Health Insurance for German Expats in the Netherlands
Moving from Germany to the Netherlands? Here's everything you need to know about switching from Krankenkasse to Dutch zorgverzekering — timelines, costs, and how the two systems compare.
The Key Difference: From Krankenkasse to Zorgverzekering
If you've lived in Germany, you know the drill: either your employer signs you up for gesetzliche Krankenversicherung (GKV) or you opt for private Krankenversicherung (PKV). Either way, your health insurance in Germany is tightly linked to your employment status.
The Netherlands works differently. Everyone who lives or works in the Netherlands must take out individual Dutch health insurance — called zorgverzekering — regardless of their employment situation. Your employer doesn't arrange it. You do.
This is one of the most important things German expats overlook: your German Krankenkasse does not cover you once you become a resident in the Netherlands. The European Health Insurance Card (EHIC) is for temporary stays, not for residents.
Who Must Get Dutch Health Insurance?
You must take out Dutch health insurance if you:
- Live in the Netherlands (registered at a municipality / gemeente)
- Work in the Netherlands, even if you live across the border in Germany
- Are a student registered at a Dutch institution
The rule is simple: if the Netherlands is your country of residence, you need Dutch insurance. This applies whether you're on a permanent contract, a temporary project, or running your own business.
Timeline: When Do You Need to Enroll?
You have 4 months from the date you register at the municipality (or start working, whichever comes first) to take out basic Dutch health insurance. Don't wait.
| Event | Deadline |
|---|---|
| Register at gemeente | 4 months to enroll |
| Start working in NL | 4 months to enroll |
| Missed deadline | Retroactive fine (boete) |
If you miss the window, the Dutch healthcare authority (CAK) will assign you an insurer and add a fine on top. The insurance is backdated — meaning you pay premiums from your start date regardless.
Open enrollment: Every year in November and December, everyone in the Netherlands can switch insurers. Your new policy starts January 1st. This is also the window to change your supplementary coverage.
What Does Dutch Basic Insurance Cover?
The basic package (basisverzekering) is defined by law and identical at every insurer. All Dutch residents get the same coverage:
- GP (huisarts) visits — completely free, no deductible
- Hospital care and specialist treatment
- Prescription medication on the vergoedingslijst
- Mental healthcare (GGZ, up to defined limits)
- Maternity care and obstetrics
- Medical aids (limited)
Cost in 2025: Basic insurance runs approximately €135–€160/month depending on the insurer. All insurers offer the same basic coverage — you're only choosing on price, service quality, and network type.
The Deductible: Eigen Risico
Every adult has a mandatory deductible of €385/year (2025). This applies to:
- Specialist consultations
- Hospital stays
- Prescription medication
- Mental healthcare
- Ambulance transport
GP visits, maternity care, and all care for children under 18 are exempt from the deductible — they're always free.
This is lower than many German PKV deductibles but higher than the typical GKV model where most care has no out-of-pocket costs. Budget for this €385 in your first year, especially if you need specialist care.
Comparing the Systems: Germany vs. Netherlands
| Germany (GKV) | Netherlands | |
|---|---|---|
| Who arranges it? | Employer (for employees) | You, individually |
| Is it mandatory? | For most employees | Everyone residing/working in NL |
| Basic coverage | Broad (set by law) | Broad (set by law) |
| GP visits | Free (covered by GKV) | Free (no deductible) |
| Deductible | €0 (GKV) / varies (PKV) | €385/year (mandatory) |
| Monthly cost | ~€200–€300 (split employer/employee for GKV) | €135–€160/month (individual) |
| Switching window | Limited (GKV: 18-month minimum) | Every November–December |
One notable difference: the Dutch system gives you more freedom to switch each year. If you found a better deal or a new plan covers your specialist, you can switch every January 1st.
Deregistering from Your German Krankenkasse
Once you establish residence in the Netherlands, you should notify your German health insurer (Krankenkasse) that you are leaving. The exact process depends on whether you have:
- GKV (gesetzliche): Notify your Krankenkasse of your move. If you're no longer employed in Germany, your membership ends automatically. Get a Mitgliedschaftsbescheinigung (proof of membership) for any transition period.
