Dutch Health Insurance: What the Eigen Risico Means, What Basic Insurance Covers, and Why Everyone Mentions the Huisarts Again

Dutch health insurance is mandatory for everyone living in the Netherlands,

including expats, from the first day of residency. This is not a formality: failure to arrange insurance within four months of registering results in a fine and a retroactive premium levy that covers the gap period. It is one of the first administrative tasks on the list, alongside your BSN and DigiD, and it is considerably more manageable than the phrase “mandatory national health insurance system” tends to suggest.

How the System Is Structured

Dutch health insurance divides into two layers. The first is the basisverzekering — the basic package, which is defined by the Dutch government and is legally identical in coverage regardless of which insurer you choose. Every insurance company operating in the Dutch health market must offer the same basic package, at the same mandated minimum coverage level. What differs between insurers is the premium amount, the supplemental options they offer, the quality of their customer service, and their contracted care arrangements with specific hospitals and providers. The insurer you choose does not determine what you are covered for at the basic level. It determines what you pay and where you can receive care.

The major Dutch health insurers are CZ, Menzis, VGZ (including its sub-brands Zilveren Kruis and OHRA), and several smaller providers. Premiums for the basic package range from approximately €130 to €165 per month depending on the insurer and the year. Comparison sites, Zorgwijzer (zorgwijzer.nl) and Independer (independer.nl) are the most used, allow you to compare premiums, contracted care arrangements, and supplemental options in one place. Switching insurers is permitted annually, and the switch window runs from November 1st to January 1st for coverage starting the following year.

The Eigen Risico: What It Is and When It Matters

The eigen risico is the compulsory annual deductible attached to every Dutch basic insurance policy. In 2026, it is €385 per adult per year. This means that the first €385 of eligible healthcare costs, excluding GP visits, district nurse care, and a small number of other exempt services, is paid directly by you before your insurer begins contributing. The eigen risico resets on January 1st each year. If you have a significant medical event in December and another in January, you may pay the deductible twice in close succession.

It is possible to voluntarily increase your eigen risico, opting for €500 or €885 rather than the compulsory minimum, in exchange for a reduced monthly premium. This makes financial sense if you are in good health, use healthcare services rarely, and prefer lower monthly costs over a higher potential exposure in a given year. It makes less sense if you have ongoing healthcare needs. The calculation is straightforward: how much you save monthly multiplied by twelve versus the additional deductible risk.

What the Basic Package Covers - and What It Does Not

The basisverzekering covers GP visits (vergoeding without eigen risico), hospital care, specialist consultations (via huisarts referral), prescription medication on the vergoedingslijst (reimbursement list), mental health care for moderate to severe conditions, maternity care, and emergency treatment. The coverage is comprehensive for acute and ongoing medical needs.

What it does not cover is the thing that surprises most new arrivals: adult dental care. Routine dental treatment, check-ups, fillings, extractions, hygienist visits, is not covered by the basic package for adults. It is either paid out of pocket or covered by aanvullende verzekering (supplemental insurance), which you purchase in addition to the basic policy. Dental aanvullende packages vary widely in what they reimburse and up to what annual limit. If dental care is a relevant consideration, which it is for most people with functioning teeth, factor this into your insurance comparison before choosing a provider.

Zorgtoeslag, a healthcare allowance from the Belastingdienst, is available to lower-income residents and partially offsets the monthly premium cost. Eligibility and amount are income-dependent; check via the Belastingdienst portal or Mijn Toeslagen using your DigiD. The Dutch health insurance system is, despite its complexity on first encounter, well-designed for what it intends to do. The main task is understanding the eigen risico before you need it rather than after.