When Dutch insurance rules apply, you must arrange cover within four months.
If Dutch insurance law covers you, you need to take out a basisverzekering (basic health insurance) within four months after your obligation begins. In that case, your policy and premiums apply from the start date. Once four months have passed, your cover and premiums begin on the date you actually take out the policy. The period before that is uninsured. Students, posted workers, and those waiting for a decision on residence must check the rules that apply to them.
Am I required to have Dutch basic health insurance?
When you live in the Netherlands, Dutch insurance normally applies. Being registered with a gemeente (municipality) by itself does not determine this. The Sociale Verzekeringsbank (SVB, Dutch social insurance bank) can assess whether you have an insurance obligation.
Your four-month window begins when your obligation starts. Use the starting points here to review your situation regarding residence and work.
Wide tables can be scrolled sideways.
| Your situation | Insurance rule | What to do |
|---|---|---|
| You start a job with a Dutch employer, including a side job while studying | Your insurance duty starts on your first workday. An EHIC (European Health Insurance Card) or international policy is no longer enough | Take out insurance within four months to cover your first workday. If late, check the start date with your insurer |
| Your permanent residence permit comes into force | Take out insurance within four months. Cover and premiums run from the permit’s effective date | Check the effective date on your permit decision |
| You are a foreign student here only to study | Dutch basic insurance usually does not apply | Keep suitable alternative cover. Check with the SVB if you start work or an internship |
| You hold a zoekjaar (orientation-year) residence permit and do not work | You cannot take out Dutch basic insurance while you are not working | Keep alternative cover. Reassess when you start work |
| You are self-employed | Your duty depends on your work and residence situation | Request an SVB assessment if your duty is unclear |
| A foreign employer posts you here temporarily | You may stay insured in your home country. An A1-verklaring (social-insurance certificate) can prove this | Check with your employer and the home-country social-insurance authority |
Certain students from the Dutch Caribbean may require Dutch basic insurance even if they do not have a job. Internships follow different rules. Before you choose coverage, check the SVB’s study and internship rules.
If you are unsure about your insurance obligation, ask the SVB.
The SVB reviews your situation under the Wet langdurige zorg (Wlz, Long-Term Care Act). It can take up to eight weeks to receive a decision. If you got a CAK (Dutch public body that contacts people recorded as uninsured) letter and believe the obligation does not apply to you, ask for an assessment now.
If you are waiting for a decision on a residence permit, check Government.nl’s residence-permit insurance rules before you buy a policy. Should a CAK letter arrive while you are waiting for a permit decision or a renewal, first request a Wlz assessment.
If you have temporary protection due to displacement from Ukraine, a BSN, and residence code 46, then RMO (medical-care scheme for displaced people from Ukraine) covers healthcare that qualifies without a premium or compulsory deductible, also if you work. Dutch basic insurance is not mandatory for you. If you work and decide voluntarily to take your own Dutch policy, the usual premiums, deductible, and personal contributions for that policy apply.
How can I arrange insurance within four months?
Set up basic insurance as soon as your obligation starts. The four months form an enrolment window. If you take out insurance during that window, your premiums are due from the earlier start date. Government.nl explains this rule.
After you have confirmed that Dutch basic insurance applies, take these steps:
- When comparing policies, look at the premium, the care providers that have a contract with the insurer, and what you pay for care outside that network.
- Send your application to the insurer you have chosen, including the documents it requires. Give the date when your insurance obligation began.
- Check the start date shown on your policy and the premiums you owe for the earlier months.
As an example, your Dutch job begins on 1 July 2026, and you take out insurance on 1 September 2026. Your cover starts on 1 July. You also owe premiums for July and August. For a permanent residence permit, its effective date is used instead of a workday.
Once four months have passed, cover and premiums begin on the date you take out the policy. The earlier gap counts as uninsured. You must pay for care from that period yourself. The CAK may also get in touch with you about being uninsured.
You might have believed that another European country covered you. Later, an authority may decide that Dutch insurance law applied during that period. If that happens, ask the CAK about its separate reimbursement scheme. The official reimbursement rules cover certain situations involving the European Union, Iceland, Liechtenstein, Norway, or the United Kingdom. Conditions apply. If the CAK approves reimbursement, you pay a contribution for eligible periods after the calendar month in which you turn 18.
What should I do after receiving a CAK uninsured letter?
If the obligation applies, take out basic insurance within three months from the date on your CAK letter. If you believe the obligation does not apply, ask for a Wlz assessment instead. These are the two routes offered by the CAK.
The CAK fine process is as follows. The fine amounts listed below apply in 2026.
