This guide explains how the Netherlands healthcare system works for expats in 2026, from compulsory basic insurance to GPs, hospitals and costs.
What is changing in 2026 and 2027
The headline: the deductible stays at €385 for 2026, while the 2027 deductible and premiums had not been confirmed when this guide was checked in October 2026. Plans for the 2027 deductible have changed several times, so do not rely on older articles that quote a fixed 2027 figure.
| Item | 2025 | 2026 | 2027 |
|---|---|---|---|
| Compulsory deductible (eigen risico) | €385 | €385 | Not yet confirmed |
| Average basic premium per month | — | approx. €157 to €159 (sources differ) | Announced by insurers in November 2026 |
| Maximum healthcare allowance, single person, per month | €131 | €129 | Not yet confirmed |
| Maximum own contribution for medicines | €250 | €250 | Not yet confirmed |
Three changes to the basic package took effect on 1 January 2026:
- Stop-smoking programmes: covered up to three times a year instead of once.
- Exercise therapy for severe axial spondyloarthritis (formerly called Bechterew’s disease): now permanently included for adults.
- Advice consultations no longer touch your deductible: when your GP asks a specialist for advice, and for an initial exploratory conversation in mental healthcare (ggz), the cost no longer counts towards your eigen risico.
Callout — 2027 figures are not final. Any change to the deductible needs parliamentary approval, and insurers only publish their actual 2027 premiums in November. Check the final figures with your insurer before the annual switching deadline.
How the Dutch healthcare system works
The Netherlands has a universal system delivered through private insurers under strict state rules. The Health Insurance Act (Zorgverzekeringswet, Zvw) obliges residents to buy a basic policy, obliges insurers to accept every applicant, and fixes the content of the basic package by law. Insurers compete on price, service and which care providers they contract, not on what the basic package includes. Arranging insurance is one of the early steps set out in our complete guide to moving to the Netherlands.
The system rests on three layers:
| Layer | What it is | Who pays |
|---|---|---|
| Basic insurance (basisverzekering) | Compulsory policy covering GP care, hospital care, maternity care, prescribed medicines, mental healthcare and more | You, through a monthly premium plus the annual deductible |
| Income-related contribution (Zvw-bijdrage) | A percentage of income that funds the system | Your employer for employees; you directly if self-employed |
| Supplementary insurance (aanvullende verzekering) | Optional extra cover, such as adult dental care or extra physiotherapy | You, voluntarily |
Long-term care (for example nursing homes) is funded separately under the Long-Term Care Act (Wlz), which is financed through tax and social security contributions rather than your insurance policy.
Callout — premiums do not depend on your health. Insurers cannot refuse you for the basic package or charge you more because of age or a pre-existing condition. Supplementary policies are different: insurers may ask health questions or refuse cover for those.
Who must take out Dutch health insurance
If you live in the Netherlands, or work there and pay Dutch payroll tax, you must take out Dutch basic health insurance, and the usual guidance is to do so within four months of arrival. International or travel health insurance is generally not accepted as a substitute, even if it offers broader cover. If you are moving from Britain, our UK moving checklist shows where this fits among your other first steps.
Common situations for newcomers:
| Your situation | Do you normally need Dutch basic insurance? |
|---|---|
| Moving to the Netherlands to work for a Dutch employer | Yes |
| Highly skilled migrant or EU citizen living and working in the Netherlands | Yes |
| Living in the Netherlands without working (for example a partner or retiree) | Usually yes, as a resident |
| Working in the Netherlands but living in another country | Often yes, if you work under Dutch social security |
| Posted worker sent temporarily by a foreign employer, covered by home-country social security | Often no, but this depends on your certificate of coverage |
| International student who does not work | Often no; a student policy may suffice. Taking a part-time job can change this |
Callout — do not wait for the four months to run out. When you take out insurance within the four-month window, cover is normally backdated to the date your obligation began, and you pay premiums back to that date. Any care you need in the meantime is then covered. Exceptions (students, posted workers, diplomats) turn on your exact social-security position, so confirm yours with your insurer or the Social Insurance Bank (SVB) before relying on one.
Children under 18 must be registered on a parent’s policy but pay no premium and no deductible.
What the basic package covers (and what it does not)
The basic package covers the core of everyday and hospital care, but adult dental care and most physiotherapy sit outside it. The exact content is set annually by the government and is identical at every insurer.
| Type of care | In the basic package? | Counts towards the €385 deductible? |
|---|---|---|
| GP (huisarts) consultations | Yes | No |
| Hospital and specialist care (with GP referral) | Yes | Yes |
| Prescribed medicines on the approved list | Yes (own contribution capped at €250 a year) | Yes |
| Maternity care and midwife | Yes | Midwife and maternity care: generally no |
| Mental healthcare (ggz) with referral | Yes | Yes (initial exploratory conversation exempt from 2026) |
| Dental care for under-18s | Yes (most treatment) | No |
| Dental care for adults | Only limited specialist treatment, such as dentures | Yes, where covered |
| Physiotherapy for adults | Only for listed chronic conditions, and not the first sessions | Yes, where covered |
| Stop-smoking programme | Yes, up to three times a year from 2026 | No |
| Eye tests and glasses for adults | No | — |
Callout — supplementary cover is optional, not compulsory. Many expats buy a dental and physiotherapy add-on by default. Compare what you would actually use in a year against the extra premium; for some people it does not pay off.