- PKV (private): Contact your provider directly. You may be able to pause or suspend the contract depending on your plan. Some people maintain a PKV Anwartschaft (option to re-enter at the same conditions) if they plan to return.
Important: Keep documentation. German authorities and pension offices will want proof of continuous insurance coverage for your pension record.
Posted Workers: A1 Forms and the Special Case
If you are employed by a German company and temporarily posted to the Netherlands (a defined project or assignment), you may be able to keep your German social insurance. The key document is the A1 certificate, issued by your German Sozialversicherungsträger.
With a valid A1 form:
- You remain in the German social security system
- You don't need Dutch health insurance for the duration of the posting
- Your German Krankenversicherung remains your coverage
However: if your posting becomes permanent, or you change jobs to a Dutch employer, the A1 arrangement ends and you must switch to Dutch insurance.
Common Mistakes German Expats Make
1. Assuming EHIC is enough. The European Health Insurance Card is for temporary visitors and short trips, not for residents. It does not replace Dutch health insurance.
2. Waiting too long. Many Germans assume their German insurance "carries over" for a few months. It doesn't. Start the process when you register at the gemeente.
3. Forgetting the deductible. If you've been on GKV with no out-of-pocket costs, the €385 eigen risico can be a surprise. Some plans offer a voluntary higher deductible in exchange for a lower premium — evaluate based on your expected healthcare use.
4. Skipping supplementary coverage. The Dutch basic package doesn't cover dental beyond emergency extractions, physiotherapy beyond a few sessions, or glasses/contact lenses. If you relied on comprehensive German PKV coverage for these, you'll want to add Dutch supplementary insurance (aanvullende verzekering).
5. Not applying for zorgtoeslag. If you earn under approximately €38,520/year (2025), you may qualify for the healthcare allowance (zorgtoeslag), which reimburses up to €127/month of your premium. Many expats don't apply because they don't know it exists.
Frequently Asked Questions
Does my German health insurance cover me when I move to the Netherlands?
No. Once you register as a resident in the Netherlands, your German Krankenkasse no longer covers you for routine care. The EHIC card only covers emergency care during short visits. You must take out Dutch health insurance within 4 months of registering.
Can I keep my German PKV (private health insurance) while living in the Netherlands?
Generally no — Dutch law requires residents to take out a Dutch zorgverzekering. You cannot substitute German PKV for Dutch basic insurance. If you have PKV, you may be able to suspend it (Anwartschaft) while you live abroad, but you still need Dutch coverage.
What happens if I miss the 4-month enrollment deadline?
CAK (the Dutch authority) will assign you a health insurer and charge a surcharge. Your coverage is backdated to when you should have enrolled, so you pay retroactive premiums plus a fine. Don't miss the window.
Is Dutch health insurance cheaper or more expensive than German GKV?
For a single person, Dutch basic insurance at €135–€160/month is often less expensive than combined GKV contributions (employee + employer share). However, the mandatory €385 deductible means more out-of-pocket spending if you use specialist care.
Can I deduct Dutch health insurance premiums from my taxes?
The premiums themselves are not deductible. However, if you qualify for zorgtoeslag, you receive a monthly tax credit. Out-of-pocket medical costs above a certain threshold can sometimes be deducted as "specific care costs" (specifieke zorgkosten).
Do I need supplementary insurance (aanvullende verzekering)?
The basic package is comprehensive but doesn't cover dental (beyond emergency care), glasses, most physiotherapy, or alternative medicine. If you want those covered — especially dental — you'll need supplementary insurance. It costs €10–€50/month extra depending on the plan.
When can I switch Dutch insurers?
Every year during the open enrollment period in November and December. Your new insurer takes over on January 1st. You can switch the basic package insurer, supplementary coverage, or both.
Your Next Steps
- Register at your gemeente — this starts your 4-month clock
- Compare Dutch health insurers at CareCompare to find the best plan for your situation
- Notify your German Krankenkasse that you're establishing residence abroad
- Apply for zorgtoeslag at Belastingdienst.nl if your income qualifies
- Register with a GP (huisarts) in your first week — don't wait until you're sick
- Check whether you need supplementary coverage for dental, physio, or glasses