Dutch health insurance: basisverzekering, eigen risico, deadlines

The short version

• Live or work in the Netherlands and you have to hold Dutch health insurance: the basisverzekering, a standard package every insurer sells on identical terms. A travel policy does not satisfy it.
• Come here only to study, with no job, and you are not allowed to hold one. Use cover from home or a private policy instead.
• You have 4 months from the day the obligation starts. The policy is backdated to that day, and so is the premium.
• The eigen risico is the first €385 of basic-package care each calendar year, paid by you. Seeing your huisarts sits outside it.
• Stay uninsured and the CAK, the government body that checks, issues up to 2 fines and then enrols you itself at a higher premium.

Health insurance is one of the few pieces of Dutch admin with a fine attached to getting it wrong, because the rule is not "buy insurance". It is "buy this specific Dutch product, and only if you are allowed to".

Which side of that you land on depends on whether you work here, not on your passport. Here is how the obligation works, what the deadlines are, what the eigen risico costs you, and what the CAK does if you skip it.

Do you need Dutch health insurance?

Government.nl puts it plainly: everyone who lives or works in the Netherlands is legally obliged to take out standard health insurance. Your nationality does not change that, and neither does the kind of permit you hold.

One group sits outside it, and it is a large share of the people reading this. If you came here to study and you do not work, you are not covered by the Wlz, the long-term care act the obligation hangs off. Study in NL, run by Nuffic, frames that as a prohibition rather than an exemption.

Earning money flips it. A part-time job makes Dutch public health insurance compulsory. A paid internship can too, on a test that differs by where you are from: students from the EU, the EEA, Switzerland, or a treaty country are covered once a Dutch employee insurance scheme covers them, and students from elsewhere once they are paid at least the Dutch minimum wage. Board and lodging can count towards that pay. If you are self-employed or you cannot tell which side you are on, the SVB, the Dutch social insurance bank, will assess your Wlz position and put it in writing.

Once you are on the obliged side of that line, cover from home does not discharge the obligation. Travel insurance, a student policy bought abroad, and your employer's scheme back home are beside the point, however good they are. Before you are obliged, the opposite holds: foreign cover is exactly what you are supposed to have.

When you have to sign up

The clock starts when the obligation starts, not when you feel settled. If you hold a residence permit, government.nl ties it to the date that permit comes into force. If the obligation comes from working here instead, Rijksoverheid gives the same 4 months without pinning a start date to it, so count from your first working day and you cannot be late.

Your policy then has to be effective from that same starting date, not from the day you got round to it, and government.nl is explicit about what follows: where the insurance commences with retroactive effect, you pay the premium retroactively too. So waiting saves you nothing. All a delay buys you is a stretch of time with no cover, and care you needed in it stays yours to pay for.

There is one case where you cannot act early even if you want to. The basic policy exists only for people who are already subject to the insurance obligation, and an insurer's duty to accept you runs no further than that. Until you are obliged, there is nothing for you to buy, however much you would prefer the cover. Some insurers sell separate policies for people in that position.

That wait has a sting in it, because a permit comes into force on its own start date, which can sit well before the card reaches you. Part of your 4 months may already have run by the time you may apply, so work from the start date on the decision letter rather than the day you collected the card.

Insurers will ask for your BSN, your Dutch citizen service number, and an account to collect the premium from, which is why this usually sits behind your gemeente appointment. If that appointment is weeks out, start the conversation with an insurer anyway.

What the basisverzekering covers

The basisverzekering is designed by the government, not by your insurer. Government.nl states that the government decides what the standard package covers and that all insurers offer the same one: your huisarts, the Dutch general practitioner who is the gateway to almost all other care, plus hospital treatment and prescription medication.

Two rules follow, and they make choosing an insurer a smaller decision than it looks. Insurers must accept anyone who applies for the standard package, and must charge every policyholder the same premium for it. No medical questionnaire, no loading for a condition you already have.

Everything outside the package is aanvullende verzekering, supplementary cover, and it works the other way round. Adult dental care, most physiotherapy, and some alternative treatments sit there, and an insurer may ask about your health before accepting you for it, or turn you down.

Premium, eigen risico, and zorgtoeslag

Three separate amounts, and they get mixed up constantly.

The premium is what you pay monthly. Each insurer sets its own and revises it every year, so it is the one figure this page will not quote at you.

The eigen risico is the compulsory excess: the first €385 of basic-package care in a calendar year comes out of your pocket rather than your insurer's. You only pay it if you use care, and it applies from the age of 18. Rijksoverheid publishes the amount for each year, which is the page to check before you assume it has not moved.

What sits outside the excess matters more than the number. Your huisarts costs you nothing against it, and neither does the huisartsenpost, the out-of-hours GP service. Midwife and maternity care and district nursing are outside it too. Inside it: the hospital emergency department, hospital treatment, prescriptions, and the lab work your huisarts sends you for. Out of hours with something that is not an emergency, that makes the huisartsenpost both the correct route and the free one.

Zorgtoeslag, healthcare benefit, is a government contribution towards your premium and your excess if your income is low. Nothing about your policy triggers it. You claim it from Dienst Toeslagen with your DigiD, and government.nl sets out who qualifies. Plenty of students and first Dutch salaries qualify and never claim.

When you can switch insurers

The insurance year is the calendar year, and Rijksoverheid is blunt that you may switch to another insurer once per year rather than whenever you like.

Two dates do the work. Cancel your existing policy by 31 December. Take out the new one by 1 February, and it runs from 1 January, so no gap opens up in between. If you have the new policy in place by 31 December, your new insurer cancels the old one for you.

Miss the window and you are with your insurer for another year, which stings most when what you wanted to change was a voluntary excess you set too high.

Cancelling is the half people get wrong. The duty to accept you covers the basic package only, so line up the new policy first and check that the new insurer will take you for the supplementary cover you want. Cancel without buying and you are uninsured from 1 January, which puts you on the CAK's list rather than on a cheaper premium.

What happens if you stay uninsured

The CAK, the government body that runs this, compares who should be insured against who is. If you are insurable and hold no policy, it writes to you.

From the date of that letter you have 3 months to do one of two things: take out a basisverzekering, or ask the SVB to assess your Wlz position if you believe the obligation does not apply to you. Do neither and the CAK fines you. In 2026 the fine is €529.74, and it is indexed every year.

Then it repeats. Another 3 months, another fine. After 2 fines the CAK stops asking: it enrols you with an insurer itself and withholds the premium from your income for 12 months, at 120% of the standard premium. That is the bestuursrechtelijke premie, and costing more than insuring yourself is the point of it.

None of that retrieves the months you spent uninsured. The bills from that period stay yours, and the fines sit on top of them.

You still have to pick someone, and soon. Since the basic package is fixed by law, that choice comes down to the premium, the supplementary packages, English service, and which hospitals your insurer has contracts with. A comparison site is built to put those side by side.

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