How to get Dutch basic health insurance in NL

Almost everyone who lives or works in the Netherlands is legally obliged to take out Dutch basic health insurance (basisverzekering). This is governed by the Health Insurance Act (Zorgverzekeringswet, Zvw), which also fixes what the basic package covers and requires every insurer to accept you. This guide gets one basic policy in place, starting on the correct date, and explains the choices you actually control: which insurer, and how much deductible you take on.

First establish whether the obligation applies to you at all, because that decides whether this guide is relevant. Rijksoverheid states that anyone who lives or works in the Netherlands must take out a basic insurance policy, and that if you work here you are obliged once you have a Dutch employer, work for that employer on a permanent basis and pay wage tax. A basic policy can only be taken out by a resident (ingezetene), and the Sociale Verzekeringsbank (SVB) decides whether you count as one. If you work for a Dutch employer but live outside the Netherlands, establish your position with the SVB before you apply, because residence status and the insurance obligation are decided separately. Some groups are covered elsewhere or exempt, including staff of EU institutions and certain international organisations, people who do not take out insurance on religious grounds, and students from abroad, whose position varies; check the branch below before applying. If the official guidance still leaves you unsure whether you are insured under the Wlz and must take out Dutch basic health insurance, ask the SVB for a Wlz insurance assessment. This is a route for genuine uncertainty, including when the CAK asks for proof; it is not a routine step for everyone and does not replace taking out basic insurance when your obligation is already clear.

The Zorgverzekeringswet obliges people who live or work in the Netherlands, but several groups are covered through another route and must not take out a basisverzekering.

• You live in the Netherlands, or work here for a Dutch employer

  Rijksoverheid states that anyone who lives or works in the Netherlands must take out a basic insurance policy. For work, the obligation applies once you have a Dutch employer, work for that employer on a permanent basis and pay wage tax. This guide is written for you. Your four-month term runs from the day the obligation arose, not from the day your paperwork is finished.

• You have been granted a permanent residence permit

  Government.nl states that you must take out Dutch health insurance within four months of your permanent residence permit coming into force, that the policy must be effective from the date the permit comes into force, and that where the insurance commences with retroactive effect you will have to pay the premium retroactively. Treat the date the permit takes effect as the start of your term. This four-month trigger is stated for the permanent permit only: if you hold another type of permit, your term runs from the day you started living or working here, as in the first option.

• You are a student from abroad

  Rijksoverheid states that the position of students from abroad varies with where you come from and what you do here, and points students at Nuffic to check whether they are properly insured; its page on working in the Netherlands points students at the Sociale Verzekeringsbank (SVB) instead. Whether you are insurance-obliged usually turns on whether you also work here. Establish your position with Nuffic or the SVB before buying anything, because a Dutch basic policy taken out by someone who is not insurance-obliged is not valid.

• You are covered elsewhere, or you are not a resident

  Rijksoverheid lists staff of European institutions covered by the Joint Sickness Insurance Scheme (GSZV) and employees of certain international organisations, such as the European Patent Office, as having no right to Dutch basic insurance, alongside people who do not take out insurance on religious grounds. A basic policy can also only be taken out by a resident (ingezetene), and the SVB determines whether you are one. Asylum seekers awaiting a decision are insured collectively under the Asylum Seekers Healthcare Scheme (RZA) rather than by taking out their own policy.

1. 1

   Confirm you are insurance-obliged, and fix the start date

   Rijksoverheid states that anyone who lives or works in the Netherlands must take out a basic insurance policy, and that if you work here the obligation applies once you have a Dutch employer, work for that employer on a permanent basis and pay wage tax. A basic policy can only be taken out by a resident (ingezetene) of the Netherlands, and the Sociale Verzekeringsbank (SVB) determines whether you are one. Write down the exact date your obligation arose, normally the day you arrived to live here, the day you started working for a Dutch employer, or the day your residence permit took effect. Every later step depends on that date.

   Do this: Establish whether the Dutch obligation applies to you and note the exact date it started.

