2,500 (maximum)

Higher deductibles lower your monthly premium, but increase your upfront costs when you need care.

Co-Payment (Retention)

After meeting your deductible, you must still pay 10% of all treatment costs up to a limit of CHF 700 per year (CHF 350 for children). This is called co-payment (Selbstbehalt/franchise).

Hospital Stay Contribution

In addition, insured individuals must contribute CHF 15 per day for hospital stays.

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7. Premium Subsidies (Prämienverbilligung)

To help lower-income individuals afford health insurance, the Swiss government offers premium subsidies, which are managed by each canton.

Eligibility and subsidy amounts depend on:

• Income and assets

• Family size

• Canton of residence

You can apply for subsidies through your cantonal health department.

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8. Choosing an Insurance Provider

There are over 60 authorized health insurance providers in Switzerland, including:

• CSS

• Helsana

• Sanitas

• Groupe Mutuel

• SWICA

• Concordia

• Atupri

While the basic coverage is identical by law, insurers vary in:

• Monthly premiums

• Customer service

• Online tools and apps

• Administrative efficiency

• Network restrictions (in managed care models)

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9. Types of Insurance Models

Swiss insurers offer several plan types for basic insurance, including:

Traditional Model

• Freedom to visit any doctor or specialist.

• Highest monthly premiums.

HMO Model (Health Maintenance Organization)

• Must visit a specific group of doctors or a health center.

• Lower premiums.

Telmed Model

• Must call a medical hotline before visiting a doctor.

• Lower premiums.

Family Doctor Model

• Must consult your assigned GP for all medical needs.

• Referrals required for specialists.

These models help reduce costs but require you to follow a specific care path.

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10. Health Insurance for Foreigners and Expats

If you move to Switzerland, you must purchase health insurance within 3 months of arrival. The coverage is retroactive to your arrival date, meaning you must pay premiums for the entire period—even if you haven’t used any healthcare services.

Expats with international health insurance may request an exemption, but this is rarely granted unless the foreign policy is deemed equivalent by the local authority.

Cross-border Workers (Frontaliers)

People who live in France, Germany, or Italy but work in Switzerland may choose between:

• Swiss health insurance

• Local insurance in their home country (under certain conditions)

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11. Health Insurance for Children and Students

• Children must be insured individually within 3 months of birth or arrival in Switzerland.

• Students must also obtain health insurance unless they have a recognized foreign plan.

Discounted student policies are available with certain providers.

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12. Switching Insurance Providers

Swiss residents can change their basic health insurance provider once per year:

• Cancellation deadline: November 30

• New policy effective: January 1

Supplementary insurance policies often have longer notice periods and stricter cancellation rules.

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13. Penalties for Not Having Insurance

If you fail to get health insurance within 3 months of becoming a resident:

• You may be automatically enrolled in a plan by the cantonal authority.

• You will be responsible for back payments of premiums.

• You may also face late fees or penalties.

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14. Emergency and International Coverage

Basic insurance covers emergency care abroad, but only up to double the Swiss rate. This often isn’t enough in high-cost countries like the U.S. For frequent travelers, supplementary insurance with global coverage is recommended.

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15. Summary

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Conclusion

Switzerland’s healthcare system is highly effective, accessible, and ensures that every resident is protected by health insurance. Although the costs can be substantial, the structure of the system—including deductible choices, policy types, and premium subsidies—offers flexibility and fairness.

Understanding how health insurance works in Switzerland is essential for managing your health, finances, and legal obligations. Whether you're a Swiss citizen, an expat, or planning to move to Switzerland, choosing the right policy and insurer can make a significant difference in the quality and cost of your healthcare experience.