Health care cost insurance

Health Care Cost Insurance

The Dutch Health Care Cost Insurance Act requires that Dutch nationals and residents in the Netherlands join the national health care insurance scheme. It is legally mandatory to sign up for an insurance with a licensed private Dutch health care cost insurer, irrespective of whether you have already set-up with an insurance in your home country which provides for coverage in the Netherlands. The requirement for a Dutch-registered insurance company is strictly adhered to. 


Health care insurance act

The Dutch health care insurance act introduced in 2006 provides for universal health care insurance for all residents of the Netherlands. The act makes it compulsory for all residents to take out a health care cost insurance with a designated Dutch private insurer.

Employees, entrepreneurs, and retirees pay an income-dependent contribution to the health care insurance act (Zvw) to the Dutch tax office.  For employees, this contribution is withheld from their salary. 

Mandatory Basic Insurance for All 

Individuals who live or work in the Netherlands have to take out health care cost insurance.  Insurers have to accept anyone irrespective of age, health condition or gender. 

The coverage of the basic health care cost insurance is determined by the health care insurance act.  The annual premium for the health care cost insurance is paid to the private insurer. Children under 18 years old are insured for free.  A maximum excess may apply. The excess is not tax-deductible. Supplementary insurances are not mandatory by the act.

Contribution Health Care Insurance Act

Everyone who lives or works in the Netherlands is legally obliged to take out standard health insurance to cover the cost of, for example, consulting a general practitioner, hospital treatment and prescription medication.


Standard package

The government decides on the cover provided by the standard package. All insurers offer the same standard package. Healthcare insurers are obliged to accept anyone who applies for the standard insurance package and must charge all policyholders the same premium, regardless of their age or state of health.

The health insurance system in the Netherlands is based on the principle of social solidarity. Together, we all pay the overall cost of health care. Everyone contributes, for example, to the cost of maternity care and geriatric care.


Additional insurance

Not all health care is covered by the standard package. You can opt to take out additional insurance to cover, for example, physiotherapy or dental care. Additional insurance is not obligatory and you are not obliged to take out the standard package and additional insurance with the same insurance company.

Insurance companies are not obliged to accept everyone who applies for additional insurance. An insurance company can refuse to accept you as a client or can ask you about your health before accepting you.


Standard health insurance premium

You pay a fixed, nominal premium to your insurance company for the standard health insurance package. People on a low income may be eligible for healthcare benefits to help pay for health insurance. 


Children under 18 insured free of charge for standard package

Children under the age of 18 must have health insurance but do not pay premiums for the standard package. Parents must register their child with an insurance company within four months of its birth.


Income-related contribution

In addition to the nominal premium, you must pay an income-related contribution to the standard package. This contribution, a percentage of your income, is laid down in the Healthcare Insurance Act (ZVW) and is also known as the ZVW contribution. Your employer will remit the ZVW contribution directly to the Health Insurance Fund.

Taking out health insurance for someone else

You can take out health insurance for the following people without their permission:

  • your children under the age of 18;
  • anyone placed under your guardianship (including financial guardianship) or tutorship.

In other cases, you must have a written declaration from the person you wish to insure. If that person is unable to give permission, you can act as his or her attorney and sign the application yourself.


Two contributions to the health care system

The first contribution paid towards the Dutch health care system comes in the form of a monthly insurance premium to a private insurer. The second contribution is collected by your employer as a set percentage of your income and paid to the Dutch tax office. This contribution is referred to a the ZVW contribution (inkomensafhankelijke bijdrage Zorgverzekeringswet). The self-employed will receive a separate payment request for the ZVW directly from the Dutch tax office. 


Health care cost insurance

Everyone in the Netherlands is obliged to take out health insurance, even if you are only living and working temporarily in the country.

Foreign health insurance

It is often recommended that during the initial period of your stay in the Netherlands, you keep the insurance you had in your country of origin. This is on the condition it covers your possible costs here, so be sure to confirm that in advance.

If you are a resident of the Netherlands, you are, in principle, obliged to take out Dutch health insurance, even if you are already insured back home. This ensures that every person is protected against the financial risks of illness and hospital admission. You are free to choose your own health insurer (zorgverzekeraar) offering the basic package (basisverzekering) and are allowed to change insurers once a year. To register for health insurance, you will require a social security number(burgerservicenummer or BSN).

Please note: If you are not covered by Dutch health insurance, you risk being fined and billed retroactively for the months you were not insured.

Health coverage

The foundation of the Dutch healthcare system is the mandatory basic health insurance policy (basisverzekering). The coverage of this standard package is determined by the government and includes medical care by specialists, GPs and midwives, hospital care, medication, rehabilitation, dental help for persons younger than 22, mental healthcare and necessary medical help during a holiday or business trip abroad.

Health insurance companies have an obligation to accept everyone for this package, irrespective of gender, age and health. Health insurance companies also offer additional premium plans (aanvullende verzekering). These may cover things such as physiotherapy, spectacles, dental care for persons 22 years and older, and alternative medicine. You will always have an excess or deductible (eigen risico) of at least €150.

You can take out health insurance with any one of a number of insurance companies. Check whether your employer offers corporate health insurance. For a comparison of insurances and prices, consult the following website (only in Dutch): www.kiesbeter.nl.


If you have too little income to be able to pay the full Zvw-contribution, then you can apply for financial compensation from the Dutch Tax Authorities: the so-called care allowance.

Exceptions

You may come from a country with which the Netherlands has entered into an agreement in the field of social security; this applies in any case to all EU countries. In this case, your personal circumstances may be such that you are not eligible for direct insurance via the Zvw and the AWBZ. For example, because you still have statutory health insurance in your former country of residence. The health insurer with whom you register can provide you with more information about this.

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