   Documents needed

   • Passport or national identity card
   • Employment contract or residence permit, if you have one
   • Proof of the date you registered at your Dutch address

   Processing time

   Under an hour. The date you establish here is the day your four-month term starts running.

   Common mistake: People treat the four months as running from the day their BSN or bank account is ready. It does not. It runs from the day the obligation arose, so time spent waiting on paperwork eats into the window in which cover can still be backdated.

   Official source

   Rijksoverheid · Is een zorgverzekering verplicht?
2. 2

   Understand what the basic package actually is

   The basic package (basispakket) covers care such as the GP (huisarts), hospital, psychiatrist and pharmacy. Rijksoverheid states plainly that the government determines what is in the basic package, so the cover itself does not vary between insurers. What does vary is the premium, the service, the number of care providers the insurer has contracted, and how much you are reimbursed if you go to a provider it has not contracted.

   Do this: Read the official list of what the basic package covers before you look at any insurer's marketing.

   Processing time

   About 15 minutes.

   Common mistake: Comparing insurers on the strength of their basic cover wastes time and can lead you to overpay, because that cover is set by government and is identical everywhere. Compare price, contracted providers and service instead.

   Official source

   Rijksoverheid · Welke zorg zit in het basispakket?
3. 3

   Choose your deductible before you choose an insurer

   The compulsory deductible (verplicht eigen risico) for 2026 is €385, payable by everyone aged 18 and over who uses care from the basic package. You may raise it voluntarily by €100, €200, €300, €400 or €500 in return for a premium discount, giving a maximum of €885 in 2026. Several kinds of care fall outside the deductible entirely, including GP care and the out-of-hours GP post (huisartsenpost), midwifery and maternity care, and district nursing. Care for children under 18 carries no deductible at all.

   Do this: Decide whether to keep the compulsory deductible only, or to raise it voluntarily.

   Cost

   No cost arises at this step. Any deductible charged later varies with the care you actually use during the year.

   Processing time

   About 15 minutes. The compulsory and voluntary amounts are set per calendar year; ask the insurer when a change to your voluntary deductible can take effect.

   Common mistake: A high voluntary deductible looks like a saving until you need care. Weigh the discount the insurer offers against the fact that you would carry up to €885 (2026) of your own costs before the insurer pays anything.

   Official source

   Rijksoverheid · Wanneer betaal ik een eigen risico voor mijn zorg?
4. 4

   Compare premiums and pick an insurer

   For the basic policy you pay the insurer a fixed premium (nominale premie), which each insurer sets for itself. Rijksoverheid puts the average premium people pay their insurer in 2026 at €1,884 a year, an average of €157 a month; individual policies sit above and below that. There is no collective or group discount on the basic package any more: the provision of the Zorgverzekeringswet that allowed a discount of up to ten per cent through a collectiviteit was removed from article 18 with effect from 1 January 2023, so an offer through an employer or association no longer reduces the basic premium itself. The consolidated text of the Act is published on wetten.overheid.nl.

   Do this: Compare basic policies on premium, contracted providers and service, and choose one.

   Cost

   Varies by insurer and by the deductible you choose. Rijksoverheid gives an average of about €157 a month for 2026, which is a national average and not a quoted price.

   Processing time

   An hour or two, depending on how many insurers you compare.

   Common mistake: Do not accept a claim that an employer or association scheme gives you a discount on the basic package. That provision was removed from the Zorgverzekeringswet with effect from 1 January 2023. Any remaining benefit sits in the supplementary policy, which is a separate product.

   Official source

   Rijksoverheid · Wat kost het om een zorgverzekering af te sluiten?
5. 5

   Apply, with the start date set to the day your obligation began

   Apply directly with the insurer, online or by post. Rijksoverheid states that insurers are legally required to accept you for the basic policy, that they may not refuse older or sick applicants or ask them for a higher premium, and that they may refuse you for a supplementary policy. Enter the date from step 1 as the start date. Article 5 of the Zorgverzekeringswet gives the policy retroactive effect to the day the obligation arose, provided it starts within four months of that day, which means premium is due for those backdated months and care you already used in them can be claimed.

