Basic health insurance in the Netherlands: how to choose and what basic really covers

Dutch basic health insurance is a product you buy from a commercial insurer, but the government writes the contents.

Every basisverzekering in the country covers exactly the same care, decided in The Hague and revised each autumn.

What differs between insurers is the price, the paperwork and which hospitals they have signed contracts with.

That single fact removes most of the anxiety from choosing.

You are not comparing what is covered.

You are comparing what it costs and how much freedom you have about where you go.

Who has to have it, and by when

Everyone who lives or works in the Netherlands is legally obliged to take out standard health insurance.

Children under 18 must be insured too, but no premium is charged for them on the basic package.

For people arriving on a residence permit the government’s wording is precise: you must take out Dutch health insurance within four months of your residence permit coming into force, and the policy must be effective from the date the permit came into force.

If the insurance starts with retroactive effect, you pay the premium retroactively as well.

The four months is a grace period for the admin, not for the cost.

You need a BSN to complete the application, which in practice means registering your address at the gemeente first.

That chain is why arrivals routinely find themselves uninsured for six weeks through nobody’s fault.

Students who are here only to study and have no paid work usually do not have to take out Dutch cover.

Take a part-time job, and the obligation switches on.

What happens if you do not

The CAK, the body that administers this, writes to you and gives you three months to arrange insurance.

Miss that and a fine follows, then a second one three months later.

After two fines the CAK enrols you with an insurer itself and deducts twelve months of premium from your income at 120% of the standard rate.

From 1 January 2026 the premium under that scheme is 172.70 euro a month, which is more than most policies you could have chosen yourself.

Being uninsured is not cheaper.

It is the most expensive way to be covered.

The excess, and why it matters more than the premium

The compulsory excess, the eigen risico, is 385 euro for 2026.

It has not risen since 2016.

You pay the first 385 euro of the care you use in a calendar year that falls under the excess, and the insurer picks up everything after that.

The exemptions are the important part, because they are generous and almost nobody reads them.

No excess applies to GP care, including the out-of-hours GP post.

None applies to midwifery care or kraamzorg.

None applies to district nursing, to chain care for type 2 diabetes, COPD and cardiovascular risk, or to care for anyone under 18.

New for 2026: a consultation where a specialist advises your GP, and an exploratory mental health conversation, no longer count towards it either.

So seeing your huisarts costs you nothing at the point of use, whatever your excess.

The bill starts when the GP refers you onwards: blood tests, a hospital outpatient appointment, a scan, most prescribed medicines.

You may voluntarily raise the excess in steps of 100 euro up to 500 euro extra, giving a maximum of 885 euro, in exchange for a lower monthly premium.

The saving is usually modest.

Take it only if you can absorb 885 euro in a bad year without flinching.

What the premium actually is

The average premium people pay their insurer in 2026 is 1,884 euro, which the government puts at 157 euro a month.

Cheap policies sit a little under 145 euro and the dearest basic policies run to around 185 euro, so the whole market fits inside about 40 euro a month.

There is a second payment you will not see on any comparison site.

Everyone also contributes a percentage of income towards healthcare through the inkomensafhankelijke bijdrage.

For employees the employer pays it; if your income comes from a pension or self-employment, you settle it through the tax return.

It is a real cost and it is not part of the 157 euro.

Low earners can claim zorgtoeslag, the healthcare allowance, which in 2026 is worth up to 129 euro a month for a single person and 246 euro with a benefit partner.

The income ceiling is 40,857 euro a year alone, or 51,142 euro with a partner.

It is paid monthly by the Belastingdienst and applied for with DigiD, alongside the other Dutch allowances.

Natura, combinatie and the hospital question

The type of policy decides where you can be treated without paying a top-up.

With a naturapolis the insurer selects care providers and signs contracts with them.

Go to one they have not contracted and you pay part of the bill yourself, typically with 60 to 80% of the contracted rate reimbursed.

A combinatiepolis gives full reimbursement and free choice for some kinds of care and the restricted natura treatment for others.

Read which is which before you sign, because the split varies wildly between insurers.

Pure restitution policies, which reimbursed everything anywhere, have largely disappeared from the market.

A budgetpolis is a naturapolis with fewer contracted providers or lower reimbursements, sold at a lower premium.

It is a real saving for a healthy person who does not mind being sent to whichever hospital the insurer has a deal with, and a genuine annoyance for anyone with an existing consultant they want to keep.

