Moving to the Netherlands? Make sure you and your family are covered for every eventuality by reading our guide to health insurance in the Netherlands.
This guide on Dutch health insurance covers the following topics:
- Introduction to health insurance in the Netherlands
- How does health insurance work in the Netherlands?
- What is covered by the basic Dutch health insurance?
- Health insurance providers in the Netherlands
- How much does health insurance cost in the Netherlands?
- Do I need health insurance in the Netherlands?
- How do I apply for Dutch health insurance?
- Health insurance for unemployed or low earners
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Introduction to health insurance in the Netherlands
Some quick, important facts about health insurance in the Netherlands:
- The Dutch healthcare system is ranked the second-best in Europe (behind Switzerland) according to the Euro Health Consumer Index.
- Health insurance is mandatory if you’re living or working in the Netherlands.
- Costs for a basic package are the same whether you’re young or old, in perfect health or with pre-existing conditions.
- Children are covered free of charge under their parents’ plan until they turn 18.
- If you earn less than €29,500, you may be eligible to receive financial health benefits from the government to help pay for your health insurance premiums.
Health insurance in the Netherlands is a complex but well-built universal system: it is regimented by public policy, but implemented via private companies (which, for the most part, function as non-profits). Many expats will find that the mandatory basic package (basisverzekering) provided by Dutch health insurance companies will be sufficient to cover their needs. However, depending on your personal circumstances and eligibility, you may prefer to get additional coverage (to get dental benefits, for example), or go the route of an international health insurance policy.
How does health insurance work in the Netherlands?
Firstly, let’s start with the basics. The Dutch health insurance is a two-level system:
- Zvw: The Zvw (Zorgverzekeringswet) system requires all residents in the Netherlands to take out a basic Dutch public health insurance package known as basisverzekering or basispakket. For a monthly fee, this package will cover most healthcare services, including doctor’s appointments and hospital trips. All insurance providers must offer the same basic package to everyone and must accept all applicants regardless of medical history.
- Wlz: The Wlz (Wet langdurige zorg) system covers long-term nursing and care treatment, such as dementia and other mental and physical impairments. In this system, the government assesses your situation to determine the necessary care. Residents aged 18 years and older must provide a monetary contribution (eigen bijdrage) from their salary. This is calculated depending on income, financial capital, and living situation.
What is covered by the basic Dutch health insurance?
The basic Dutch insurance package typically covers all costs for common medical care services. The services included in this package are decided annually by the Dutch government. Currently, the basic health insurance package covers the following:
- GP consultations
- treatments from specialists and hospital care
- dental care and physiotherapy up to 18 years old
- care from certain therapists, such as speech therapists
- basic mental health services
- anti-smoking programs
- dietary advice
- obstetrics and maternity care.
Should you require other treatments or wish to be covered for every eventuality, you can ‘top-up’ your public health insurance policy by choosing additional coverage and packages. The availability and coverage of these additional packages will vary between providers. Any additional packages will increase the amount you pay monthly.
Health insurance providers in the Netherlands
You are free to select the health insurance provider of your choice. However, you may find it easier to opt for a company that offers information in English, as many have Dutch-only websites. Some notable expat-friendly health insurance providers include:
International health insurance
Many expats prefer the ease of international health insurance premiums. They are particularly popular with expats who move around a lot, as these premiums often cover you in multiple countries. Furthermore, most offer all their services in English, meaning there’s no worry of anything getting lost in translation.
International health insurance companies in the Netherlands include:
Read how to choose between local or international private health insurance.
Dutch health insurance through employment
Some employers also offer corporate health insurance schemes for employees. This may be cheaper than taking out a policy individually, so be sure to ask your employer if they offer a corporate scheme. Should you need to, you are able to purchase additional coverage (aanvullende pakket) from a different insurer. You can use this to ‘top-up’ your health cover.
Comparing health insurance plans and options
When signing up for health insurance, it’s essential you find the cover best suited to you and your family. This means doing your research. You’ll need to know exactly what treatments are covered, how much you’ll need to pay, and what excess payments you might need to make. This is especially important if you or a family member have any particular medical needs.
A quick and easy way to compare health insurance policies is by using a comparison tool. Websites like Independer and the Dutch Government’s Kies Beter (Choose Better) can help you make better decisions when it comes to protecting you and your family’s health coverage.
How much does health insurance cost in the Netherlands?
Costs of the basic health insurance package
Generally speaking, the basic package costs just over €100 per month. However, what you pay exactly will depend on the insurance company you pick, but what is good to know is that the system works on a fair basis of solidarity so your age, gender, pre-existing medical conditions or any other factor will not change that price.
Own risk: Dutch health insurance deductibles
Dutch health insurance companies typically charge a contribution to your “own risk” (eigen risico). This is an excess fee (or deduction) towards your annual medicals bills. For 2020, the standard excess fee for all insurance companies is set at €385. This is the amount you need to pay yourself for certain medicines and treatments before your insurance premium kicks in and covers the rest of the costs.
