Healthcare Basics

Health insurance in the Netherlands

Questions about Dutch health insurance? From basic coverage to vrijwillig eigen risico, discover the ins and outs of this life-saving topic.

Health insurance Netherlands

By Laura van der Most

Updated 9-4-2024

The Netherlands has arguably one of the best healthcare systems in the world. Financed through a combination of mandatory medical insurance, social security contributions, and voluntary payments, the Dutch healthcare sector provides essential medical to all residents, no matter their income.

Learn all there is to know about health insurance in the Netherlands, including:

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The healthcare system in the Netherlands

The Dutch have a first-rate healthcare system (gezondheidszorg) that provides broad universal health coverage for all residents. While not completely free, the system based on mandatory health insurance makes sure all residents can access primary care, no matter their income.

Two ambulance workers standing by an ambulance in The Hague, the Netherlands.
The Hague, the Netherlands (Photo: Patrick van Katwijk/BSR Agency/Getty Images)

The nonprofit think tank Foundation for Research on Equal Opportunity (FREOPP) ranks the healthcare system in the Netherlands as third best in the world, and Organization for Economic Co-operation and Development (OECD) calls it “very effective“.

While mandatory health insurance (basisverzekering) covers primary care (e.g., mental healthcare and emergency care), it is very common for residents to take out additional coverage (aanvullende verzekering). In 2022, 83.6% of the population had supplementary coverage for their secondary care needs such as dental care, glasses, and alternative medicines.

In 2019, the Netherlands reportedly spent €97 billion on healthcare (or over €5,600 per inhabitant). This is around 10.2% of the GDP, which is slightly above the EU average of 9.9%.

How does health insurance work in the Netherlands?

All residents aged over 18 – including multi-year students, employees, and retirees – must take out basic medical coverage. This covers the cost of any primary medical care, should they need it. Minor children under the age of 18 are covered by the insurance policy of their parent or guardian.

Aside from that, every adult pays an annual deductible (own risk or eigen risico) if they have received primary care treatment. This excess must be paid first before the insurance provider pays the remainder of the costs. In 2023, the own risk deductible is a total of €385 for the entire year. In other words, if you have had a medical bill of €385 in January, you don’t have to pay for any primary medical treatment for the rest of the year.

The own risk does not apply to visits to a general practitioner (GP) or family doctor (huisarts), obstetric or maternity care, or district nursing (wijkverpleging). These primary care services are completely free.

In some cases (e.g., you need a hearing aid), you are asked to pay a personal contribution (eigen bijdrage). The government annually decides which needs require this eigen bijdrage. You can visit the government website for more information.

Almost 85% of the Dutch population also has additional health insurance. These policies cover secondary treatment, such as dentistry and alternative medicines. It does not cover the deductible or eigen bijdrage.

Health insurance for international students and expats

Temporary visitors (i.e., non-residents) from the EU/EFTA (European Free Trade Association – Iceland, Liechtenstein, Norway, and Switzerland) can access medical care with a European Health Insurance Card (EHIC). Third-country citizens will need to have medical and travel insurance to cover their healthcare needs.

Tourists visiting de Keukenhof in Lisse, the Netherlands.
Keukenhof in Lisse, the Netherlands (Photo: Abdullah Asiran/Anadolu Agency via Getty Images)

Temporary residents (e.g., international students) are not required to take out health insurance in order to study in the Netherlands. That said, if they’re employed during their studies – even on a zero-hour contract – they do need to get medical insurance. Unfortunately, there is no special student health insurance policy. However, they can apply for a subsidy, as explained below.

Finally, expats with a residence permit must take out insurance like everyone else in the Netherlands. That said, if they are employed with a European organization (e.g., Europol), they can get healthcare treatment through the European Joint Sickness Insurance Scheme (JSIS).

What happens if I am not covered by health insurance?

