Dutch Health Insurance (Zorgverzekering), Eigen Risico & Huisarts Guide for Expats & KNM (2026)
Healthcare and health insurance (Zorgverzekering) are mandatory for everyone living or working in the Netherlands—and represent one of the highest-weighted topics on the DUO KNM exam. Learn how the basisverzekering, eigen risico (€385), zorgtoeslag, and huisarts system work.
2026 Dutch Healthcare & Insurance Coverage Matrix (What Is Free vs. Deductible)
| Medical Service / Insurance Rule | Covered by Basisverzekering? | Counts Toward €385 Eigen Risico? | Official KNM Exam Rule |
|---|---|---|---|
| Huisarts (General Practitioner) Visit | ✅ Yes (100%) | ❌ No — 100% Free | Always your first stop for non-emergencies; needed for a specialist referral (verwijzing). |
| Hospital Specialist & Ambulance (112) | ✅ Yes | ✅ Yes (First €385/year) | Requires a huisarts referral unless it is a life-threatening emergency (112 / SEH). |
| Maternity Care (Verloskundige & Kraamzorg) | ✅ Yes | ❌ No (Midwife exempt) | Healthy pregnancies are led by a verloskundige; home kraamzorg assists after birth. |
| Children Under 18 (Including Dentist) | ✅ Yes (Free policy) | ❌ No — €0 Deductible | Children under 18 pay €0 monthly premium and €0 eigen risico, including routine dental care. |
| Adult Routine Dentist & Physiotherapy | ❌ Only via Aanvullende Verzekering | N/A (Supplemental) | Adults (18+) need optional supplemental insurance (aanvullende verzekering) or pay out-of-pocket. |
| Zorgtoeslag (Healthcare Benefit) | 💶 Monthly Subsidy | N/A | Low- and middle-income residents apply at Belastingdienst Toeslagen to reduce monthly premiums. |
1. Mandatory Basic Health Insurance (Basisverzekering) Within 4 Months
Every person who registers at a Dutch municipality (gemeente) or starts working in the Netherlands is legally required to take out a Dutch basic health insurance policy (basisverzekering) within 4 months. The government sets the exact contents of the basic package every year, and health insurers have an acceptance obligation (acceptatieplicht)—meaning they cannot refuse you for pre-existing conditions during the basic enrollment window.
2. How the €385 Mandatory Deductible (Verplicht Eigen Risico) Works
In addition to your monthly insurance premium (premie), every adult aged 18 or older has a mandatory annual deductible (verplicht eigen risico) of €385 per calendar year. Whenever you use hospital care, prescription medicines at the pharmacy (apotheek), blood tests, or ambulance transport, you pay the first €385 yourself. Crucially for the KNM exam: appointments with your huisarts (GP), midwife care (verloskundige), and all healthcare for children under 18 never cost eigen risico.
3. Huisarts vs. Huisartsenpost (HAP) vs. 112 Emergency
The DUO KNM exam tests this distinction on almost every test paper:
- During office hours (Mon–Fri, 08:00–17:00): Call your registered huisarts for an appointment.
- Evenings, nights, weekends & public holidays (Urgent but not life-threatening): Call the Huisartsenpost (HAP) first. Never walk into the HAP without calling ahead.
- Life-threatening emergencies (Heart attack, severe accident, unconsciousness): Call 112 immediately or go to the hospital Spoedeisende Hulp (SEH).
4. Lowering Your Costs with Zorgtoeslag
Because Dutch health insurance premiums average €140–€160 per month per adult, residents with a low or moderate income can apply for zorgtoeslag (healthcare allowance) via Mijn Toeslagen at the Belastingdienst using their DigiD. If your income increases during the year, you must report it immediately so you do not have to repay excess subsidy later.
Frequently Asked Questions on the DUO KNM Exam
❓ Do you pay eigen risico when visiting the huisarts in the Netherlands?
No. Visiting your registered huisarts (General Practitioner) is 100% covered by your basisverzekering and is completely exempt from the €385 mandatory deductible (eigen risico). However, if the huisarts prescribes medication or orders hospital lab tests, those follow-up items do count toward your eigen risico.
❓ Are children under 18 insured for free in the Netherlands?
Yes. Children under 18 must be registered on a parent's health insurance policy, but they pay €0 monthly premium, have €0 eigen risico, and have basic dental care covered under the basisverzekering.
❓ When should you call the Huisartsenpost (HAP) instead of 112?
Call the Huisartsenpost (HAP) when you need urgent medical evaluation in the evening, at night, or on the weekend that cannot wait until your regular huisarts opens the next business day. Call 112 only in life-threatening emergencies.
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