Health Insurance in the Netherlands: A Comprehensive Guide

The Netherlands is globally recognized for having one of the best healthcare systems in the world. Central to its healthcare structure is a well-organized health insurance system that ensures access to medical services for all residents. In this article, we will explore the key features, structure, benefits, challenges, and nuances of the Dutch health insurance system, providing a comprehensive understanding for both residents and newcomers.

1. Overview of the Dutch Healthcare System

The Dutch healthcare system is a combination of public and private elements, regulated by the government but executed by private insurance companies. It is built on the principle of universal coverage, meaning that everyone who lives or works in the Netherlands is legally required to have basic health insurance (basisverzekering).

This system is largely funded by mandatory health insurance premiums and income-related contributions, ensuring that healthcare is accessible, affordable, and of high quality.

2. The Legal Requirement for Health Insurance

All residents and workers in the Netherlands must take out a basic health insurance policy with a Dutch health insurer. This obligation applies to:

• Dutch citizens

• EU/EEA citizens living in the Netherlands

• Expats working or residing in the Netherlands

• International students (depending on work or internship status)

People have up to four months from the day they register with their local municipality to choose a health insurance provider. If they fail to do so, they may be fined or automatically enrolled in a policy by the government.

3. Structure of Health Insurance in the Netherlands

A. Basic Health Insurance (Basisverzekering)

The basic health insurance package is mandatory and covers essential medical services. The government determines the content of this package, and all insurance companies are required to offer it. Some of the services included are:

• General practitioner (GP) visits

• Hospital care

• Emergency services

• Prescription medications

• Maternity care

• Mental health care

• Basic dental care for children under 18

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

The coverage is the same regardless of the insurer, but the monthly premiums and customer services may vary.

B. Supplemental Insurance (Aanvullende verzekering)

Supplemental or additional insurance is optional and covers healthcare services not included in the basic package, such as:

• Dental care for adults

• Physiotherapy

• Alternative medicine

• Glasses and contact lenses

• Extended mental health services

These policies are not regulated by the government, and insurers can deny coverage based on health history.

4. Cost of Health Insurance

A. Monthly Premiums

The average monthly premium for basic health insurance is around €130 to €150 per person (as of 2025). This amount is paid directly to the insurance provider.

B. Deductible (Eigen risico)

There is an annual deductible of €385 (as of 2025). This means that you must pay the first €385 of most healthcare costs yourself each year. Some services, like GP visits, maternity care, and children's healthcare, are excluded from the deductible.

People can voluntarily increase their deductible up to €885 to lower their monthly premium.

C. Income-Related Contribution (Zvw)

In addition to monthly premiums, employees must also pay an income-based contribution (Zorgverzekeringswet or Zvw). Employers typically withhold this from salaries and pay it to the tax authorities. The contribution rate is approximately 6.68% of income, up to a maximum cap.

5. Health Insurance Providers

There are over 40 health insurance providers in the Netherlands. Although there are many brands, most are subsidiaries of four major groups:

1. Achmea

2. VGZ

3. CZ

4. Menzis

Despite the private nature of insurers, they are obligated to accept every applicant for the basic package regardless of age, gender, or health status.

Some of the well-known insurance providers include:

• Zilveren Kruis

• FBTO

• OHRA

• Anderzorg

• Ditzo

Types of Policies

There are three main types of policies offered:

1. Restitutiepolis (Reimbursement policy) – Freedom to choose any healthcare provider; higher premium.

2. Naturapolis (In-kind policy) – Limited to contracted providers; lower premium.

3. Combinatiepolis (Combination policy) – Mix of both.

6. Health Allowance (Zorgtoeslag)

To help low- and middle-income individuals afford health insurance, the Dutch government offers a healthcare allowance (zorgtoeslag). This is a monthly financial support paid by the tax office.

In 2025, the maximum monthly allowance can reach:

• Around €140 for singles

• Around €270 for couples

Eligibility depends on income level and assets, and applications can be submitted through the Belastingdienst (Dutch Tax Office) website.

7. Children and Health Insurance

Children under the age of 18 are covered for free under their parents' health insurance policy. They receive the same benefits as adults, including dental care, vaccinations, and specialist treatment.

Once a child turns 18, they are required to get their own insurance policy and start paying premiums.

8. Choosing and Changing Insurers

Residents can compare and switch insurance providers once a year during the annual open enrollment period from November 12 to December 31. The new policy begins on January 1 of the following year.

Comparison websites (e.g., Independer, Zorgwijzer) are widely used to compare premiums, policies, and services.

9. Healthcare Access and Quality

The Netherlands ranks highly in international healthcare quality indices. Key features include:

• Strong primary care system – GPs act as gatekeepers to specialist services.

• Efficient referral system – You need a referral from your GP to see a specialist or go to the hospital.

• Short waiting times – Generally low compared to other European countries.

• Digital health records – Most medical information is stored digitally and accessible to professionals.

10. Challenges in the Dutch System

Despite its strengths, the Dutch health insurance system faces some challenges:

• Rising premiums – Healthcare costs are increasing annually.

• Complexity – The variety of policies and deductibles can be confusing.

• Mental health access – Waiting times for psychological care can be long.

• Affordability – Even with allowances, some low-income residents struggle to pay premiums and deductibles.

11. Health Insurance for Expats

Expats living and working in the Netherlands are generally required to get Dutch health insurance within 4 months of arrival. They must deregister and cancel their insurance upon leaving.

For short stays or people not subject to mandatory Dutch insurance, private international insurance is often sufficient.

Key tips for expats:

• Register with the Gemeente (municipality) as soon as possible.

• Apply for a BSN (citizen service number).

• Choose a policy that includes English-language support if needed.

• Apply for zorgtoeslag if eligible.

Conclusion

Health insurance in the Netherlands is a well-regulated, comprehensive system designed to ensure access to high-quality healthcare for everyone. While it is mandatory and involves some personal cost, the system guarantees excellent medical care, wide provider choice, and protection against unexpected medical expenses. Understanding how it works—especially for newcomers—is essential for making informed decisions about your health and financial well-being.

Whether you're a Dutch citizen, student, expat, or a long-term resident, securing the right health insurance policy is a vital step in becoming part of Dutch society.