If you’re coming from the American health-insurance system, the Dutch one can feel like stepping through a portal into a parallel universe.
Here’s everything you should know as an American getting health insurance in the Netherlands.
Let’s start with the basics: the Netherlands runs on mandatory, universal health insurance.
Every legal resident buys a basisverzekering (basic insurance package) from a private insurer, and the government dictates what that package must cover. Insurers have to accept everyone, regardless of health history — nobody gets turned away.
For Americans used to a system built on employer luck, fine print, and anxiety-inducing deductibles, this is a welcome, but big adjustment.
What makes Dutch health insurance different for Americans
First things first: your US health insurance almost certainly won’t cover you in the Netherlands in any meaningful way, and Medicare doesn’t cover international care at all. You’ll need Dutch insurance.
The two systems are structurally opposite. In the US, coverage is determined by your employer. In the Netherlands, insurance is mandatory; you choose your own insurer, pay each month directly, and the government sets the rules.
The other big adjustment is the huisarts — your GP. In the Netherlands, the GP is a gatekeeper: you can’t see a specialist without a referral. It sounds restrictive, but it keeps costs down and prevents the kind of fragmented, specialist-hopping care that’s common in the US.
Do US expats need Dutch health insurance?
Yes. If you’re legally living or working in the Netherlands, Dutch health insurance is mandatory. You have four months after registering with your gemeente to sign up — but your premiums run from your registration date, not the date you actually sign up for health insurance.
Sign up in month three, and you’ll owe two months of back premiums on the spot. Most insurers allow instalments, but it’s still a bill you weren’t expecting. So while the four-month window exists, it isn’t a free pass.
There are some exceptions. Workers still covered by their home-country social security system, or those covered under a social security treaty, may be exempt.
But the vast majority of Americans arriving via DAFT visas or any other route fall squarely under the mandatory rule.
What if I’m only in the Netherlands temporarily?
There are two situations here:
If you’re in the Netherlands for fewer than four months and have no plans to register as a resident, Dutch basic insurance doesn’t apply to you. Make sure your existing US health insurance covers you abroad, or take out a travel insurance policy that does. For context, Schengen guidelines recommend at least €30,000 in medical coverage for visitors.
If you’re planning to stay long-term but your residence permit isn’t confirmed yet, that’s a different situation. During that gap — which can last several weeks — it’s best to sign up with an international health insurance provider, such as GeoBlue, Cigna Global, or IMG Global, for a bridging policy that you can cancel later when you get your registration.
The threshold that matters is four months. Stay under it as a visitor, and your home country or travel insurance is sufficient. Cross it as a resident, and Dutch basic insurance becomes mandatory.
Special cases: students, freelancers, and the self-employed
International students who don’t earn income in the Netherlands aren’t usually required to take out Dutch basic insurance. They can use their home-country coverage or a private international policy (often student-specific) instead.
Freelancers and ZZP’ers (zelfstandigen zonder personeel, or self-employed sole traders), however, face the same mandatory rules as everyone else.
How Dutch health insurance works: the basics
The Dutch system is a hybrid. The government sets the rules; private insurers compete on price, customer service, and supplementary packages.
However, no one can be denied basic coverage, and the basic package is identical across all providers.
Crucially, healthcare insurers must accept all applicants for the basic package. Pre-existing conditions are not grounds for refusal. That alone is a significant departure from what many Americans are used to.
Basic insurance (basisverzekering)
The basisverzekering is the minimum coverage option. It covers GP visits, hospital care, prescription medication, maternity care, and mental health treatment via referral.
However, it doesn’t cover dental care for adults, glasses, physiotherapy beyond a limited number of sessions, and most alternative therapies.
Supplementary insurance (aanvullende verzekering)
Supplementary insurance covers gaps such as dental care, extra physiotherapy, overseas coverage, and glasses.
Keep in mind, providers can refuse supplementary applications (unlike the basic insurance), so if you have a condition that requires a lot of physiotherapy, for example, it’s worth shopping around early.
Most Dutch residents take out some form of supplementary cover — and it’s easy to see why. Whether you need it depends on your situation, but if you have a family, teeth, or a tendency to injure yourself, it’s worth considering.
How much does Dutch health insurance typically cost?
Dutch health insurance is considerably cheaper than what most Americans are used to — but there are a few different costs to understand before you pick a plan.
Monthly premiums (maandelijkse premies)
The cheapest basic premiums for 2026 start at around €145 per month, while more comprehensive options run higher. The average sits at around €159 per month.
That’s what some Americans pay for a week of employer-sponsored insurance, for perspective.
Your employer also deducts a separate income-based ZVW (Healthcare Insurance Act) contribution directly from your salary.
This isn’t your monthly premium but an additional contribution to the national insurance fund. You don’t pay it separately; it’s deducted before you see your payslip.
