What Does Dutch Health Insurance Actually Cover? A Complete Guide for 2026
Confused about what Dutch health insurance (zorgverzekering) covers? This plain-English breakdown explains exactly what's included in the basic plan — and what you'll need to pay extra for.
The Short Answer
Dutch basic health insurance (basisverzekering) covers most essential medical care: your GP, hospital treatment, most specialist care, and prescription medication. What it doesn't cover is dental care for adults, most physiotherapy, and a range of extras that require supplementary insurance.
Read on for the full breakdown.
What's Included in the Basic Package
Every insurer in the Netherlands must offer the same legally-defined basic package. The government sets what's in it — insurers cannot remove or reduce coverage. They can only compete on price and service.
GP Care (Huisarts)
Visits to your general practitioner are free — no deductible applies. Your GP is the gateway to all specialist care in the Netherlands. You need a referral from your GP before seeing most specialists.
Covered without deductible:
- Consultations (in-person and phone/video)
- Minor procedures at the practice
- Repeat prescriptions
- Preventive care and check-ups
Hospital and Specialist Care
All medically necessary hospital treatment is covered, including:
- Inpatient and outpatient hospital stays
- Surgery and procedures
- Emergency care (including A&E)
- Specialist consultations (with GP referral)
- Maternity care and delivery
- Cancer treatment and oncology
- Cardiology, neurology, and other specialties
The deductible applies here. You pay the first €385 (2026) yourself before insurance kicks in. Your GP referrals are exempt.
Mental Health Care
Basic mental health care is covered for conditions that meet clinical criteria:
- Psychologist sessions for anxiety, depression, trauma, and similar conditions (up to 8 sessions in primary care)
- Psychiatric care in specialised settings
- Crisis care and hospitalisation
There are waiting lists for mental healthcare in the Netherlands. Your GP will refer you, but expect to wait several weeks to months for non-urgent treatment.
Not covered: Lifestyle counselling, coaching, or therapy that doesn't meet the clinical threshold.
Prescription Medication
Most prescription drugs are covered through a reimbursement list (geneesmiddelvergoedingssysteem). Your pharmacy will check automatically. Some medications have a patient co-payment (bijbetaling) if a cheaper generic is available but you choose the branded version.
The deductible applies to prescription medication.
Maternity and Obstetric Care
- Prenatal consultations and ultrasounds
- Delivery at home, in a birth centre, or hospital
- Kraamzorg (postnatal home maternity care): up to 49 hours covered in the first 10 days after birth
- Newborn screening (hielprikscreening)
Medical Aids and Devices
- Mobility aids (wheelchairs, walkers)
- Hearing aids (partially covered, with deductible)
- Prosthetics
- Orthopedic footwear (medically indicated)
Nursing and Long-Term Care
Basic nursing care for up to three years is covered, with longer-term care falling under the WLZ (Long-term Care Act) system rather than your zorgverzekering.
What's NOT Covered by Basic Insurance
This is where many expats get caught out. The following require either out-of-pocket payment or supplementary insurance:
Dental Care for Adults
Routine dental care (check-ups, fillings, cleanings) for adults aged 22 and over is not covered by the basic package. Emergency treatment for acute pain may be partly covered, but standard care is not.
To cover dental care, you need aanvullende verzekering (supplementary insurance). See our guide: Supplementary Insurance Explained
Exception: Orthodontics for children under 18 is covered for medically necessary treatment.
Physiotherapy
Standard physiotherapy is not covered for adults — except in specific cases:
- Chronic conditions that qualify for unlimited physiotherapy (listed in the "kronische lijst")
- The first 9 sessions are covered if you have a qualifying chronic condition; sessions 1–9 in primary care may be covered under the chronic care pathway
For most adults with a sports injury, back pain, or recovery from surgery, you pay out of pocket or use supplementary insurance. Physiotherapy costs roughly €30–70 per session in the Netherlands.
Glasses and Contact Lenses
Eyeglasses and contact lenses are not covered, with narrow exceptions for children up to 18 or specific medical conditions.
Alternative Medicine
Acupuncture, homeopathy, osteopathy, and other alternative therapies are not covered by basic insurance. Some supplementary plans cover limited sessions.
Cosmetic Procedures
Purely cosmetic treatments are excluded. Reconstructive surgery following illness or injury may be covered.
Elective Treatments Abroad
Planned medical treatment abroad (medical tourism) is covered only under restitutie plans, and only up to the Dutch tariff for equivalent care. Natura plan holders generally need pre-authorisation.
The Deductible (Eigen Risico)
You pay the first €385/year (2026) of covered healthcare costs yourself. This applies to most care except GP visits.
The deductible resets on 1 January each year.
You can voluntarily raise your deductible by up to €500 (total €885) in exchange for a monthly premium discount of roughly €26/month.
Tip: The deductible is per person per year. If your partner or child is also on a separate policy, each person has their own deductible.
Healthcare Allowance (Zorgtoeslag)
If your income is below the threshold (€38,520 single / €48,500 with partner in 2026), you receive a monthly government contribution toward your premium. The maximum is €127/month.
You don't have to be Dutch to receive it — you just need to be registered in the Netherlands and have a BSN number.
Apply for zorgtoeslag at the Belastingdienst website
Natura vs. Restitutie: Does It Affect Coverage?
The covered services are the same for both plan types. The difference is in how you access care:
- Natura: You use contracted providers. If you go outside the contracted network without permission, costs are reimbursed at 75% (or less). Great for most people who use standard Dutch healthcare.
- Restitutie: You can see any provider in the Netherlands and the costs are reimbursed at 100% of the market rate. Better for expats who want maximum flexibility.
For expats who may want to see English-speaking specialists or receive care abroad, restitutie plans offer more flexibility.
Frequently Asked Questions
Is my GP visit covered? Yes — GP visits don't count toward your deductible and are fully covered.
Does Dutch health insurance cover care in other EU countries? Emergency care in EU countries is covered via the European Health Insurance Card (EHIC). Planned treatment abroad is more complex — check with your insurer.
I just arrived — when does coverage start? You have four months from registering in the Netherlands (inschrijving gemeente) to get insurance. Coverage starts from your registration date, not the date you sign up. If you sign up late, you may be charged a fine.
Are my children covered? Children under 18 are covered on your policy at no additional premium. They do not have their own deductible.
What about maternity costs? Maternity care and delivery are covered. Your newborn should be added to a health insurance policy within four months of birth.
Dutch health insurance is comprehensive — but knowing the gaps helps you plan. If you need dental or physio coverage, compare supplementary plans alongside basic insurance on CareCompare.