Health insurance in the Netherlands for expats, also without a BSN

Do I need Dutch health insurance?

In most cases, yes. If you live in the Netherlands, or you live abroad but work here, you are generally obliged to take out Dutch basic health insurance. The moment that obligation starts depends on your personal situation, and so does the answer for posted workers and people who keep an international health plan (see below). We check which rule applies to you before you sign anything, because arranging cover too late can lead to a fine and to medical bills you have to pay yourself.

What Dutch basic health insurance covers

The content of the basic package is set by the Dutch government and is identical at every insurer. It covers care from a GP, hospital treatment, most prescription medicines, maternity care and emergency care. Dental care for adults, physiotherapy beyond what basic insurance covers and glasses or lenses are not in the basic package; for those you need an additional package (aanvullende verzekering).

Two numbers matter for what you pay. The compulsory excess is € 385 in 2026: the first € 385 of most treatments is for your own account, although visits to your GP and maternity care fall outside it. On top of that you may choose a voluntary excess of € 100 up to € 500, in five steps, which lowers your monthly premium. That is a bet on your own health, so it only pays off if you expect little care. Both figures come from Rijksoverheid and apply to 2026.

How much is health insurance per month in the Netherlands?

The average premium for basic health insurance is € 157 per adult per month (source: the CAK, 2026). Premiums differ by insurer. Your insurer may offer a choice of hospital at a higher premium (source: the CAK). The compulsory excess is € 385 per year, with GP visits excluded (source: Rijksoverheid, 2026).

On top of the premium you pay an income-related contribution (Zvw contribution), a percentage of your income (source: Government.nl). On your salary, your employer arranges the income-related contribution, usually through an employer levy of 6.10%, but in some cases by withholding 4.85% from your pay (source: the Belastingdienst, 2026). On profit, you pay 4.85% yourself via a separate Zvw assessment after your income tax return (source: the Belastingdienst, 2026). With salary and profit, both apply. The contribution is charged on income up to € 79,409, so above that your contribution stops rising (source: the Belastingdienst, 2026).

Children under 18 must be insured but pay no basic insurance premium and have no excess (source: Government.nl and Rijksoverheid). Insurers must accept anyone applying for the basic package and charge everyone the same premium, regardless of age or state of health (source: Government.nl).

Comparing health insurance in the Netherlands

Because the basic cover is the same everywhere, comparing is not about who covers more. It is about three things:

Can I keep my international health insurance instead of Dutch basic insurance?

In most cases, no. If you live or work in the Netherlands, you must have Dutch basic health insurance under the Zvw scheme (source: the SVB). An international plan or EHIC is not sufficient when you work here (source: SKGZ). There are exceptions, such as a secondment. We check which rule applies before you cancel or keep any cover.

International health insurance is an alternative if you do not qualify for Dutch basic health insurance (source: SKGZ, the independent complaints body for health insurance). The following situations can mean you are not obliged to take out Dutch basic insurance:

• You are temporarily seconded to the Netherlands, known as detachering. You can sometimes remain insured in your country of origin. Depending on that country and the duration of your secondment, you or your employer may be able to apply there for an A1 form. This proves your exemption from Dutch basic insurance for all or part of the secondment (source: SKGZ).
• If you do not live in the Netherlands and you work in the Netherlands and one or more other countries, you are not normally insured under the Wlz scheme and are then not obliged to take out Dutch basic insurance. If you live in the Netherlands and work in two or more countries, the SVB takes this into account in its assessment (source: the SVB).
• You work in the Netherlands for an international organisation and are insured through it. You then have no right to Dutch basic insurance. Examples include the European Patent Office and the European Space Agency (ESA/Estec). For some international organisations, this also applies to family members (source: Rijksoverheid).

Every situation is different. On request, the SVB assesses whether you are insured under the Wlz scheme and therefore whether you must take out Dutch health insurance. Processing can take up to 8 weeks (source: the SVB).

Can I choose my own doctor or a private clinic?

Usually, yes. If your policy works with contracted providers and you go to another provider, the insurer sets the reimbursement, and it may be lower (source: Healthcare Insurance Act, art. 13, and Rijksoverheid). Some policies reimburse certain care only from contracted providers (source: policy conditions of VGZ Ruime Keuze, 2026). Basic insurance reimburses treatment at an independent treatment centre (zelfstandig behandelcentrum) if it is medically necessary, in the basic package and referred by your GP or another designated referrer (source: Rijksoverheid).