The practical Hague test: check that HMC Westeinde, HagaZiekenhuis and Reinier de Graaf are all contracted before you buy.

If you are likely to end up at an emergency department, you want the nearest one to be the contracted one.

The supplementary policy

Aanvullende verzekering is where the basic package stops.

Adult dentistry, most physiotherapy, glasses and contact lenses, alternative medicine, extra maternity hours: all of that lives here, and none of it is regulated, so cover and price are entirely the insurer’s choice.

The asymmetry is worth knowing.

An insurer must accept you for the basisverzekering regardless of age or health, and may not charge you more for being older or ill.

For supplementary cover there is no such duty.

They may refuse you, and they may price by age or condition.

Do the arithmetic rather than the instinct.

A dental add-on that costs 15 euro a month and caps out at 250 euro of treatment is not insurance, it is prepayment with a ceiling.

What dental and physiotherapy cover is worth deserves its own look, since these are the two most commonly bought and most commonly misunderstood extras.

Insurance agencies in The Hague will run the comparison for you, though the government’s own comparison rules make it a job you can do in an evening.

Switching, and the two dates that matter

You may change insurer once a year and the window is narrow.

Cancel your existing policy by 31 December.

Take out the new one by 31 January, and it applies retroactively from 1 January.

In practice the easier route is to sign up with the new insurer before 1 January and let them cancel the old policy for you.

You cannot switch while you are in arrears on your premium, although arrears on the excess alone do not block you.

Insurers publish 2026 premiums in November, which is when the comparison sites become useful rather than speculative.

Nothing else about the basic package changes during the year, so an annual look in the second half of November covers it.

The Hague’s own scheme

If your income is low the gemeente has negotiated a collective policy with VGZ.

Eligibility runs up to 150% of the bijstandsnorm, with capital limits of 8,000 euro for a single person and 16,000 euro for a household.

The Den Haag package includes 20 physiotherapy treatments, 500 euro of dental care and 150 euro towards glasses every three years, and on that package the eigen risico is fully insured.

The gemeente contributes 20 to 30 euro a month for those under 110% of the norm, tapering to nothing at the 150% ceiling.

You can switch into it each year between 12 November and 31 December.

For anyone living on a tight margin, having the 385 euro excess taken off the table is worth more than the headline premium difference.

Sources

• Government.nl, standard health insurance: that everyone living or working in the Netherlands must take out standard health insurance, that all insurers offer an identical package set by government, that under-18s are insured without premium, and that low earners may claim healthcare benefit
• Government.nl, health insurance and residence permit: the four-month deadline, the requirement that the policy be effective from the date the permit comes into force, and retroactive premium
• Rijksoverheid, eigen risico zorgverzekering: the 2026 compulsory excess of 385 euro, the exemptions for GP care including the huisartsenpost, midwifery and kraamzorg, chain care, district nursing and under-18s, the voluntary excess in steps of 100 euro to a maximum of 885 euro, and payment by instalment
• Rijksoverheid, veranderingen basispakket 2026: the specialist consultation and exploratory mental health conversation no longer counting towards the excess, and the 250 euro medicine co-payment ceiling
• Rijksoverheid, premie zorgverzekering: the 2026 average premium of 1,884 euro a year and 157 euro a month, and the income-dependent contribution
• Rijksoverheid, wat gebeurt er als ik niet verzekerd ben: the three-month CAK letter, two fines, enrolment by the CAK and twelve months of premium deducted at 120%
• CAK, zorgpremie 2026 voor de regeling onverzekerden: 172.70 euro a month from 1 January 2026
• Rijksoverheid, polissen zorgverzekeraar: naturapolis, combinatiepolis and the budgetpolis as a naturapolis with restricting conditions
• Rijksoverheid, acceptatieplicht zorgverzekering: the duty to accept everyone for the basic policy with no surcharge for age or illness, and the absence of that duty for supplementary cover
• Rijksoverheid, overstappen zorgverzekeraar: cancel by 31 December, new policy by 31 January, applying from 1 January, and the premium-arrears bar
• Zorgwijzer, zorgtoeslag 2026: maxima of 129 euro a month single and 246 euro with a partner, income ceilings of 40,857 and 51,142 euro
• Zorgwijzer, expat health insurance: the position of students without paid work
• Gemeente Den Haag, Haagse zorgverzekering bij VGZ: the 150% bijstandsnorm ceiling, the 8,000 and 16,000 euro capital limits, the Den Haag package contents, the fully insured excess, the municipal contribution and the 12 November to 31 December window