   Do this: Submit the application with the start date set to the day your insurance obligation arose.

   Documents needed

   • BSN
   • Passport or national identity card
   • Dutch address
   • Bank account details (IBAN)

   Cost

   Varies by insurer and policy. Where cover is backdated, premium is payable for the backdated period as well; the insurer decides how it invoices that.

   Processing time

   Applying online usually takes well under an hour. Acceptance for the basic policy is automatic, and the insurer sends the policy documents afterwards.

   Common mistake: Leaving the start date at today's date inside the four-month window throws away the retroactive cover you are entitled to, and with it any reimbursement for care you have already paid for.

   Official source

   Rijksoverheid · Moet een zorgverzekeraar mij accepteren?
6. 6

   Insure your family, and act at once if you are already late

   Every insurance-obliged person needs their own policy, including your partner. Children must be registered with a health insurer within four months of birth. No premium and no deductible apply while a child is under 18; the deductible starts when the child turns 18, and premium becomes payable from the first month after the child turns 18. If you have already passed your own four months, apply immediately anyway. The CAK writes to people who are registered with a municipality but have no insurance, gives three months to insure or to show the obligation does not apply, and imposes a fine if nothing happens. If you still have no insurance after two fines, the CAK takes out a policy for you. Under the Uninsured Regulation, the premium for that CAK-arranged policy is €172.70 per month in 2026 and is paid to the CAK for 12 months. This is the procedure for someone who should be insured but is not; it is separate from the CAK premium-arrears scheme for someone who already has insurance but has not paid their insurer.

   Do this: Take out a policy for each insurance-obliged family member, and apply now even if your own four months have already passed.

   Documents needed

   • BSN for your partner and each child
   • Birth certificate or proof of birth date for a newborn

   Cost

   Varies by insurer and policy. No premium and no deductible are charged for children under 18.

   Processing time

   Children: within four months of birth. Adults: the same four-month rule as your own.

   Common mistake: Being late is not a reason to wait longer. Rijksoverheid states you do not owe premium retroactively for the uninsured period, but you carry the medical costs from that period yourself and cover starts only from the day you insure, so every further day of delay is a day of costs you cannot recover.

   Official source

   The CAK · Premium and payment period for insurance arranged by the CAK

People usually arrive at this question because an institution in another country has asked them for a form, often by an older E-form number. Under EU social security coordination the E-forms were replaced by portable documents issued from 1 May 2010, so the number you were given may not be the one in use today. Work out which situation below is yours before you chase any paperwork.

• You were asked for an E104, or for proof of your previous insurance periods

  The E104 is not among the portable documents the EU identifies today, and under modern coordination the underlying insurance-period information is normally exchanged directly between social security institutions rather than carried by you. The European Commission states that the former paper E-forms disappear under modernised coordination and that the information a citizen needs is in some cases issued as a portable document, with the rest moving between institutions as structured electronic documents. In practice, start with the institution that asked for the E104: ask whether it can obtain your Dutch insurance-period information directly from the relevant Dutch institution before you try to source a paper form yourself.

• You were asked for an E106, E109, E120 or E121

  The current equivalent is the S1. Your Europe, the official EU portal, lists the S1 as formerly E106, E109, E120 and E121. Who issues your S1 depends on your situation rather than on the form number, so use the two cases below to find the right route. If you already hold one of these documents and it was issued before 1 May 2010, it can remain valid until it expires or is withdrawn or replaced by the competent institution, so an older document in your file is not automatically void.

• You receive or will soon receive a Dutch pension or benefit, and you live abroad or are moving abroad

  Start with the CAK eligibility check. If reciprocal healthcare applies to you, this is the CAK route. Netherlands Worldwide states that if you live in a country with a reciprocal healthcare agreement with the Netherlands and you receive, or will soon receive, a Dutch pension or benefit, you may be required to arrange health insurance through the CAK. If you are still in the Netherlands, tell the body paying your pension or benefit that you are leaving, tell your Dutch health insurer at least two months before you go, and register with the CAK. The CAK says it sends a letter confirming your registration within 4 weeks, with a document attached that it describes as an S1 or 121 document depending on your country of residence, so being handed something labelled 121 is normal. You take that document to the health insurer named in the letter. If you live in the United Kingdom, Cabo Verde, North Macedonia or Tunisia the CAK sends the document straight to the health insurer in your country of residence instead, and that insurer contacts you, so chase them rather than waiting for post.

