Calculate costs, compare options, and understand what employers actually provide. Everything expats need to know about mandatory health insurance in the Netherlands.
Last updated: May 2026
The Netherlands has mandatory private health insurance with heavy government regulation. You buy it yourself from private companies, not through your employer or the government.
Everyone living/working in Netherlands must have Dutch health insurance. Your employer doesn't provide it (unlike the US). You choose a private insurer and pay monthly premium (~€159/month) yourself. No insurance = €530 fine.
The government mandates what basic insurance must cover. VGZ basic = CZ basic = Zilveren Kruis basic by law. Only differences: price (€142-€175/month) and customer service. Choose the cheapest.
After you pay €159/month premium, you ALSO pay the first €385 of medical costs each year out of pocket (eigen risico). Exceptions: GP visits (always free), maternity care, kids under 18. After €385, insurance covers the rest.
Basic insurance does NOT cover dental (except emergencies), glasses, or physiotherapy beyond 20 sessions. Add supplementary insurance (€10-50/month) if you need these. Most expats need at least dental.
| Aspect | Netherlands | United States | United Kingdom |
|---|---|---|---|
| Who pays premium? | You (€1,908/year) | Employer pays most | Free (NHS) |
| Monthly cost | €159-191/month | $50-200/month (your share) | £0 |
| Annual deductible | €385 | $1,000-$5,000 | £0 |
| Dental included? | No (pay extra) | Often yes | No (pay separately) |
| Can you choose insurer? | Yes (any) | Limited by employer | N/A |
What happens: Fine of €530 after 3 months. If you get sick before signing up, you pay 100% out of pocket (ER visit = €500-1,000).
Do this: Sign up in week 1 of arriving. Coverage starts immediately or 1st of next month.
Wrong: Employers in NL almost never provide health insurance. Maybe 5% offer small benefits.
Do this: Budget €150-€200/month for health insurance yourself. Don't expect employer help.
Wrong: All basic insurance is legally identical. €175/month = same coverage as €142/month.
Do this: Pick cheapest basic insurance, then add supplementary if needed.
Risky: One root canal = €500 = 2 years of dental supplement. Waiting periods mean you can't sign up when you need it.
Do this: Get basic dental supplement (€10/month) if you value your teeth.
Wrong: You MUST see GP first, get referral. Without referral, insurance won't cover (you pay €200-500).
Do this: Always start with GP, follow the system.
Wrong: You pay €1,908/year (premium) + €385/year (deductible) = €2,293/year minimum.
Do this: Budget €200/month for health costs.
Expensive: No loyalty benefit, wasting €20-40/month. Over 10 years = €2,400-€4,800 wasted.
Do this: Compare prices every November, switch to cheapest (takes 15 minutes).
Risky: Save €360/year but if you need ONE specialist visit (€150), you already lost money.
Do this: Stick with standard €385 unless you're 25, healthy, and literally never see doctors.
Wrong: Birth control is NOT covered by basic insurance. You pay €8-15/month out of pocket. IUD insertion also not covered (€150-300).
Do this: Budget for it separately or get supplementary that covers contraception.
Illegal: Health insurance is mandatory by law. Fines: €530 + interest + back-payment. One broken leg without insurance: €5,000-€10,000 bill.
Do this: Get insurance, it's the law.
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