Guide
The eigen risico: how the Dutch health insurance excess actually works
By Covered Abroad Research Desk · Last verified July 2026
The rule in writing
“Anyone insured by operation of law under the Wlz — in practice residents of the Netherlands, and non-residents taxed on employment performed there — must take out a Dutch zorgverzekering. Residence or Dutch-taxed work is the trigger, not nationality and not the residence permit. A non-working spouse who becomes resident is caught with no Dutch income at all.”
Official source: Zorgverzekeringswet Article 2(1), read with Wlz Article 2.1.1 — Last verified:
What the eigen risico is
Every adult with a Dutch basic policy carries a compulsory excess. Rijksoverheid states it plainly: "Het verplichte eigen risico voor 2026 is €385" — the compulsory own-risk for 2026 is €385. The first €385 of qualifying healthcare costs in a calendar year comes out of your pocket; above that, the policy pays.
Two clarifications stop most of the confusion. First, it is annual, not per-treatment — once you have paid €385 across the year, it is spent. Second, it applies per adult, not per household, because the Dutch system has no family policies: every adult holds an individual zorgverzekering.
One caution on the number itself: the 2027 figure was not stated on the official page as we read it, so treat €385 as the 2026 value rather than a constant. It is set nationally, so no insurer charges a different compulsory excess.
Source: Rijksoverheid, eigen risico zorgverzekering, read 20 August 2026.
What never touches the excess
The exemption list is where the system is more generous than newcomers expect, and it is worth knowing before you avoid care to protect your €385.
GP care is exempt — visits to your huisarts, including the out-of-hours huisartsenpost, never draw down the excess. The Netherlands wants nothing standing between you and the gatekeeper, which is coherent: the huisarts is how you reach everything else.
Maternity care and kraamzorg — the postnatal home-care package — are exempt. District nursing (wijkverpleging) is exempt. So are named chronic disease management programmes for type 2 diabetes, COPD and cardiovascular risk management, follow-up care after organ donation, and certain lifestyle interventions.
And the cleanest rule of all: "Voor kinderen tot 18 jaar betaalt u geen eigen risico" — children under 18 pay no excess at all. Children are also insured without a nominal premium, though they must still be registered with an insurer.
Source: Rijksoverheid, eigen risico zorgverzekering, read 20 August 2026.
60-second check
Not sure the policy you have meets your destination's written rule? Run it through the policy check now, before you build the rest of the file around it.
Check my policyThe voluntary raise, and who should take it
You may voluntarily raise the excess by €100, €200, €300, €400 or €500 in exchange for a lower premium — taking the total exposure to as much as €885 in 2026.
The honest way to frame this: it is a bet on your own health for the year, and the house sets fair odds. Take the maximum raise and a single hospital episode consumes the whole €885 before your policy pays anything above it. For a healthy thirty-year-old who sees only the exempt huisarts, the discount is close to free money; for anyone managing a condition that involves specialists, prescriptions or hospital care, it usually is not.
For new arrivals specifically, we would name one bias: your first Dutch year is the year you least know your own usage pattern in this system — unfamiliar referral routes, an unfamiliar formulary. There is a case for taking the standard €385 in year one and revisiting the raise once you have seen a year of your own claims.
Source: Rijksoverheid, eigen risico zorgverzekering, read 20 August 2026.
How it fits the rest of the Dutch system
The excess sits inside a structure worth seeing whole. The basic policy is compulsory for anyone insured by operation of law under the Wlz, every insurer must accept every applicant at the same premium regardless of age or health, and the premium is a nominal amount you pay monthly, with an income-related contribution collected separately. The eigen risico is the third leg: the part of the cost the system deliberately leaves with you.
Lower-income residents can claim zorgtoeslag, the healthcare allowance, from the Belastingdienst — but note the conditions: it requires a Dutch policy (international cover does not qualify you), and the 2026 income ceiling is €40,857 for a single person, €51,142 with a partner. Most readers of this site sit above those lines; treat the allowance as a fact of the system rather than a benefit to plan around.
One thing the eigen risico is not: a visa problem. Several countries on this site refuse policies with deductibles at the visa stage — France most famously. The Dutch excess is a feature of the compulsory domestic policy itself, imposed by law on everyone, and no consulate holds it against you.
Source: Belastingdienst, kan ik zorgtoeslag krijgen, read 20 August 2026.