You have four months to take out medical insurance after arriving in the Netherlands. After that, the governmental Central Administrative Office (Centraal Administratief Kantoor – CAK) will send you a warning. You then have three months to get insured, before you get a fine of € 472,25 (2023).

If you disagree with this warning because you feel you don’t need insurance, you can request an inquest with the Social Insurance Bank (Sociale Verzekeringsbank – SVB). This is the regulatory body that takes care of social security in the Netherlands. If you disagree with this warning because you already have healthcare coverage, you must contact your insurance company.

After two fines, the CAK will take out insurance for you and deduct the premium from your income. This premium is 120% of the standard premium that you’d pay if you had taken out the insurance yourself. If they are unable to deduct the premium, the bills are sent to the Central Judicial Collection Agency (Centraal Justitieel Incassobureau – CJIB). This agency is part of the Dutch justice system and is responsible for collecting fines (e.g., traffic fines).

What is covered by basic medical insurance?

Mandatory health insurance covers all primary care needs as determined by the Dutch government. This so-called basic package (basispakket) is reevaluated every year. If the costs are covered by the basisverzekering, you will have to pay the own risk deductible (except in the case of visits to a family doctor, obstetric or maternity care, or district nursing (wijkverpleging)).

Doctors, hospitals, and emergency care

Any consultation with a GP is covered by basic insurance and does not require you to pay your own risk. However, if you undergo testing that is sent to a lab (e.g., a blood test), the deductible does apply.

Cancer patient smiling with his son, who is sitting with his arm around his father.
Photo: 1shot Production/Getty Images

Emergency care, hospital treatment, as well as ambulance rides are also covered by mandatory medical insurance. It also includes treatment at home, which can be particularly useful to the elderly and those living with a disability.

How to find a doctor or GP near you

If you are new to the Netherlands, it’s important to register with a family doctor as soon as possible. If you haven’t and you become ill, you might find it difficult to see a nearby doctor as their practice may already be full.

To find a GP near you, you can use a locator site such as Zorgkaart Nederland or Kies Uw Huisarts. Although many doctors speak relatively good English, there are also many international health centers that offer expat-friendly care. For example:

Prescription medication

All prescribed medication is covered by basic health insurance. Some require you to pay eigen bijdrage, for example, because there is a cheaper generic brand available.

Mental healthcare in the Netherlands

Basic medical insurance only covers mental healthcare when you have a referral from the family doctor. If you experience mental health issues but your doctor neglects to refer you, any treatment you seek thereafter will not be covered. This includes online therapists.

Maternity care in the Netherlands

Most maternity services, including midwives, mandatory health scans, hospital births, and home births are covered by Dutch health insurance. If you want additional testing that is not recommended by a doctor, you will likely pay for it yourself.

As a side note, you will often receive free baby essentials from your insurance company if you have an additional healthcare policy.

Dental care in the Netherlands

Minor children under the age of 18 receive free basic dental care in the Netherlands. This excludes orthodontics (i.e., braces). Adults are only covered for dentistry if they have taken out additional health insurance.

Note that if your dental issues are treated in a hospital (e.g., wisdom tooth removal), it falls under hospital care, which is covered by basic insurance.

Vision care and eye doctors

Visits to an optician and ordinary contact lenses and glasses are not covered by basic health insurance. However, medically necessary contact lenses and special glasses often are. Keep in mind that you will likely have to pay an eigen bijdrage.

Sexual and reproductive health

While mandatory insurance coverage includes some sexual health treatments, it does not cover everything.

Two young women on an ice cream date, one is leading on her hand, smiling and looking passionately at the other.
Photo: David Espejo/Getty Images

Hormonal anticonception (anticonceptie) is available with a prescription and will only be covered by basic health insurance if you are younger than 20 years old. This includes the pill (pil) and intra-uterine devices (IUD – spiraaltje). If you are aged 21 and up, you will have to pay the costs of anticonception yourself. In some cases, you can get coverage for anticonception if you have additional healthcare coverage.

