Dutch health insurance for newcomers: rules, costs and deadlines

If you live or work in the Netherlands, you almost always need Dutch basic health insurance (basisverzekering). Arrange it as soon as your obligation to insure begins. If your policy starts within four months of that day, your cover is backdated to it. The four months are not a reason to wait; taking out cover later can leave you paying for care in the gap yourself.

Who this applies to

If you live here, or work here and pay Dutch wage tax, you must insure. Legally, the Long-term Care Act (Wlz) covers residents and people paying Dutch wage tax on work here. A foreign national also needs a qualifying residence status, such as a residence permit or EU free-movement rights; waiting for a permit decision does not count on its own, apart from the two groups described below. Almost everyone the Wlz covers must take out a policy.

If you come to work, you must insure once you work regularly for a Dutch employer and pay wage tax, even if you live abroad or keep foreign insurance. With an employer based abroad you may keep your home-country insurance, under certain rules. If you come to live but not to work, register with your municipality. Municipal registration alone does not establish whether you are insured under the Wlz; how long you have lived here and why you came also matter.

Children must be insured too, but under 18 they pay no premium and no own risk. Register a baby born here with an insurer within four months of the birth.

Exceptions

• Students and working holidays. With a residence permit for study, a Working Holiday (WHS or WHP) or cultural exchange, your foreign insurance is enough if it covers the Netherlands, unless you work here. Other international students who come only to study usually need no Dutch insurance, though a paid internship can change that. A paid side job, even for a few hours a week, normally means you must insure.
• EU institutions and international organisations. If you work only for an EU institution and are insured through the EU’s Joint Sickness Insurance Scheme (JSIS), that scheme covers you and, in principle, your family. Dutch insurance becomes compulsory if you have other work here, or if a family member works here or receives a Dutch social insurance benefit. Staff insured through an international organisation here, such as the European Patent Office, have no right to Dutch basic insurance.
• Asylum seekers awaiting a final decision are insured collectively through a special scheme.

If you think you need not insure, ask the SVB for a Wlz assessment. It can take up to eight weeks, so ask early.

The four-month insurance window

The legal trigger is the day your obligation to insure begins, not automatically your arrival or the date you collect a permit. If your policy starts within four months of that day, it runs back to that day. Backdated cover also means backdated premiums.

If your residence status is uncertain, the SVB can assess whether you are insured under the Wlz and therefore need Dutch basic insurance. If you are waiting for a permit decision or renewal and receive an uninsured letter, the CAK says to request that assessment first. If Dutch insurance is required, you can use the decision to obtain it. Do not assume that the assessment or permit decision gives everyone a new four-month period.

Two groups count as insured while they wait and need a policy now: people who already work here lawfully as employees and pay Dutch wage tax, and residents who applied to continue their stay before their permit ran out.

Asylum seekers have separate arrangements. The ministry’s guidance for asylum seekers ties the policy start and any backdated premiums to the residence permit coming into force. That is not a universal permit-based clock for every newcomer.

Arranging it, step by step

1. Arrange your BSN and contact an insurer promptly. Insurers must record your BSN, and everyone registered with a municipality has one. Living abroad? Register in the Non-residents Records Database (RNI) to get one. Our address and BSN guide covers both routes.
2. Compare insurers and policies. Every insurer offers the same standard package and must accept you for it; premiums differ by insurer and policy, not by age or health. There are two types of policy: with an in-kind policy you pay part of the cost at a provider your insurer has not contracted; with a combination policy you pay that provider up front and claim all or part back. Check whether your doctor or hospital is contracted.
3. Arrange cover promptly, within four months of your obligation starting, for yourself and your children, and choose your own risk.
4. Apply for healthcare allowance if your income is low.

What the basic package covers

The government’s overview of the basic package (in Dutch) lists care such as GP and hospital care, medicines, mental health care, maternity care and medical aids. Common gaps:

• Dental care. For adults, the package covers surgical dental care, X-rays and removable dentures, but not regular check-ups. Under 18, most dental care, such as check-ups and fillings, is covered, but braces, crowns, bridges and implants are not. At any age, special dental care for a serious mouth disorder, including orthodontics and implants, is covered.
• Adult physiotherapy. In 2026, for conditions on the chronic list, the package pays from the 21st treatment, so you usually pay the first 20 yourself. Some, such as hip or knee arthritis, have separate rules.
• Glasses and lenses. Ordinary glasses and contact lenses are not covered; medically necessary contact lenses and special glasses often are.

Supplementary insurance (aanvullende verzekering) is optional and covers care outside the package, such as glasses, dental care or extra physiotherapy. Insurers can refuse you for it.