Wide tables can be scrolled sideways.
| Stage | What happens | What to do |
|---|---|---|
| Uninsured letter | The CAK records you as uninsured | Within three months of the letter date: insure if the duty applies; request a Wlz assessment if you think it does not |
| First fine | No action within three months leads to a €529.74 fine in 2026 | Take out insurance within three months after the first fine |
| Second fine | Remaining uninsured leads to another €529.74 fine in 2026 | Arrange insurance. The duty still applies |
| CAK-arranged policy | If you remain uninsured after the second fine, the CAK takes out a policy for you | Follow its payment and policy instructions |
When your policy starts within three months of the original CAK letter date, the CAK cancels the fine automatically. This is also true if the fine has already been issued. The Centraal Justitieel Incassobureau (CJIB, central judicial collection agency) automatically refunds any amount you have paid.
If your policy starts later, you still have to pay the fine. The payment request explains how to pay in instalments. The SVB may determine that you did not need Dutch insurance at the time you were fined. In that case, the CAK cancels the fine. The CJIB refunds any amount you paid.
Warning
Keep paying a fine while the decision is pending.
A Wlz assessment or an objection does not stop payment of a CAK fine. Follow the payment request while you wait for the decision. If the CAK cancels the fine, the CJIB refunds any amount you paid.
If you need help checking digital government post, use the MijnOverheid (government account) and Berichtenbox (message box) guide.
Compare policies, deductibles, and financial assistance.
What are the differences between basic insurance policies?
Each insurer has to offer the basic package defined by the government. Insurers must accept people who are required to have basic insurance, no matter their age or health. Policies can still vary in monthly premium, which care providers have a contract, payments for care outside the insurer's network, and customer service.
What is the amount of the eigen risico (deductible)?
In 2026, adults who are 18 or older pay the first €385 of care costs that fall under the compulsory deductible. Care from a huisarts (general practitioner, or GP) is exempt. The Rijksoverheid (Dutch government) lists the other exemptions.
How can I insure children under 18?
When Dutch basic insurance applies, a parent or guardian has to register the child with an insurer. Children under 18 do not pay a basic-insurance premium or a compulsory deductible.
Am I eligible for zorgtoeslag (healthcare benefit)?
Zorgtoeslag helps with the cost of health insurance. You need to be at least 18, have Dutch basic health insurance, and meet the income and asset conditions. Check the Dienst Toeslagen (benefits agency) conditions, including the residence rules that apply to newcomers.
The limits below apply in 2026. A toeslagpartner (benefit partner) is a person whose income or assets are counted together with yours under benefit rules.
Wide tables can be scrolled sideways.
| 2026 limit | Without a benefit partner | With a benefit partner |
|---|---|---|
| Annual income used for benefits | €40,857 | €51,142 combined |
| Assets on 1 January 2026 | €146,011 | €184,633 combined |
If you have a benefit partner for only part of the year, their assets do not count for that year. Your assets on 1 January determine your eligibility for the entire year. If your assets are above the limit on that date, lowering them later does not bring back that year's benefit.
The benefit goes down as your income goes up. If you have bijzonder vermogen (special assets), such as certain compensation payments, do not use the proefberekening (trial calculation) to estimate your zorgtoeslag. Read the special-assets guidance instead. In other cases, use the trial calculation to estimate your amount.
How can I apply for zorgtoeslag?
Apply via Mijn Toeslagen (benefits portal). The portal is in Dutch. You need a BSN (citizen service number). Log in using DigiD (Dutch digital identity). Residents of the EU (European Union) can also use European inlog (European login).
If you are unable to use DigiD, the BelastingTelefoon (Tax Information Line) can arrange help at a tax office or a benefits service point.
You can apply for the 2026 healthcare benefit until 31 December 2027. If you are granted an extension for filing your Dutch income tax return, this deadline moves to the end of that extension. Applying earlier means you can receive monthly support earlier.
Report any changes that affect your benefit, including changes to income or a partner. Check your assets on 1 January for every new benefit year.
What can I do if I cannot get insured on time?
What if my BSN has not arrived yet?
The SKGZ (health insurance complaints body) application checklist lists a BSN, a bank account, and registration with a Dutch municipality. If your BSN is delayed, that does not automatically change your insurance start date. Finish your registration and contact the insurer before the deadline. Ask which documents it needs so it can use the correct start date.
What if four months have already gone by?
If the insurance obligation applies, take out a policy now. Once four months have passed, cover and premiums begin on the date you take out the policy. The earlier gap is uninsured. If you got a CAK letter, check the three-month deadline in it. When your policy starts within three months of the letter date, the CAK automatically cancels the fine.
What should I do after I am insured?
