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Healthcare in the Netherlands

How is the healthcare system regulated in the Netherlands

Anyone who is legally obligated to take out Dutch health insurance under the Health Insurance Act, must enroll with a health insurer, within four months of arrival in the Netherlands, to cover medical expenses.

The Dutch healthcare system is based on the principle of social solidarity. Therefore anyone, healthy or not, must contribute to the medical expenses of those who are ill. If you have an income or receive a social security benefit, you are also due to pay an income related premium, the percentage of this premium may vary.

How do I apply for health insurance?

If you have the obligation to take out Dutch basic health insurance, you are free to choose a health insurer and an insurance policy that fits your needs. There are over thirty health insurers to choose from and you are allowed to switch health insurer every year, with effect from January 1st. All insurers must offer the same government standardized coverage, for the Dutch basic insurance. You are insured from the day stated on the policy sheet. 

Can a health insurer deny my application?

Dutch health insurers must accept anyone who is obligated to take out the Dutch basic health insurance, regardless of their age or state of health. The insurer may however deny your application for optional additional health insurance, as the insurers are allowed to wield their own terms and conditions on the additional insurances.   

What is the difference between basic health insurance and additional health insurance?

A Dutch health insurance consists of the above mentioned Dutch basic health insurance, which is mandatory, and an optional additional health insurance. All Dutch health insurers offer additional insurance policies as well.
The Dutch basic health insurance offers coverage on standard health care. Additional insurance covers other forms of medical care, for example: dentistry and physiotherapy, among many others. An extra premium must be paid monthly if you choose to take out these additional insurances. 

Are there alternatives if I do not qualify for the Dutch basic health insurance in the Netherlands?

You are obligated to have some form of insurance to cover medical costs when coming to the Netherlands. Below are some alternatives to the Dutch basic health insurance. 

• A commonly used alternative is a so-called international health insurance. These are private health insurances that offer coverage in a target country (i.e. The Netherlands). For international students, some insurers can provide you with a specific student plan, inform with your educational institution for more information. There are lots of providers to choose from, make certain your insurer and policy of choice gives proper coverage in the Netherlands. 
• If you are from the EU/EEA, you may apply for a European Health Insurance Card (EHIC) or Global Health Insurance Card (GHIC, only if from the UK) in your home country. This should provide coverage for emergency medical costs in the Netherlands. Check with the health insurer in your home country for their policies and duration of the EHIC. 

Am I entitled to Dutch healthcare benefit? 

The Dutch government offers the healthcare benefit to some citizens, to help pay for the health insurance premium. Terms and conditions do apply to determine eligibility:

• You must have a Dutch basic health insurance and pay the monthly premium for it.
• You must be below a predetermined income threshold. 

You can apply for the healthcare benefit online using your DigiD, or in person by making an appointment. You can call 'de BelastingTelefoon' 0800 0543 for information. If calling from abroad: +31 555 385 385. 
 
Beware: If your obligation to be insured under the Dutch basic health insurance stops and therefore you must cancel the insurance, your right to the healthcare benefit is also forfeit. 

Am I paying extra for the mandatory deductible (‘eigen risico’)?

Besides the monthly premium there is a yearly mandatory deductible, for everyone over eighteen years old with a Dutch basic health insurance. The government determined that the deductible for 2025 amounts to € 385,-. This means that, per calendar year, the first €385 of cumulative medical costs covered by the basic health insurance, must be paid out of own pocket. Any further medical costs that exceed this sum of €385 during that same calendar year, will be reimbursed as normal by the health insurer.

Do I pay the mandatory deductible for all medical costs covered by the basic insurance?

No, there are a few exemptions. For example, if you visit your GP (Huisarts), you will not have to pay for the mandatory deductible out of own pocket. 

Are children under 18 automatically insured?

Newborns must be registered with a health insurer within four months after birth. If they are insured within 4 months after birth, the insurance will start from the day they were born. If you apply after the first 4 month period, the insurance will start on the day of application. This also applies to older underaged children new to the Netherlands, if they are legally obliged to take out Dutch basic health insurance. 

Children under the age of 18 do not pay any premium or mandatory deductible. 

Coming from abroad

I am an international student with Dutch nationality. Which rules apply to me?

When you work next to your studies (regardless of how many hours), or if you receive an internship allowance that is equal to or higher than the Dutch minimum wage you are obliged to take out Dutch basic health insurance. Sometimes you are also obliged to take out basic health insurance without having a job or internship. Please contact us or ask the SVB to have your insurance position assessed.

Am I required to have health insurance in the Netherlands as an international student?

You must have some form of health insurance at all times. If you are in the Netherlands for study purposes only, it is neither required nor possible to take out a Dutch basic health insurance. You can keep the health insurance from your home country (EHIC) or take out an international health insurance.

Different rules apply to students from e.g. Aruba, Curaçao, Sint Maarten, Bonaire, Sint Eustatius and Saba. 

I am from Aruba, Curaçao, Sint Maarten, Bonaire, Saba or Sint Eustatius and studying in the Netherlands

Are you a student from these countries and do you have a Dutch passport? Then you must take out Dutch basic health insurance if you meet the following conditions:

You live in the Netherlands, your study programme lasts at least 3 years and

• You receive student financing from the Netherlands (DUO); and
• Your cost of living is (partly) paid from the Netherlands; and
• You will only return to your country of origin for holidays and/or family visits.