The own-risk deductible (eigen risico)
Before accessing certain types of medical care in the Netherlands, sometimes you have to pay a personal deductible: the eigen risico (own risk)
Eigen risico is the amount you pay out of pocket each year before your insurer starts covering non-GP costs. Think of it as an annual threshold, not a per-visit fee.
In 2026, the compulsory deductible is €385. You can choose a higher deductible of up to €885 per year to lower your monthly premiums.
GP visits are exempt from the eigen risico. So are maternity care and care for children under 18. In fact, for most routine medical needs, you won’t hit the deductible at all.
Growing up in the US, the idea of a predictable, capped annual deductible feels almost radical, especially since a friend of mine back home hit $8,000 out-of-pocket in a single year. Here, the worst it can get — by design — is €885.
The healthcare allowance (zorgtoeslag)
Good news: if your income is below a certain threshold, the Dutch government chips in to help cover your premiums. In 2026, the income threshold is €40,857 for individuals and €51,142 for couples.
The allowance can be up to approximately €132 per month for single households and up to approximately €250 per month for couples.
You apply via your DigiD through the Mijn Toeslagen portal. The forms are in Dutch, but running them through a browser translation tool gets you most of the way there.
If you’re eligible, apply as soon as you’re set up. It’s paid directly into your bank account each month and genuinely takes the edge off the premium cost.
Can you deduct medical costs from taxes?
In certain circumstances (like for people with chronic illness or unusually high medical costs), it’s possible to deduct some healthcare expenses from your Dutch income tax.
This is worth investigating with a Dutch tax accountant if you have significant ongoing medical needs.
Choosing a Dutch health insurance provider
All providers must offer the same basisverzekering coverage. What varies is price, network, customer service, and supplementary options.
There are two main policy types available in 2026.
- A naturapolis (contracted network policy) restricts you to providers with which your insurer has agreements. It’s cheaper, but with fewer choices.
- A combinatiepolis (combination policy) offers broader access to hospitals and specialists, including some coverage for non-contracted providers, depending on the policy terms.
An important note: the restitutiepolis — the most flexible policy type, which offered full reimbursement at any provider — was discontinued at the start of 2025 and is no longer available. Most former restitutie holders have been automatically moved to a combinatiepolis.
Dutch health insurers worth knowing
Glider (formerly Loonzorg) is the go-to recommendation for most expats. Everything from customer service to policy documents is in English, and Glider waives the mandatory eigen risico, meaning you don’t have to pay any out-of-pocket costs upfront. It’s an intermediary of HollandZorg and covers all public hospitals and GPs.
ONVZ is another strong option for English-speaking expats, known for excellent customer service and clear communications.
Zilveren Kruis is the largest insurer in the Netherlands by market share and offers a wide range of plans, though it’s not specifically geared toward internationals.
FBTO is popular for its competitive pricing and straightforward use.
To compare providers side by side, Zorgwijzer has an English-language comparison tool and is the most expat-friendly place to start.
To break it down even further, here’s a table of the main providers:
| Provider | English support | Eigen risico waived | Good for |
| Glider | ✅ Full | ✅ Yes | Expats, newcomers |
| ONVZ | ✅ Partial | ❌ No | High-service seekers |
| Zilveren Kruis | ❌ Limited | ❌ No | Wide network coverage |
| FBTO | ❌ Limited | ❌ No | Budget-conscious |
| VGZ | ❌ Limited | ❌ No | Broad family coverage |
International health insurance for US expats in the Netherlands
If you’re moving as a contractor invoicing US clients and planning to spend part of the year travelling, an international plan might be a better fit than Dutch basic insurance — at least initially. GeoBlue, IMG Global, and SafetyWing all offer US-citizen-friendly international plans. Allianz Care, Cigna Global, and APRIL International are also worth comparing.
Just note: international insurance doesn’t satisfy the Dutch legal requirement. Once you’re a registered resident in the Netherlands, you need Dutch basic insurance.
Switching or cancelling your Dutch health insurance
Every year, there’s a switching window that opens in mid-November and runs until December 31. Whatever you choose takes effect on January 1.
Switching is straightforward as your new insurer handles the transfer. If you leave the Netherlands permanently, you can cancel outside this time window by providing proof of deregistration from your gemeente.
How to register for Dutch health insurance
Step 1: Register with your gemeente and get your BSN. You can’t get Dutch basic insurance without it.
Step 2: Choose a provider and apply. You’ll need your passport or ID, BSN, proof of Dutch address, and a Dutch bank account.
Step 3: Register with a local GP (huisarts). This is separate from your insurance and essential since your GP is your entry point to the whole system.
Step 4: Register with a local pharmacy (apotheek). Your insurer will send you a zorgpas (insurance card), but in practice, most pharmacies and GP practices identify you by your BSN, name, or date of birth.
If you arrive before your permit is finalised, use bridging international insurance in the interim. It’s best not to go uninsured, even for a few weeks.
What happens if you don’t get Dutch health insurance?
The process escalates in steps.
- The CAK (Central Administration Office) sends a letter once it detects you’re uninsured.