If you cannot pay the premium, check whether you are eligible for zorgtoeslag. Premiums still have to be paid. Talk to your insurer about a payment arrangement before you miss payments.
The first 90 days checklist lists insurance together with registration, your BSN, and your bank account.
For benefits and care after you enrol, use these guides:
- Toeslagen (benefits) in the Netherlands: choose the right benefit
- Eigen risico in 2026: what the €385 deductible covers
- Finding and using a huisarts in the Netherlands
Official Sources
- Government.nl: When newcomers need compulsory health insurance - explains the four-month enrolment window, retroactive cover within it, and the uninsured gap if a policy is taken out after four months
- SKGZ: Dutch health insurance in English - explains who may or must take out Dutch basic insurance, the work and study routes, the 2026 deductible and the rules for children
- Government.nl: Health insurance and residence permit - sets the four-month deadline and retroactive premium rule for a permanent residence permit and explains cover while a permit decision is pending
- CAK: I received a letter that I am uninsured - gives the two actions after an uninsured letter, the three-month response period and the 2026 fine of €529.74
- CAK: I received a fine - explains the second fine, automatic revocation when insurance starts in time and insurance arranged by the CAK after continued inaction
- Rijksoverheid: Compulsory deductible for health insurance - sets the compulsory deductible at €385 for 2026 and lists care exempt from it, including GP care
- Dienst Toeslagen: Maximum income for healthcare benefit - sets the 2026 income limits at €40,857 alone and €51,142 combined with a benefit partner
- Dienst Toeslagen: Maximum assets for healthcare benefit - sets the 1 January 2026 asset limits at €146,011 alone and €184,633 combined with a benefit partner
- Dienst Toeslagen: Apply for a benefit - explains the BSN and DigiD requirements, help without DigiD and the application deadline of 31 December of the following year
- SVB: Living in the Netherlands - explains why living in the Netherlands usually brings Wlz insurance, but address registration alone does not establish it
- SVB: Studying or doing an internship - explains foreign-student exceptions, Dutch Caribbean students and separate internship rules
- SVB: Apply for an insurance assessment - explains Wlz assessments, applications after a CAK letter and the processing time of up to eight weeks
- Rijksoverheid: Health insurance when working in the Netherlands - explains the insurance duty for Dutch employment and checking the duty when moving without working
- Rijksoverheid: Working for a foreign employer - explains the posted-worker exception and an A1 certificate from the home-country social-insurance authority
- SKGZ: Health insurance application checklist - lists the BSN, bank account and municipality registration needed to apply, plus differences between policy types
- CAK: Fine rules in Dutch - confirms the letter-date deadline, fine refunds and the duty to pay while an assessment or objection is pending
- Dienst Toeslagen: Healthcare-benefit conditions - lists the age, insurance, income and asset conditions and links to residence rules
- Dienst Toeslagen: Healthcare-benefit amounts - explains how the benefit falls as income rises
- Dienst Toeslagen: Trial calculation - provides a benefit estimate and explains that the tool does not account for certain special assets
- Dienst Toeslagen: Log in to Mijn toeslagen - explains the application portal and DigiD or European login options
- DigiD: Digital identity - provides the official digital identity service and login information
- Official gazette: Four-month rule and retrospective cross-border cover - confirms the four-month backdating rule and the separate reimbursement scheme for certain retrospective European insurance-status decisions from 1 January 2025
- Official gazette: Insurance duty under the Wlz - explains the legal link between Wlz insurance status and the duty to hold Dutch basic health insurance
- CAK: Uninsured-letter rules in Dutch - explains the two response routes and requesting a Wlz assessment while a residence-permit or renewal decision is pending
- CJIB: Fine payment services - official collection agency for fine payments and payment arrangements; the CAK fine rules explain its refund role
- Rijksoverheid: Unpaid health-insurance premiums - explains payment reminders, insurer payment arrangements and continued premium debts
- Dienst Toeslagen: Special assets - explains which special assets may be excluded and how to request an exclusion
- Dienst Toeslagen: Contact about benefits - provides official telephone contact and appointment routes for benefit help
- CAK: About us - explains the public body’s duties and confirms that CAK has not officially been an abbreviation since 2013
- Rijksoverheid: Als zorgverlener kosten declareren voor zorg aan vluchtelingen uit Oekraïne - If you have temporary protection for displacement from Ukraine, a BSN and residence code 46, RMO (medical-care scheme for displaced people from Ukraine) covers qualifying healthcare without a premium or compulsory deductible, including when you work. Dutch basic insurance is not compulsory for you. If you work and voluntarily choose your own Dutch policy, its ordinary premiums, deductible and personal contributions apply.