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Healthcare in the Netherlands for expats: how the system works

By Covered Abroad Research Desk · Last verified July 2026

Dutch healthcare runs through a compulsory basic policy bought from a private insurer. Your huisarts is the gate to almost all specialist care, and the compulsory eigen risico is €385 for 2026. Registration with the gemeente gives you a BSN, which is what everything else hangs off. The basic package has real gaps for adults.

Visa-ready plans from $721 per adult, billed annually · see your exact price by age.

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:

The rule in writing

“Dutch insurers must accept every insurance-liable applicant for the basic policy, at the same premium, regardless of age or health. Any claim that a private plan offers easier acceptance than the Dutch basic package is false.”

Official source: Zorgverzekeringswet Article 3 (acceptatieplicht) — Last verified:

Your first week: the gemeente, the BRP and your BSN

Government.nl sets the sequence out plainly. If you are going to stay in the Netherlands for more than four months you register with the municipality where you will live, and you must do this within five days of arriving. When you register, the municipality arranges a citizen service number, the BSN, which you use in all your dealings with government and to get healthcare, and you are entered in the Personal Records Database, the BRP.

If you are moving for no more than four months you cannot register with the municipality, but you can be registered as a non-resident in the BRP instead. Keep that separate from the insurance question in your head: BRP or non-resident registration is a records matter, while the insurance test is residence or Dutch-taxed employment. Someone here briefly who is nonetheless taxed on Dutch employment is still caught. In practice the order that works is arrive, register at the gemeente, receive your BSN, take out the basisverzekering, then register with a huisarts.

One more disambiguation, because two different four-month rules run alongside each other. The four months above is the BRP threshold that decides whether you register as a resident or a non-resident. The other four months, the one people quote about insurance, is Article 5(5) of the Zorgverzekeringswet, and it is a retroactivity window rather than a grace period: the obligation starts the day it arises, and a policy bought inside four months back-dates to that day. They are unrelated rules that happen to share a number. Do I need health insurance in the Netherlands takes the second one apart.

The huisarts is the gate, and can say no

This is the part that surprises American and British arrivals most. Per rijksoverheid.nl, for specialist care, for instance in hospitals, you need a referral letter from your huisarts. The GP gives a referral only where it is medically necessary, and refuses one where convinced it would not be useful for you, in which case they must explain why.

Go to a specialist without a valid referral and, per the same page, you may have to pay for the treatment yourself, or you may not be treated until you have the right referral. Some care needs no referral at all: physiotherapist, exercise therapist, dental hygienist, skin therapist, dietitian, occupational therapist, speech therapist and podiatrist. Nor is a referral needed for urgent or emergency specialist care. You can also choose to be treated privately without a referral, but you cannot then claim the bill from your insurer.

The eigen risico: €385 for 2026, and what it does not touch

The compulsory own-risk excess for 2026 is €385, per rijksoverheid.nl as read on 20 August 2026. You pay the first €385 of qualifying costs each year yourself before the basic policy starts paying.

Several things sit outside it, and they matter more than the headline number. There is no eigen risico on huisartsenzorg, which includes the out-of-hours huisartsenpost, nor on verloskundige zorg and kraamzorg, nor on wijkverpleging. The same page lists exemptions for chronic disease management programmes covering type 2 diabetes, COPD and cardiovascular risk management, for organ donation follow-up and associated travel costs, and for the combined lifestyle intervention. For children under 18 there is no eigen risico at all, on any care in the basic package. If you want a lower premium you may voluntarily raise your own excess in steps of €100, €200, €300, €400 or €500. Do not publish a 2027 figure from memory; that page did not state one as read on 20 August 2026.

What the basic package leaves out for adults

The basic package is broad and the exclusions are specific. Per rijksoverheid.nl, read 20 August 2026, three gaps hit adults in particular.

Adult dental care. For adults aged 18 and over the package covers only chirurgische tandheelkundige hulp en röntgenonderzoek, surgical dental care and X-rays. Routine check-ups, cleaning, fillings and crowns are not in it. Under 18, by contrast, check-ups, treatment and fluoride treatment from the eruption of the permanent teeth are covered.

Physiotherapy. For adults the package covers limited physiotherapy and exercise therapy from the 21st treatment onward, and then only for conditions on the designated chronic list. The first 20 sessions are yours. Under 18 the package covers up to 18 sessions.

Glasses and contact lenses. Ordinary spectacles and contact lenses are not reimbursed through the basic package, although medically indicated lenses and special glasses often are.

Dutch insurers sell aanvullende, supplementary, packages against exactly these gaps, so this is a market with incumbents rather than an empty field. The honest question is not whether to have supplementary cover but which one suits a household that also moves between countries.

Zorgtoeslag, and why it probably is not for you

The healthcare allowance exists and it is worth knowing about, but it is means-tested and most people reading this will be above the line. Per belastingdienst.nl, read 20 August 2026, you must be 18 or over, you must have your own health insurance from that age, and you must in any case hold a Nederlandse zorgverzekering. An international policy does not qualify you.

The 2026 ceilings on that page: income no higher than €40,857 a year, or €51,142 combined with a partner. Assets on 1 January 2026 no higher than €146,011, or €184,633 combined. The page notes there are further conditions listed separately, so check the full conditions rather than treating those four numbers as the whole test.