Emergency Contraception (morning-after pil) is available without a prescription and can be bought at any drugstore or pharmacy. Abortion is legal in the Netherlands and requires a referral from a family doctor. As such, it’s covered by mandatory insurance.

Depending on your situation, you can get a free and anonymous STD (Seksueel Overdraagbare Aandoening – SOA) test at the Municipal Health Services (Gemeentelijke Gezondheidsdienst – GGD). However, in most cases, you’ll have to contact your GP for a test. Although that ensures that it is covered by basic insurance, you will likely need to pay the own risk.

Some fertility treatments (vruchtbaarheidsbehandelingen) are also covered by standard medical insurance. However, you should check with your family doctor before pursuing IVF or the ROPA method.

Transgender healthcare

Most gender-affirming treatments are covered by basic insurance in the Netherlands. That said, there are many hoops you will have to jump through. It’s recommended to consult with your GP and the insurance company before you start any treatment. Also, getting legal insurance (rechtsbijstandverzekering) with medical coverage would not be unwise.

Vaccinations in the Netherlands

Most recommended vaccines are covered by basic insurance, including:

Required and recommended vaccinations for international travel are not covered by Dutch health insurance. You can get those costs covered by an additional insurance policy.

Alternative/complementary therapies

Dutch medical insurance does not cover holistic treatments (alternatieve geneeswijzen), such as acupuncture, halotherapy, homeopathy, iridology, and chiropractic treatment. Additional healthcare policies can cover these forms of treatment, depending on the insurance company.

Treatment abroad

Medical expenses in another country are usually not covered by Dutch health insurance unless it is a severe emergency that cannot be left untreated.

Bul run in Pamplona, Spain
Bull run in Pamplona, Spain (Photo: David Domench/Europa Press via Getty Images)

You can take out additional health or travel insurance to cover non-essential treatment and repatriation from abroad.

Dutch health insurance companies

There are 20 Dutch healthcare companies operating in the Netherlands, as well as a number of international insurance providers. Global coverage is a great option for expats who move around a lot, as these policies often cover you in multiple countries.

Top-rated health insurance companies in the Netherlands include:

Whichever you go for, choose wisely, because you can only change policies in the Netherlands once a year from mid-November to December. If you need help choosing one, you can use our Directory to find affordable medical care options.

If you’re looking to take out an additional policy, it is best to compare companies and see which one you like. For example, you can see what is what with a comparison tool like Independer. Otherwise, you might select your insurer on its contracted healthcare providers and monthly premium.

How much is Dutch health insurance?

Despite the impression some might have, the Dutch healthcare system is not free. Instead, it is financed by a combination of social security contributions and mandatory medical insurance.

The social security contributions are set out by the law on health insurance (zorgverzekeringswet). Employers and benefits instances pay a percentage per employee/benefits recipient and deduct a percentage of the wages or benefits. Together it forms the social security contribution. In 2023, the percentages are 6.68% for employers and 5.43% for employees/recipients.

Freelancers and self-employed workers are responsible for making their own contributory payments. These percentages are also set at 543% in 2023.

Nurse is wheeling a cart with a computer to an empty bedside.
Photo: Arno Masse/Getty Images

Depending on the primary care treatment, residents are also asked to pay an own risk deductible of up to €385 per year, and an eigen bijdrage. Visit the government website for more information on this topic.

Cost of basic health insurance policies

The insurance companies negotiate and contract healthcare providers based on quality and price. Although all Dutch insurance companies cover the same medical services, the prices can differ a lot.

There are four kinds of basic healthcare policies in the Netherlands:

  • Budget policy (budgetpolis) – only a handful of insurers offer this kind of policy. It covers the same primary needs, however, you can only go to a select group of medical care providers. It is often the cheapest policy available.
  • Natura policy (naturapolis– this policy covers 100% of the medical costs when you go to a contracted care provider, and only 60-80% of the costs when you go to a non-contracted provider
  • Restitution policy (restitutiepolis) – this policy covers 100% of your medical costs, regardless of whether the healthcare provider is contracted or not
  • Combination policy (combinatiepolis) – this is a combination of the natura and restitution policy. The coverage of medical costs differs per insurance provider.