What healthcare costs an expat in 2026
For a single adult, a realistic annual budget is around €1,880 to €1,910 in premiums plus up to €385 in deductible, so roughly €2,270 to €2,300 a year in a bad year, before any supplementary cover. Sources differ slightly on the 2026 average premium: the government-backed Wijzer in geldzaken puts it at €1,884 a year (about €157 a month), while a comparison site cites about €159 a month. For the full cost picture beyond healthcare, see our Cost of Living in the Netherlands for Expats guide.
| Cost | 2026 figure | Notes |
|---|---|---|
| Average basic premium | approx. €157 to €159 a month | Varies by insurer and by policy type |
| Compulsory deductible | €385 a year | You can choose a voluntary extra deductible of up to €500 for a lower premium |
| Own contribution for medicines | Max €250 a year | Applies to certain medicines only |
| Income-related contribution (employees) | 6.10% of wages up to €79,409 | Paid by your employer, not deducted from your net pay |
| Income-related contribution (self-employed) | 4.85% of income up to €79,409 | Charged through your income tax assessment |
| Children under 18 | €0 premium, €0 deductible | Must still be registered on a parent’s policy |
Choosing a policy type. A “natura” (in-kind) policy is cheaper but fully reimburses only contracted providers. A “restitutie” (reimbursement) policy costs more but lets you choose any provider, which matters if you want an English-speaking specialist or a particular clinic. “Combinatie” policies sit in between.
Callout — the voluntary deductible is a gamble. Raising your deductible to the maximum €885 total lowers your premium, but one hospital visit can wipe out the saving. It suits healthy people with cash reserves, not families or anyone with an ongoing condition.
Healthcare allowance (zorgtoeslag)
If your income is below about €40,857 (single) or €51,142 (with a partner) in 2026, you may receive a monthly healthcare allowance from the Dutch tax authorities’ benefits service (Dienst Toeslagen). The maximum for a single person is €129 a month (down from €131 in 2025), and for households with an allowance partner it is €246. An asset (savings) limit also applies; check the current figure with Dienst Toeslagen.
| Single | With allowance partner | |
|---|---|---|
| Maximum allowance per month (2026) | €129 | €246 |
| Income limit (2026) | €40,857 | €51,142 combined |
| Asset limit | Applies; check with Dienst Toeslagen | Applies; check with Dienst Toeslagen |
Callout — allowance is paid on estimates. You apply based on expected annual income. If your income rises (for example a pay rise or a partner starting work), update your estimate promptly, or you will have to repay the difference after the year ends. Many highly skilled migrants earn too much to qualify at all. Use the official trial calculation (proefberekening) on the Dienst Toeslagen website before applying.
Your GP: the gatekeeper to the system
In the Netherlands you cannot normally see a hospital specialist without a referral from your GP (huisarts), so registering with a local GP practice should be one of your first tasks after arrival. GPs handle most care themselves, including minor procedures, prescriptions and initial mental-health support, and they are often more conservative with antibiotics and scans than expats are used to.
Practical points:
- Register early. Practices only accept patients living within their catchment area, and many in Amsterdam, Utrecht and The Hague have waiting lists. Start looking as soon as you have an address.
- GP visits do not touch your deductible, so there is no financial reason to delay seeing one.
- Most GPs speak good English, but some clinic paperwork and online portals are in Dutch only.
- Hospital referrals go through your insurer’s contracted network if you hold a natura policy.
Our Healthcare directory listings include English-speaking GP practices and clinics by city. Other expat services are listed on our Netherlands country hub.
Emergencies, out-of-hours care and pharmacies
For a life-threatening emergency call 112; for urgent care outside GP opening hours, call the regional out-of-hours GP service (huisartsenpost) rather than going straight to hospital. Turning up at hospital emergency departments without a referral is discouraged, and non-urgent cases may be redirected.
| Situation | Where to go |
|---|---|
| Life-threatening emergency | Call 112 |
| Urgent, cannot wait until your GP opens | Phone the huisartsenpost first |
| Non-urgent health problem | Your own GP, during office hours |
| Prescription medicines | Pharmacy (apotheek); register with one near home |
| Minor ailments | Chemist (drogist) for basic over-the-counter products |
What happens if you are not insured
If you are obliged to be insured and are not, the CAK (the government body handling uninsured persons) will write to you and give you three months to take out a policy, after which it issues fines. After two fines, the CAK registers you with an insurer itself and deducts an administrative premium (bestuursrechtelijke premie) from your income for 12 months.
| Step | What happens |
|---|---|
| 1 | CAK letter: you have three months to insure yourself or prove an exemption |
| 2 | First fine if you do not act |
| 3 | Second fine if you still do not act |
| 4 | CAK registers you with an insurer; administrative premium deducted from income for 12 months |
Callout — the fines are substantial. Each fine is roughly equal to three months of the standard premium, which means more than €500 per fine; check the CAK website for the current amount. Any care received while uninsured is billed to you directly.
Frequently asked questions
