Dutch Health Insurance for Seniors: What You Need to Know

Healthcare in the Netherlands is among the best in Europe, but the system comes with its own language and logic. If you have recently moved here, or have lived here for years without fully understanding how your zorgverzekering works, you are not alone. The Dutch health insurance system is mandatory, heavily regulated, and subsidised for lower incomes, but navigating it in English can feel like guesswork. 💚

This guide explains how the system works, what is covered, how the annual deductible affects your costs, and how to reduce your monthly premium if you are on a pension or fixed income.

1. How Dutch health insurance works

Health insurance is compulsory for everyone living and working in the Netherlands. You must take out a policy within four months of registering as a resident, and coverage is backdated to your registration date. There is no opt-out.

Every insurer in the Netherlands must offer the same standard package, called the basispakket. The content of this package is set by the government and is identical regardless of which insurer you choose. What differs between insurers is the monthly premium, the level of customer service, and the optional supplementary cover they offer.

You are free to switch insurer once a year, during the open enrolment period from 1 November to 31 December, with the new policy taking effect on 1 January. Many people never switch, but comparing premiums each year can save a meaningful amount.

Simple action: If you have not compared health insurance premiums recently, visit zorgwijzer.nl where you can compare all Dutch insurers side by side in English.

2. The eigen risico: your annual deductible

The eigen risico is the amount you pay out of pocket each year before your insurance covers most costs. The government sets the minimum eigen risico annually. You can check the current amount at rijksoverheid.nl.

The eigen risico resets on 1 January each year. Once you have spent that amount on qualifying healthcare in a calendar year, your insurer covers the remaining costs.

Some services are exempt from the eigen risico, meaning your insurer covers them from the first visit regardless of what you have spent. GP visits are exempt, as are maternity care and some mental health services. Hospital care, specialist referrals, physiotherapy, and most prescription medicines count toward your deductible.

You can choose to take a higher voluntary eigen risico in exchange for a lower monthly premium. This makes sense if you expect to use little healthcare in a given year. For older adults who use regular specialist care or prescription medicines, staying at the minimum is often the more cost-effective choice.

💡 Tip: If you are admitted to hospital in December, costs may straddle two calendar years and trigger two separate eigen risico periods. It is worth being aware of this if you have elective procedures planned.

3. What the basispakket covers

The standard package covers a wide range of care, including:

• GP visits (no eigen risico applies)
• Hospital care and specialist consultations
• Prescription medicines on the approved list
• Mental health care
• Physiotherapy (limited number of sessions; check your policy)
• Maternity care
• Some medical equipment and aids

What it does not cover: routine dental care for adults over 18, glasses and contact lenses, and most alternative therapies. These fall outside the standard package.

Simple action: Download your insurer's policy document (polisvoorwaarden) and look for the list of vergoedingen (reimbursements). Most major insurers have an English-language version on their website.

4. Supplementary insurance for older adults

Because the basispakket excludes dental care and glasses, many people take out aanvullende verzekering (supplementary insurance) to cover these costs. Supplementary packages vary widely between insurers and are entirely optional.

For older adults, the most useful supplementary coverage typically includes:

• Dental care: routine check-ups, fillings, and dentures
• Optical: glasses and contact lenses
• Physiotherapy: additional sessions beyond the basispakket limit
• Hearing aids: often partially covered, with the remainder on supplementary

Unlike the basispakket, insurers can refuse supplementary cover or charge higher premiums based on your health history. If you want supplementary cover, it is easiest to take it out when you first take out insurance, rather than adding it later when you have a specific need.

Example: A 68-year-old who visits the dentist twice a year and wears glasses might spend several hundred euros annually on these costs without supplementary cover. A mid-range supplementary plan might cost around half that amount in additional premiums while covering most of those costs.

5. Zorgtoeslag: reducing your monthly premium

Zorgtoeslag is a government healthcare allowance paid to people whose income falls below certain thresholds. It is designed to make the mandatory premium affordable for lower-income households.

You apply for zorgtoeslag through the Belastingdienst (Dutch tax authority), not through your insurer. If you qualify, the allowance is paid directly into your bank account each month and offsets part of your premium.

Eligibility and the amount you receive depend on your income and household situation, and both thresholds and amounts are updated annually. Check the current figures and apply at toeslagen.belastingdienst.nl.

If you are receiving the Dutch AOW state pension and have no other significant income, there is a reasonable chance you qualify. It is worth checking even if you assume you will not.

Simple action: Log in to toeslagen.belastingdienst.nl with your DigiD to check your eligibility and apply. The application takes about ten minutes.

6. Home care and long-term care

Beyond everyday health insurance, two other systems are relevant for older adults in the Netherlands.

WMO (Wet maatschappelijke ondersteuning) covers home support services arranged through your municipality (gemeente). This includes home help, adaptations to your home, and transport support. You apply through your local gemeente, which then assesses your needs.

WLZ (Wet langdurige zorg) covers intensive, long-term residential care, typically nursing home care for people who need continuous professional support. Eligibility is assessed by the CIZ (Centrum Indicatiestelling Zorg), an independent body. You can request an assessment at ciz.nl.

Both systems operate separately from your regular zorgverzekering. If you or someone you support is approaching the point of needing regular home help or residential care, speaking to your GP or a social worker at your gemeente is the best starting point.

The Dutch health system rewards those who understand it. A few hours spent reviewing your coverage, checking your zorgtoeslag entitlement, and comparing premiums in November can make a real difference to what you pay and what you get back. 💛

Start with your current insurer's website or visit zorgwijzer.nl to see how your premium compares. For more guides on living well in the Netherlands, visit the Una guides or sign up to our newsletter.