In 2023, the average premium of health insurance (zorgpremie) is €1,661.40 per year (or €138,45 per month).

Discounts, allowances, and tax deductibles

You can choose to top up your own risk deductible in exchange for a discount. This is called vrijwillig eigen risico. Depending on your insurance company, you can increase it by €100-500 a year. Although your premium will be discounted by up to €300 a year (or €25 a month), you do take the risk that you have to pay a deductible of up to €885.

If your income is below a certain threshold, you can apply for a healthcare allowance (zorgtoeslag) from the Dutch tax office (Belastingdienst). This allowance is available from the day you turn 18. In 2023, these threshold levels are set at €38,520 for single individuals and €48,224 for couples. If you do not have an income but have assets, they cannot be more than €127,582 for individuals and €161,329 for couples.

Those who have exorbitant medical costs (e.g., because they’re chronically ill), can deduct it from their income tax return. You can check the rules and your eligibility on the government website.

How to register for health insurance in the Netherlands?

To sign up for mandatory healthcare, you must have a Citizen Service Number (burgerservicenummer – BSN). You can apply for this at your local municipality.

View of stereotypical windmills in the Netherlands.
Kinderdijk windmills in the municipality of Molenlanden, Netherlands (Photo: Nicolas Economou/NurPhoto via Getty Images)

After that, you are free to choose the insurance company you want to go with. By law, insurers cannot refuse your application, even if you have pre-existing conditions.

Signing up can be done online or over the phone. You’ll need to provide your:

Once your application has been processed, you’ll receive your EHIC by mail, which you might need to present when you use any of the healthcare services in the Netherlands.

When and how to change health insurance

You can only change Dutch health insurance policies once a year from mid-November to December. That is when the government reveals the medical coverage package for that year and the insurance companies adjust their monthly fees.

To change providers, you simply contact your new insurer and tell them you want to switch. They will take care of the rest.

Insurance companies also offer a cooling-off period, where you can cancel your policy after initially signing up. Typically this period is set at 14 days.

How to cancel your Dutch health insurance

If you change your mind and want to stay with your old provider, you can contact the new insurer to cancel your application. Be sure to do so within the 14-day cooling-off period.

If you’re leaving the Netherlands for another country, you must deregister yourself from your municipality. Because your policy is linked to your BSN, your health insurance will be canceled automatically.

For more information, you can check the government-backed Zorgverzekeringslijn.

Additional health insurance in the Netherlands

The basic healthcare package contains most of the medical treatments a person would need to live a healthy life. Procedures that fall outside of this package are often covered by an additional healthcare policy.

Woman lying on a bench, getting an acupuncture treatment.
Photo: tekinturkdogan/Getty Images

Examples of additional health coverage include:

Depending on the extra coverage, you’ll pay an extra €120-960 per year (or €10-80 per month).

You can sign up for additional coverage with your insurance company. Some insurers allow you to have a basic policy with one insurance company and take out extra insurance with another. However, this is not advisable as it will give you a lot of administrative hassle.

It’s important to note that insurance companies are not legally obliged to accept your application for additional healthcare coverage.

Health insurance for unemployed and low earners

All basic healthcare policies are the same in the Netherlands (though they do differ in price). If you cannot afford the premiums, you can apply for a healthcare allowance from the Dutch tax office.

Useful resources

  • Dutch tax office – website where you can apply for the Dutch healthcare allowance
  • Rijksoverheid Zorgverzekering – government website with information about the Dutch healthcare system
  • SVB – official website of the social security agency where you can request an inquest if you believe you do not need to take out health insurance in the Netherlands
  • ZorgKiezer – independent comparison website with a complete overview of Dutch health insurance policies, including premiums

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