Natura vs Restitutie vs Combinatie: Which Dutch Insurance Type Is Right for You?
The three types of Dutch health insurance explained in plain English. Which one saves you money, and which one gives you freedom? Here's how to choose.
Three Types. One Confusing Decision.
Every Dutch health insurance plan is one of three types: natura, restitutie, or combinatie. This is the single most important choice you'll make — it determines how much you pay, which doctors you can see, and how much paperwork you'll deal with.
Here's the honest breakdown.
Natura: Cheapest, but You Stay in the Network
How it works: Your insurer contracts with specific hospitals, GPs, specialists, and pharmacies. You go to those providers, and everything is covered (minus your deductible). Go outside the network, and you pay most of the bill yourself.
The good:
- Lowest premiums — starting from €115.50/month
- No claim forms for in-network care
- In practice, most major hospitals and GPs are contracted
The catch:
- Limited choice for specialists, mental health providers, and physiotherapists
- If you want a specific specialist, check the contract list first
- Out-of-network care is barely reimbursed (sometimes 0%)
Best for: Budget-conscious expats who are happy using major hospitals and don't need specific specialists.
| Plan | Monthly Premium | Deductible |
|---|---|---|
| CZ Zorgbewust | €115.50 | €885 |
| Menzis JongerenPolis | €117.00 | €885 |
| Menzis Basis Voordelig | €119.95 | €385 |
| CZ Basis | €118.75 | €385 |
| Zilveren Kruis Basis | €121.95 | €385 |
Restitutie: Freedom, at a Price
How it works: You can go to any licensed healthcare provider in the Netherlands — contracted or not. Your insurer reimburses you based on Dutch market rates. Some restitutie plans even cover care abroad.
The good:
- Total freedom of choice — any doctor, any hospital
- Great if you already have a specialist you trust
- Better for international care and cross-border situations
- No "is this provider contracted?" stress
The catch:
- Higher premiums — starting from €132.50/month
- You might pay upfront and get reimbursed later
- Some providers charge above market rates — you'd pay the difference
Best for: Expats who travel, want specific specialists, or value flexibility over saving €15/month.
| Plan | Monthly Premium | Extras Included |
|---|---|---|
| DSW Basisverzekering | €132.50 | — |
| Menzis Basis Vrij | €143.50 | Physio |
| ONVZ Vrije Keuze | €145.25 | — |
| VGZ Eigen Keuze | €148.90 | Dental + Physio |
| Zilveren Kruis Exclusief | €155.00 | Dental + Physio + Alt. medicine |
| DSW AV Top | €152.75 | Dental + Physio + Alt. medicine |
Combinatie: The Middle Ground
How it works: Part natura, part restitutie. For most care, you use contracted providers (like natura). But for certain categories — often specialists and mental healthcare — you get restitutie-style freedom.
The good:
- Lower premiums than pure restitutie
- More flexibility than pure natura
- Good balance of cost and choice
The catch:
- You need to check which care categories are "free choice" and which are "contracted only"
- It varies between insurers — read the fine print
Best for: People who want some freedom for specialists but don't want to pay full restitutie premiums.
| Plan | Monthly Premium | Extras Included |
|---|---|---|
| CZ Zorgkeuzepolis | €134.25 | Dental |
| VGZ Ruime Keuze | €136.00 | Physio |
| Zilveren Kruis Zorg Zeker | €139.50 | Dental + Physio |
| ONVZ Zorgverzekering | €158.00 | Dental + Physio + Alt. medicine |
How to Decide: 3 Questions
1. Do you care about choosing your own specialist?
- No → Natura (save money)
- Yes → Restitutie or Combinatie
2. Do you travel or see doctors abroad?
- No → Natura or Combinatie
- Yes → Restitutie
3. How much do you want to spend?
- Under €120/month → Natura (standard or high deductible)
- €130–€140/month → Combinatie or basic restitutie (DSW)
- €145+/month → Full restitutie with extras
The Expat Angle
If you're new to the Netherlands and don't know the system yet, restitutie gives you peace of mind. You won't accidentally go to the "wrong" hospital or get stuck with a bill because you didn't check the contract list.
Once you know the system better — your GP, your local hospital, how referrals work — you can confidently switch to natura and save money. The annual switch window is November 12–December 31.
One More Thing: The Deductible
Regardless of type, every plan has a mandatory deductible (eigen risico) of €385. Some plans offer a voluntary higher deductible of €885 for a lower premium.
The deductible applies to specialist care, hospital visits, prescriptions, and mental healthcare. It does not apply to GP visits, maternity care, or children under 18.
If you rarely see specialists, the €885 deductible can save you €3–5/month. If you have ongoing treatment, stick with €385. Read more about eigen risico.
Still not sure? Compare all 15 plans side by side — filter by type and see exactly what each plan covers.