• You work in the Netherlands but live abroad with your family

  For this route, the S1 itself comes from your Dutch health insurer, not from the CAK. The CAK's own guidance is to ask your Dutch health insurer for an S1 document and take it to the designated health insurer or authority in your country of residence, though your Dutch insurer may send it there directly. You register yourself and your family members with that body, and it assesses the registration and decides whether to insure your family members. The CAK remains part of the arrangement: that health insurer tells the CAK which of your family members are insured, the CAK writes to you stating who is covered, and you pay a contribution to the CAK rather than to your health insurer. If instead you live in the Netherlands yourself while your family lives in another treaty country, this is not your route. The CAK states that the process is different there, and in that case the CAK issues the S1.

• Your citizen service number (burgerservicenummer, BSN)
• Passport or national identity card
• Your Dutch address, as registered with the municipality (gemeente)
• Your residence permit or proof of employment, if you are not an EU, EEA or Swiss national
• The date your insurance obligation started (arrival, start of work, or the date your permit took effect)
• Bank account details (IBAN) for paying the monthly premium
• The same details for your partner and for each child you are insuring

• Monthly premium (nominale premie): set by each insurer, not by the government. Rijksoverheid puts the average premium people pay their insurer in 2026 at €1,884 a year, an average of €157 a month. Your own policy may cost more or less.
• Compulsory deductible (verplicht eigen risico): €385 (2026). You pay this only if and when you use care that counts towards it.
• Voluntary deductible (vrijwillig eigen risico): optional, in steps of €100, €200, €300, €400 or €500 on top of the compulsory amount (2026), in exchange for a premium discount the insurer sets.
• Income-dependent contribution (inkomensafhankelijke bijdrage): a percentage of your income, collected by the Belastingdienst, separate from the premium you pay your insurer.
• Children under 18 pay no premium and no deductible for basic package care.

Applying online usually takes well under an hour, and insurers must accept you for the basic policy, so there is no assessment period. Under article 5 of the Zorgverzekeringswet the policy takes effect retroactively on the day your insurance obligation arose, provided it starts within four months of that day. After four months there is no retroactive cover at all, and the policy runs only from the date you took it out.

Requirements depend on your situation. Check the latest requirements with the relevant authority.

• Waiting for a BSN, a bank account or a permanent address before applying. The four-month term runs from the day your obligation arose, not from the day your paperwork is complete, and the term does not pause.
• Assuming travel insurance, an expat policy or a policy from your home country satisfies the Dutch obligation. If you are insurance-obliged, only a Dutch basisverzekering does, and the CAK writes to people who are registered with a municipality and have no Dutch health insurance.
• Setting the policy start date to the day you applied rather than the day your obligation arose. Inside the four months you are entitled to the earlier date, which is what makes care you already used reimbursable.
• Taking the maximum voluntary deductible to cut the monthly premium, then finding you owe up to €885 (2026) of your own care costs before the insurer pays anything.
• Comparing insurers on the content of the basic package. The government fixes that content, so it is the same everywhere; the real differences are price, service, which providers the insurer has contracted, and what it reimburses for non-contracted providers.

• Look into the healthcare allowance (zorgtoeslag) if your income is low: the conditions and how to claim are published by Dienst Toeslagen.
• Register with a local GP (huisarts), because GP care is the entry point to the Dutch system and is excluded from the deductible.
• Decide separately whether you want a supplementary policy (aanvullende verzekering); insurers may refuse you for that, unlike the basic policy.
• Check the Rijksoverheid pages on changing insurer before the end of the calendar year if you want a different policy for the following year.