Who must take out Dutch basic health insurance
Everyone who lives or works in the Netherlands must take out basisverzekering (basic health insurance) with a Dutch insurer. That includes expats and other foreigners, even if you still have private health insurance or international health insurance from your home country.
The main exceptions:
- Your employer is outside the Netherlands. You may be able to keep your foreign insurance, but specific rules apply.
- You work only for an EU institution and are insured through its Joint Sickness Insurance Scheme (JSIS), or for an international organisation such as the European Patent Office or the European Space Agency that insures you.
- You are a gemoedsbezwaarde: you object to insurance because of your faith. You then pay an amount to the Belastingdienst instead of a premium.
Children must be insured too. Parents arrange this, but children under 18 pay no premium for the basic package.
The 4-month deadline
Take out your policy as soon as possible and no later than 4 months after you arrive or start working here. If you sign up within those 4 months, the cover starts on the day you arrived, and you normally pay premium from that day too. You must also register with the gemeente (municipality), even before your insurance is arranged.
If you sign up after 4 months, you are not insured retroactively. You pay premium from the date you take out the policy, but medical costs from the uninsured months are not reimbursed. The CAK checks who is uninsured, sends letters and can fine you.
The official timing rules on Government.nl cover the details.
What the basic package covers
The government decides what is in the basispakket (basic package), and every insurance company must offer the same package. It covers care such as:
- the huisarts (GP)
- hospital treatment
- prescription medicines from the pharmacy
- mental health care
- maternity care
Dental care for adults and most physiotherapy are not in the basic package. For those you can buy aanvullende verzekering (additional insurance). It is optional, and you can buy it from a different insurer than your basic policy.
An insurer must accept you for the basic package whatever your age or health, and may not charge you more because you are older or ill. For additional insurance an insurer may ask health questions, refuse you or use a waiting period.
What it costs in 2026
You pay three things:
- A monthly premium to your insurer. Insurers set their own monthly premiums, so prices differ. The average 2026 premium for the basic package is €158.39 a month, about €1,900 a year, according to the Dutch Healthcare Authority (NZa).
- The eigen risico (deductible): you pay the first €385 of covered care in 2026 yourself. Some care does not count towards it, such as GP visits, maternity care and all care for children under 18.
- An income-related contribution under the Zorgverzekeringswet (Zvw). If you are employed, your employer pays it on your behalf.
If your income is low, zorgtoeslag (healthcare benefit) helps with the premium. In 2026 your income must be no higher than €40,857, or €51,142 with a partner. You can get it from the moment you must be insured; our zorgtoeslag guide explains how to apply.
How to choose an insurer and switch
Because the basic package is the same everywhere, compare health insurance companies on premium, policy type and service. A naturapolis (in-kind policy) is usually cheaper but only fully pays care from providers the insurer has contracts with. A restitutiepolis (restitution policy) lets you choose any provider.
Keep the decision about additional insurance separate. The cheapest basic policy is not always the best place for dental or physiotherapy cover.
You can switch insurer once a year. Cancel your old policy by 31 December, then take out a new one by 1 February; it starts on 1 January. Your new insurer can cancel the old policy for you. Insurers usually ask for your BSN (burgerservicenummer, citizen service number) when you sign up.
No residence permit yet: temporary health insurance
While the IND has not yet decided on your residence permit application, you cannot take out Dutch health insurance, even if you already have an mvv. For temporary health insurance in the Netherlands, some insurers offer international policies for people moving here. You qualify if you have no Dutch health insurance, no permanent residence permit yet, and do not live in an asylum reception centre. Foreign insurance that covers you in the Netherlands can also pay your medical costs in this period.
Once your permit comes into force, take out Dutch health insurance within 4 months. The policy then starts on the date of your permit, and you pay the premium from that date.
Asylum seekers in a reception centre are insured through the Regeling Medische Zorg Asielzoekers (RZA) until a decision is made. See Government.nl on health insurance and residence permits.
What the KNM exam asks about this
KNM questions test the practical rules: health insurance is compulsory if you live or work here, you have 4 months to take it out, basic insurance is compulsory and additional insurance is optional, children under 18 pay no premium, and zorgtoeslag helps people on a low income. You may also see the huisarts as the first step before a hospital or specialist.