What it costs in 2026

Besides the premium, you pay your first care costs each year yourself, up to your own risk (eigen risico, or excess). Some care, such as maternity care and hearing aids, also carries a co-payment (eigen bijdrage).

Income-related contribution. On top of the premium, you contribute a percentage of your income, collected by the Belastingdienst. On a salary or benefit, your employer or benefits agency pays it; on other income, such as a pension, you pay it through a tax assessment. See our first-year tax guide.

Own risk. It does not apply to GP care, midwife and maternity care, district nursing or care for children under 18, among other things. You can agree with your insurer to pay it in instalments.

What is set and what is estimated for 2027

The compulsory own risk for 2027 is set at €400 by ministerial regulation, in force from 1 January 2027. The government’s 2027 health overview estimates an average basic premium of €169 a month. That average is an estimate, not an insurer’s quote. Check the published premium and conditions for the policy you are considering for 2027, separately from the 2026 figures above.

Healthcare allowance (zorgtoeslag)

Healthcare allowance, or healthcare benefit, is a contribution towards your premium and compulsory own risk. The Dienst Toeslagen, which pays it, lists the conditions (in Dutch): the applicant must be 18 or over, have qualifying Dutch health insurance and meet the income and asset tests. A partner’s circumstances can change the calculation.

• Income in 2026: no more than €40,857 a year, or €51,142 combined with a benefits partner. The income that counts is roughly your gross annual income. You report your income for the whole year, foreign income included, even if you claim for only part of it, which matters in your arrival year. If you have a benefits partner for only part of the year, the combined full-year incomes count only for the months when you are partners.
• Assets in 2026: no more than €146,011, or €184,633 with a partner. Too much on 1 January means no allowance for the whole year. If you have a benefits partner for only part of the year, their assets are not counted. Assets of children under 18 count towards your assets.
• Lawful residence: you must be here lawfully. EU, EEA and Swiss citizens need no residence permit; for the allowance they need a valid residence status that gives a right to allowances, and the municipality tells the Dienst Toeslagen whether they have it. Other non-Dutch nationals need a valid residence permit that gives that right.
• Partners: a partner living here with you must be here lawfully too, unless they are waiting for a permit decision, or have appealed a refusal and may await the outcome here. For a partner abroad, request a BSN for them first. If your partner has no Dutch insurance, you normally get half the joint allowance and their income still counts. A partner abroad who can be co-insured through the CAK may also qualify for allowance; the country-of-residence factor (woonlandfactor) can reduce that amount.
• Partner under 18: an applicant aged 18 or over can receive half the joint allowance when their benefits partner is under 18. The partner’s income still counts.

Apply yourself through Mijn toeslagen, usually with DigiD (see our DigiD guide), once you are insured and registered with your municipality; if you live abroad, once you are insured and have a BSN. Late applications have a deadline, so apply as soon as you are insured. Report relevant changes promptly and within four weeks, such as a new job or moving in together. You need not report a change again if the municipality already passes it on to the Dienst Toeslagen.

Healthcare allowance in 2027: lower asset limits

For 2027, Dienst Toeslagen sets lower asset limits: €119,122 without a benefits partner, or €158,748 for both partners together, assessed on 1 January 2027. The lower limits follow from a law published on 19 October 2026. Meeting the asset limit alone does not establish entitlement; the other allowance conditions still apply. Do not use the 2026 income limits above for 2027.

If you receive allowance and expect your assets to exceed the new limit, report your estimated assets for 1 January 2027 in Mijn toeslagen. Reporting for 2027 opens on 1 November 2026; Dienst Toeslagen asks for the change by 8 December 2026 to stop payments that would have to be repaid.

What happens if you do not insure

If you are not insured, the CAK writes to you, and you have three months from that letter to insure or ask the SVB for a Wlz assessment. Otherwise you are fined €529.74 in 2026, and again three months later if you still have not. After two fines, the CAK registers you with an insurer and charges an administrative premium of 110% of the average nominal premium for 12 months, normally withheld from your income. If you have no fixed income, you receive a bill.

Switching insurer

Each November your insurer sends your policy for the coming year, and conditions can change even if you stay. Taking out a new policy by 31 December lets the new insurer cancel your old one. Alternatively, if you cancel the old policy yourself by 31 December, Government.nl says you have until 1 February to take out a new one. Confirm the replacement policy’s effective date when arranging it.

Common mistakes

• Counting on an international or expat policy. A private, international or home-country policy is not Dutch basic insurance.
• Taking the highest own risk without savings to cover €885 in 2026.
• Skipping healthcare allowance because, as an EU citizen, you have no residence permit. You do not need one; your residence status is what counts.