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Anyone who resides or works in the Netherlands is required, under the Health Insurance Act (Zorgverzekeringswet), to enroll with a health insurer to cover medical expenses within four months of arrival. The Dutch healthcare system is based on the principle of social solidarity. This means that healthy people contribute to the medical expenses of those who are ill. If you have an income or receive a social security benefit, you are also due to pay an income related premium. Depending on your situation, the percentage varies.
Health insurers must accept anyone who applies for the mandatory healthcare insurance, regardless of their age or state of health. You are free to choose your own health insurer and change your health insurer once a year, with effect from January 1st.
The health insurance consists of the above mentioned mandatory health insurance and an optional supplementary insurance. There are more than forty health insurers (including labels) that offer mandatory insurances as well as optional supplementary insurances.
The mandatory health insurance covers:
The supplementary insurance covers expenses that are not included in the mandatory health insurance. For example:
The monthly premium for the mandatory health insurance is approximately around € 110 (2018). Besides the monthly premium there is a mandatory policy excess. The policy excess concerns healthcare costs that are not reimbursed. The government determined that the excess for 2018 amounts to € 385,-. Medical costs that exceed this sum and are covered by your health insurance will be paid by the insurer.
Everyone over the age of 18 pays a monthly premium for the mandatory health insurance. Those who are younger than 18 years are insured and do not have to pay any premium or excess. Note that newborns must be registered with a health care insurer within four months after birth.
The healthcare benefit (‘zorgtoeslag’) is a contribution by the government towards the health insurance premium and is issued by the Belastingdienst. Visit www.toeslagen.nl to calculate whether you qualify for the healthcare benefit. The amount of healthcare benefit depends on your income. The healthcare benefit also applies to children aged over 18 who are living with their parent(s). The healthcare benefit is not dependent on the parents’ income. You can apply for the healthcare benefit online or by mail.
If you are not insured, you will receive a letter from the Netherlands Healthcare Institute (het CAK) reminding you to take out a mandatory health insurance within three months. If you do not enroll with a health insurer within three months, you will have to pay a penalty of € 386,49 (2018).
If you have incorrectly received the letter, then you need to submit an appeal to het CAK. You can download the appeal form. When in doubt, you can contact the Social Security Bank (in Dutch ‘Sociale Verzekeringsbank’) to request for an investigation of your insurance situation under the Wlz scheme. For more information see www.svb.nl.
If your premium is overdue, you risk having to pay a higher premium. The health insurer will send you a letter when you are two months or more behind on your payments. You can then request for a payment arrangement. When you are four months behind or more on you premiums, you will receive a last warning from your health insurer. Make a payment arrangement with your health insurer in time or go to your municipality for assistance to solve your debt problem.
What you should do in the event of payment arrears:
In the event of a six months premium debt, your health insurer will report you to het CAK. The monthly due to het CAK is € 134,38. This new monthly premium will be deducted directly from your wages or benefit. The increased premium will end once the entire debt has been paid or if you have made arrangements for debt counselling.
If you reside or work in the Netherlands, you are obliged to take out Dutch health insurance according to the Health Insurance Act.
You are not required to be insured in the Netherlands if you reside and work in the Netherlands for an employer based in your home country, you can remain insured in that country. You need to have an A1 certificate and apply for an S1 or E106 form with your health insurer in your home country. This form is used by the memberstates of the European Union (EU), European Economic Area (EEA) and Switzerland. With this certificate and form you can get medical care in the Netherlands.
If you are in the Netherlands for study purposes only, you are not required to be insured under the Health Insurance Act. This means you do not have to enroll with a Dutch health insurer. You can remain insured with the health insurer in your home country.
Check the Leaflet Dutch health insurance international students (PDF) if you are obligated to take out a Dutch health insurance.
If you have a paid internship and/or a part-time job next to your study, you are required to have a basic health insurance policy with a Dutch health insurer.
Check the Leaflet Dutch health insurance international students (PDF) if you are obligated to take out a Dutch health insurance.
The EHIC will no longer be valid if you reside and/or work in the Netherlands and you are required to have a Dutch health insurance.
Check whether your employer offers a corporate health insurance to benefit from the discount on the premium for the mandatory health insurance.