If your studies last shorter than three years and you do not plan on working a part-time job next to your studies, please contact the Sociale Verzekeringbank (SVB) to have your insurance position assessed.

If you are from Bonaire, Saba or Sint Eustatius and cannot get Dutch health insurance, make sure you are registered with BES Health Insurance. 

Video: Health insurance for students from the Dutch Caribbean area

Am I required to have Dutch health insurance because of my paid internship?

If you are going to do an internship for which you are being paid an allowance on par with/higher than the Dutch minimum wage, you must be insured with a Dutch basic health insurance. Compensation for living expenses are regarded as income for your internship, room and board may also be seen as such. If the internship allowance you receive is much lower than the Dutch minimum wage, the internship is not seen as income from work, and therefore there is no obligation for you to take out a Dutch basic health insurance.

Am I required to have Dutch health insurance because of my part-time job besides my studies?

If you have a part-time job, you are required to have a basic Dutch health insurance from the first day of work. Your EHIC or international health insurance is no longer sufficient. When registering for a Dutch basic health insurance, you may provide your most recent salary slip, or an employer declaration as proof of your obligation to be insured in the Netherlands. Also note: you may be eligible for the aforementioned Dutch health benefit, to help you pay for the monthly insurance premium.
Are you quitting your (part-time) job? Do not forget to cancel your Dutch basic health insurance (and health benefit).

I think I received the uninsured letter from the CAK incorrectly. What should I do?

If you have received a letter from the CAK stating that you are ‘not insured’, it means that you do not have a Dutch basic health insurance at a time you are obligated to have one. Act immediately. A Dutch basic health insurance is obligated for people who work in the Netherlands, your EHIC or international health insurance is no longer sufficient.
If you think you should not have to take out a Dutch basic health insurance as you are here for study purposes only (no work, no internship), contact the SVB to to have your insurance position assessed, through a Wlz-assessment. 

Is my European Health Insurance Card (EHIC) from my home country valid in the Netherlands?

Yes, the EHIC from your home country is valid in the Netherlands for necessary medical care during your stay. Check with your own health insurer before coming to the Netherlands how long the EHIC will be valid as it might expire. The EHIC will no longer be valid if you start to work in the Netherlands. You must then take out a Dutch health insurance.

Working in the Netherlands 

When moving to the Netherlands for work purposes, when should my Dutch basic health insurance be active?

Your basic Dutch health insurance must start from the first day of work. If you are still searching for work after having moved to the Netherlands, you cannot be insured with a Dutch basic health insurance yet. 

Am I required to have Dutch basic health insurance when self-employed?

There is definitely a possibility you need to take out Dutch basic health insurance, but this is not self-evident. Start a Wlz-assessment and the SVB (Sociale Verzekeringsbank) will determine whether you need to be insured under the Wlz-scheme.

Living abroad, but working in the Netherlands

This specifically applies to people who live in e.g. Belgium and Germany and commute to the Netherlands to perform their work (mostly) there. Your insurance obligation lies in the Netherlands, therefore you must take out a Dutch basic health insurance. 

In addition, you can acquire an S1-form (previously E106) with your Dutch health insurer and turn this in with the health insurer in your country of residence. This enables you to receive the care that you need in both the country of work (the Netherlands) and country of residence. 

What if I am temporarily seconded to the Netherlands, do I need Dutch basic insurance?

Sometimes, when working and living in the Netherlands under a secondment construction (Dutch: detachering), there is a possibility you can stay insured in your country of origin. Depending on the country of origin and duration of the secondment, you or your employer may be able to apply for an A1-form (previously E101) with the proper authorities in the home country. The A1-form serves as proof in the Netherlands, that you are excluded from having to take out Dutch basic health insurance, for the (partial) duration of the secondment. 

I did not pay my health insurance premium, what happens now?

If your premium payment is overdue, you risk paying extra (debt collection) costs. The health insurer will first send you reminders and warnings about the consequences of overdue payments. Contact your insurer as soon as possible to make a payment arrangement. If overdue payments are at risk to spiral out of control, ask your municipality about their debt assistance services. 

Registered with the CAK

The monthly premium is automatically deducted from my wages. What can I do to stop this?
In the event of an overdue of six premium payments, your health insurer will report you to the CAK. The monthly premium (Dutch: ‘bestuursrechtelijke premie’) due to the CAK is € 172,33 (2025), which is more expensive compared to a regular Dutch basic health insurance. 
This new monthly premium will be deducted directly from your wages or healthcare benefit. If it is deducted from your healthcare benefit you will additionally receive a payment request from the CJIB (Dutch: ‘Centraal Justitieel Incassobureau’) to pay the remainder of the higher premium.
Beware: with this new monthly premium, you do not pay off your original debt with the health insurer. Your registration with the CAK can be temporarily suspended by making a payment arrangement with the health insurer/debt collection agency over the total amount of debt owned. You will then pay the normal premium again to your health insurer from the first day of the new month, and stop paying the higher premium to the CAK for the time being.
A definitive deregistration with the CAK takes place after either the entire debt has been paid off, or if you end up in a legal debt restructuring process.

What happens with my registration with the CAK when I leave the Netherlands?
If you deregister  with the municipality and end your policy with the health insurer, you will still have to pay the debt you have with both the health insurer and the CAK. Your debt will not be solved by leaving the Netherlands.