Dutch law allows a policy to provide the care itself, to reimburse its cost, or to combine both (source: Healthcare Insurance Act, art. 11). A policy that provides care through contracted providers is a naturapolis and a mix is a combinatiepolis (source: Rijksoverheid); a policy that reimburses costs is often called a restitutiepolis. With a naturapolis, the insurer selects and contracts providers. You can go elsewhere, but reimbursement may be lower. A naturapolis with fewer contracted providers or lower reimbursements is also called a budgetpolis, a policy with restrictive conditions (source: Rijksoverheid). The insurer must state how reimbursement for non-contracted care is calculated in the policy (source: Healthcare Insurance Act, art. 13).

An independent treatment centre offers specialist medical care, such as cataract surgery or a knee replacement. Sometimes your insurer does not reimburse the full bill, for example if it has no contract with the centre. The compulsory excess, and any voluntary excess, always applies. Ask your insurer in advance. If treatment there is not reimbursed from basic insurance, additional insurance may (partly) reimburse it. Care that is not medically necessary, such as cosmetic procedures, is not reimbursed by your health insurance, and you pay for it yourself (source: Rijksoverheid). We compare how policies reimburse non-contracted care before you choose.

Does Dutch health insurance cover me abroad?

On holiday abroad, your Dutch health insurance covers care you need suddenly and urgently, but it may not pay every cost in full (source: Rijksoverheid). Basic insurance reimburses what treatment costs in the Netherlands, never more than Dutch providers are allowed to charge (source: Rijksoverheid).

A private clinic abroad may leave you paying a substantial amount yourself, sometimes thousands of euros. Additional insurance or travel insurance can prevent that (source: Rijksoverheid). Repatriation, meaning transport home after illness or death, is not covered by basic insurance. Only travel insurance or additional insurance reimburses these costs (source: Rijksoverheid).

Within Europe, take your European Health Insurance Card (EHIC). It gives access to medically necessary care that cannot wait until you return, and that care falls under the excess. For trips shorter than 1 year, you remain insured under Dutch legislation and can keep your health insurance (source: Rijksoverheid).

Travel cover on top of your Dutch basic insurance

If you have come to live and work in the Netherlands for at least one year, De Goudse's Expat Policy for Foreign Professionals in the Netherlands includes Continuous Travel as one of the insurances you can combine (General Terms and Conditions 992176, art. 2.1 and 2.4). It comes on top of your Dutch basic insurance, not instead of it, because De Goudse expects you to hold Dutch health insurance (General Terms and Conditions 992176, art. 1.2). It pays necessary medical expenses if you fall ill unexpectedly or have an accident abroad and treatment cannot wait until you return to the Netherlands, but not expenses insured through your Dutch health insurance (Continuous Travel 992168, art. 2.2.2.1 and 2.2.3). If you are seriously injured or ill and transport to the Netherlands is necessary on health grounds, it pays an air ambulance or other medical transport, but you must contact De Goudse Assistance in advance for consent (Continuous Travel 992168, art. 2.1.1 and 2.1.2). It covers trips of up to 90 consecutive days, not trips for business purposes (Continuous Travel 992168, art. 1.5). We explain more about the package on our expat insurances page.

No BSN yet? You can still be insured

You can apply for Dutch basic insurance without a BSN. You only get a BSN after registering with your municipality. If you work here, your basic insurance must start on your first working day, and international cover is no longer enough from that day (source: SKGZ). A basic policy you apply for within four months is backdated to the day your obligation started. Once your BSN comes through, let your insurer know.

De Goudse's ISIS Incoming insurance, which you will find below, is a different product. It is meant for temporary guests who normally live abroad, stay with a host family in the Netherlands and intend to return home, such as students and au pairs, up to the age of 45 and for up to 24 months (source: ISIS Incoming policy conditions 0123272, art. 2, 5 and 6). It pays for medical care that cannot wait until you return home, and only on top of any compulsory social insurance (art. 10 and 19.1). If you work here, it does not take the place of the Dutch basic insurance you must have (source: SKGZ).

We also arrange the rest of your cover, from expat insurances to a mortgage as an expat mortgage advisor.