- If you don’t take out Dutch basic insurance within 3 months of that letter, you will be fined €529.74.
- Failure to act within a further three months results in a second fine of the same amount.
- After that, the CAK enrols you in a plan, and the premium is withheld directly from your salary or income for 12 months.
One important note on timing: if you do take out insurance within the four-month window after arriving, your coverage is backdated to your registration date. That means any care you received during that window is covered.
What you cannot do is avoid paying for care you received during a period where you were genuinely uninsured — those costs fall on you. So don’t chance it!
Using the Dutch healthcare system as a US expat
Visiting a GP (huisarts)
Your GP is your first and often only port of call. That said, visiting the doctor in the Netherlands is not as simple as just showing up.
To find one accepting new patients, try ZorgkaartNederland, which lets you filter by language. Many Amsterdam-based practices operate in English.
The main difference from the US is that you cannot see a specialist without a GP referral. Full stop. It feels restrictive, but in practice, it means less unnecessary treatment and fewer conflicting diagnoses.
Dutch healthcare is, in short, much more hands-off than US healthcare. Don’t expect to be referred for every issue: they may just prescribe paracetamol instead.
Hospitals
The Netherlands has three types of hospitals: academic hospitals (research and complex care), general hospitals, and teaching hospitals.
All basic insurance covers inpatient hospital care, though waiting lists exist for non-urgent procedures.
Mental health care
Mental health treatment is covered under the basic package via GP referral to GGZ (Geestelijke Gezondheidszorg, mental healthcare).
Though wait times can be long for specialised services, expat-specific mental health providers — many English-speaking — are increasingly available in the major cities.
Dental care
Here’s a big one: dental care is free for children under 18. Adults need supplementary insurance for anything beyond emergency treatment.
This catches many newcomers off guard, so factor it in when choosing your plan.
Pharmacies (apotheek)
Register with a local pharmacy when you first arrive. Your GP sends prescriptions directly; you pick them up.
Keep in mind, the Dutch are much more cautious about prescribing medication — especially for antibiotics. Overall, they’re considerably more cautious than US practices.
Have you made the switch from the US healthcare system? Drop your experiences in the comments below.
Frequently Asked Questions (FAQ)
Can I keep my US health insurance when I move to the Netherlands?
You can keep your US health insurance when you move to the Netherlands, but it won’t do much for you day-to-day. Most American plans provide minimal or no meaningful coverage abroad. If you’re planning to return to the US eventually, it may be worth keeping your premiums up — but for healthcare in the Netherlands, you’ll need Dutch insurance.
Does Medicare cover me in the Netherlands?
Medicare does not cover you in the Netherlands. It doesn’t cover care outside the US except in very limited circumstances, and it won’t satisfy the Dutch insurance requirement either.
Do I need travel insurance on top of Dutch health insurance?
You may need travel insurance in addition to your Dutch health insurance, depending on how much you travel. Standard basic insurance covers emergency care within Europe up to Dutch tariff rates, which may not cover the full cost of treatment in more expensive countries.
Can my family members use my Dutch health insurance?
Your family members cannot use your Dutch health insurance — each person needs their own policy. The exception is children under 18, who are covered at no extra premium under a parent’s insurer; the government pays the premium.
What’s the difference between a naturapolis and a combinatiepolis?
A naturapolis limits you to contracted providers and is the cheaper option. A combinatiepolis gives you broader access, including partial or full reimbursement for some non-contracted providers, depending on policy terms — it’s the more flexible choice. The old restitutiepolis, which offered full reimbursement at any provider regardless of contract, was discontinued in 2025 and is no longer available.
What happens to my Dutch health insurance if I lose my job?
Your Dutch health insurance continues if you lose your job — it’s tied to you as an individual, not your employer. You’ll need to keep paying premiums yourself until you find new work or leave the country.
Do I need a BSN before I can get health insurance?
Yes, you need a BSN before you can get Dutch health insurance. You can’t apply for basic insurance without one, so registering with your gemeente and getting your BSN should be your first priority after arriving.
Can I get health insurance in the Netherlands if I have a pre-existing condition?
Yes, you can get health insurance in the Netherlands with a pre-existing condition. Insurers are legally required to accept all applicants for the basic package, regardless of health history. Supplementary insurance is a different story — providers can refuse those applications — but the basisverzekering is open to everyone.
How do I claim reimbursement if I visit a non-contracted provider?
How you claim reimbursement for a non-contracted provider depends on your policy type. With a combinatiepolis, reimbursement varies by insurer and care type — typically somewhere between 70% and 100% of the standard rate. With a naturapolis, out-of-network reimbursement is lower. Always check your policy terms before choosing a provider outside the contracted network.
Is mental health care covered by basic Dutch health insurance?
Yes, mental health care is covered by basic Dutch health insurance through a GP referral to a GGZ (Geestelijke Gezondheidszorg) provider. Some sessions require a co-payment once you’ve used your eigen risico.