Should you wish – if you are healthy as a horse, for example – you are able to increase this own risk amount, from €385 up to €885. This typically means a slightly lower monthly payment. However, should you require certain treatment and medication you will need to pay more out of your own pocket before your insurance kicks in.
On the other hand, you can also choose to select a basic plan that includes the eigen risico, but of course your monthly premiums will then be higher – which could be advantageous by spreading out the costs if you know you will be needing a lot of medical treatment throughout the year.
Topping up your basic health insurance coverage
You can also take out cover for extra treatments (for example, physiotherapy, psychiatric care or extensive dental treatments), either through your basic insurer or another private company.
There are other perks, too, such as not having to share a hospital room and more comprehensive services for in-patient and out-patient care, hospices, rehabilitation, and maternity.
Unlike the basic policy, insurance companies are not obliged to accept you for extra insurance. As a result, your age and health condition can impact your chances of approval – and of course the cost of your health insurance package.
Do I need health insurance in the Netherlands?
Probably. Generally speaking, most foreigners living or working in the Netherlands are required by law to sign up for the Dutch public health insurance system within four months of obtaining their residency:
- Employees: All foreign workers in the Netherlands, including freelancers, interns and volunteers, must take out health insurance.
- Children: Children under 18 receive free coverage under their parents’ Dutch health care insurance plan.
- EU/EEA/Swiss citizens: If you’re staying less than one year and not working, you can typically use your European Health Insurance Card (EHIC). You may have to pay upfront for treatment and medication in the Netherlands and claim the money back later. If you’re working or staying longer than a year, you will need insurance. Retirees may be covered by healthcare from their home country, but should check.
- Non-EU citizens: If you stay longer than three months, you’ll need a residence permit. After this, you must take out Dutch health insurance.
- Students: EU/EEA/Swiss citizens should be able to use their EHIC unless they have paid employment, in which case they’ll need Dutch health insurance. Unemployed non-EU/EEA/Swiss students should arrange health insurance unless covered by insurance from your home country.
There are, however, some exceptions depending on your situation. The flowchart from Euraxess can help you find out which Dutch health insurance is required for your situation.
How do I apply for health insurance in the Netherlands?
You have four months to take out health insurance in the Netherlands after arriving. Failing to do so leaves you liable for a hefty fine and a retroactive bill.
Health insurance policies are valid from the time you pay your very first premium. When you register with a health insurance company, you must provide your Citizen Service Number (burgerservicenummer). This is usually issued to you by your local municipal authority. For more information, read our guide to getting your Citizen Service Number.
You’ll also need to provide proof of residence in the Netherlands as well as an identification document. If you’re an employee, you’ll also have to provide a letter from your employer confirming your employment.
Signing up can be done quickly and easily with your chosen provider, either online or over the phone. Some providers offer an English sign-up process. However, should you require any further assistance you should be able to phone up and talk to an English-speaking representative.
How to choose a health insurance provider
When comparing providers, ask the following questions:
- how much is the premium?
- how does the policy work? There are three types: a policy in kind, where the health insurer has contracts with specific providers and pays the bills directly to them; a restitution policy, where you choose your health provider, pay for treatment upfront and get a refund from the insurance afterwards; and a combination policy, where the insurer partially covers the bill.
- what is the excess? Increasing your excess payment (e.g., up to €885) can be a way to lower your monthly payments.
- can you take out supplementary insurance for any care or treatment that’s not included in the standard package?
- some health insurance providers offer additional benefits free of charge, such as dental accident insurance. It is in these ‘extras’ that insurers compete with their basic Dutch insurance package.
Look carefully at individual packages to find the one that provides the best cover for your circumstances. Consider the following:
- do you have any pre-existing conditions?
- what are the premiums and excess?
- do you have children?
- do you plan to travel abroad regularly and need coverage for any medical emergencies?
Can I change my Dutch health insurance provider?
Yes, but residents of the Netherlands may only change health insurance providers once per year. To do so, you need to declare your intentions to cancel your policy prior to 1 January.
Providers also offer a cooling-off period, allowing you to cancel your premium within a set amount of time after initially signing up. Typically this period is set at 14 days.
Health insurance for unemployed and low earners
Low-income earners may be eligible to apply for healthcare benefit for support with the payments.
The allowance is offered on a sliding scale to people who earn less than
€29,500. The benefit reaches a maximum of €99 a month for people who earn less than €20,500, and falls to just €2 a month for workers earning 29,500.
Allowances are calculated on your individual income or collective income with a partner, and you can find the current rates for 2019 on the tax authority website.
You can apply for the allowance using the My Benefits (Mijn Toeslagen) website.