Where a top-up fits, and where it does not

Read the two halves of this page together and the honest position is easy to state. The compulsory basic policy is the foundation, it is bought from a Dutch insurer, and nothing we arrange replaces it. Insurers must accept you for it at the same premium as everyone else regardless of age or health, which the requirement below sets out. What our cover can sensibly do is sit alongside it, or carry you through the periods before it starts.

Annual limits run from US$1,000,000 to US$2,000,000 through a single insurer across every destination we cover, so the policy travels if you move on. Cover starts the same day with no medical exam and there is a 14-day cooling-off period; children aged 0 to 17 are priced at a flat rate. Pre-existing conditions are excluded and treatment inside the United States is not covered. New applicants are accepted up to age 70, or 80 on Essential. See the cost page for real numbers, who is actually obliged to hold a Dutch policy, or run a policy check.

Honest limits: Cover is worldwide but excludes treatment in the United States. Pre-existing conditions are excluded, including conditions you did not know about. We disclose this before you request a quote. Consulates keep discretion, and requirements can change. We show the published rule and its source; the final decision is the consulate’s.

Cover levels that meet the rule

Benefits are public, and so are the 2026 prices: your exact rate depends on age.

Standard

From $1,133/yearabout $94/mo billed annuallyChildren 0–17: flat $853/yr

Adds everyday outpatient care — GP and specialist visits, prescriptions, and tests — to hospital cover.

  • US$1,000,000 overall plan limit per year
  • GP, specialist, medication & lab tests (US$750 each)
  • Outpatient surgical to US$25,000
  • Semi-private hospital room & board
  • Pre- & post-hospitalisation cover

New applicants up to age 70.

+ everything included — hover to expand

Scope: No dental or wellbeing benefits at this level.

Choose StandardSee your price by age →

Fully Comprehensive

From $1,906/yearabout $159/mo billed annuallyChildren 0–17: flat $1,439/yr

The highest level: full-cover room, uncapped surgeon fees, routine dental, and the largest limits.

  • US$2,000,000 overall plan limit per year
  • Full-cover private room & board
  • Full surgeon, professional & outpatient cover
  • Routine & major dental (after 6-month wait)
  • Wellbeing check-ups & vaccinations to US$500

New applicants up to age 70.

+ everything included — hover to expand

Choose Fully ComprehensiveSee your price by age →

See your exact price by age →

Budget options — limited cover

Essential Health

From $392/yearabout $33/mo billed annually

A budget plan for accident and emergency care in state hospitals only. Not full private health cover.

  • US$100,000 maximum plan limit per year
  • Unforeseen accident & emergency care only

Scope: State hospitals only, accident/emergency only. No outpatient, dental, or wellbeing cover. Not a substitute for full private health insurance on a visa application.

Choose Essential Health →

Major Medical

From $721/yearabout $60/mo billed annually

Hospital-focused cover: inpatient treatment, surgery, and emergencies, worldwide outside the US.

  • US$1,000,000 overall plan limit per year
  • Semi-private hospital room & board
  • Theatre, ICU, and emergency-room cover (full)

Scope: No outpatient, dental, or wellbeing benefits at this level.

Choose Major Medical →
  • Treatment is covered worldwide, excluding the United States.
  • Pre-existing conditions are excluded — including conditions you did not know about.
  • Evacuation & repatriation is an optional benefit that costs an additional premium.
  • Prices are Regency’s 2026 rates for the EU region: per person, per year, billed annually, starting at adult age 18 — your exact price depends on age. Children 0–17 pay a flat rate on every plan.
  • Plans run in 12-month terms and renew at the anniversary; the age limits shown apply to new applicants.

Common questions

How does the Dutch healthcare system work for a new arrival?

You register with the gemeente within five days of arriving if you are staying more than four months, which gives you a BSN, then you take out a compulsory basic policy from a Dutch insurer and register with a huisarts. The huisarts is the gate to specialist care, and the compulsory eigen risico for 2026 is €385.

Do I need a referral to see a specialist in the Netherlands?

Yes, for specialist care such as in hospitals, per rijksoverheid.nl. Without a valid referral you may have to pay the treatment yourself, or not be treated until you have one. Physiotherapists, dietitians, dental hygienists, speech therapists and several others need no referral, and neither does urgent or emergency care.

What is the eigen risico in 2026?

€385 for the year, per rijksoverheid.nl as read on 20 August 2026. It does not apply to huisartsenzorg including the out-of-hours post, to verloskundige zorg and kraamzorg, or to wijkverpleging, and children under 18 pay none of it. You may voluntarily raise your own excess by €100 to €500 in exchange for a lower premium.

Does Dutch basic insurance cover the dentist and glasses?

For adults, only surgical dental care and X-rays are in the basic package, so routine check-ups, cleaning and fillings are not. Ordinary glasses and contact lenses are not reimbursed either, and the first 20 physiotherapy sessions for adults are self-paid. Dental care for under-18s is covered.

Can I claim zorgtoeslag as an expat?

Only if you hold a Dutch health policy and fall under the means test. Per belastingdienst.nl for 2026 that means income no higher than €40,857, or €51,142 with a partner, and assets on 1 January 2026 no higher than €146,011, or €184,633 combined. Further conditions are listed separately on that site.

Get a certificate that meets the published rule

Tell us your destination, visa, and who’s moving. Our team reviews it against the current requirement and calls you with a quote — no obligation.

Cover underwritten by Regency Assurance · every rule on this site cited and dated · a person calls back within one business day.

Before you request a quote: cover is worldwide but excludes treatment in the United States, and pre-existing conditions are not covered — including conditions you did not know about. We say this up front so a quote is worth your time.

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