Health Insurance for French Expats in the Netherlands

From Assurance Maladie to Zorgverzekering: A Different Model

French nationals moving to the Netherlands arrive with one of Europe's most comprehensive public health systems behind them. The French Sécurité Sociale — and specifically its health branch, Assurance Maladie — covers 70% to 80% of most medical costs for residents, with the remainder typically picked up by a private mutuelle that your employer often contributes to or arranges entirely. Visits to a doctor are reimbursed. Prescriptions are partially covered. The Carte Vitale makes transactions seamless and paperwork minimal.

The Dutch system is built differently. It is a regulated private insurance market, not a state-run reimbursement scheme. Every resident of the Netherlands — including you — must take out individual health insurance called zorgverzekering, paying a monthly premium directly to a private insurer. The Dutch government mandates the coverage, regulates what every insurer must offer, and subsidises lower incomes through zorgtoeslag. But unlike Assurance Maladie, your insurance is not linked to your employment or your employer. It is yours to arrange, compare, and manage.

Your Carte Vitale is not valid in the Netherlands as a resident. Your CPAM affiliation does not extend to the Netherlands once you have relocated. Your employer-provided mutuelle will not be accepted by Dutch healthcare providers. And the EHIC on the back of your Carte Vitale is for temporary visitors, not residents.

This guide explains the full transition — what changes, what you need to do, what the Dutch system covers, and how to navigate the shift from the French to the Dutch approach.

Who Must Get Dutch Health Insurance?

You must take out Dutch health insurance if you:

• Live in the Netherlands and are registered at a municipality (gemeente)
• Work in the Netherlands under a Dutch employment contract
• Are a student enrolled at a Dutch institution and registered as a resident
• Are self-employed and registered as a sole trader (ZZP'er) in the Netherlands
• Are a family member registered in the Netherlands as a dependent

The rule is residence-based. French nationality gives you full EU freedom of movement and the right to live and work in the Netherlands without a permit. But EU citizenship does not exempt you from Dutch health insurance requirements. Once you are a Dutch resident, you need Dutch insurance.

Your Carte Vitale and CPAM Affiliation: What Happens When You Leave

When you move to the Netherlands, you must notify CPAM of your departure and inform them that you are no longer a resident of France. This is not automatic. If you do nothing, your CPAM affiliation may technically remain open, but you have no right to use it for care received in the Netherlands, and reimbursements from CPAM for foreign care will not be processed as routine claims.

The relevant system is PUMA — Protection Universelle Maladie — which grants health coverage to all French residents based on residency, not employment status. When you leave France, your PUMA entitlement ends because you are no longer a French resident.

Steps to take on the French side:

1. Notify CPAM of your departure and change of residence — you can do this online through ameli.fr or by contacting your local CPAM office
2. Close or suspend your mutuelle — if employer-provided, inform HR; if private, contact your insurer directly
3. Retain your numéro de sécurité sociale — you will always keep this number and may need it for pension purposes or if you return to France
4. Keep documentation of your insurance history for continuity of coverage records

Your numéro de sécurité sociale (13-digit NIR number) remains yours permanently. It does not expire when you leave France. Store it somewhere safe — you will need it if you return to France and re-enter the French system.

Does Your French Mutuelle Work in the Netherlands?

No. Whether your mutuelle is employer-provided or independently purchased, it is a French supplementary insurance product designed to top up French Assurance Maladie reimbursements. It has no contractual relationship with Dutch healthcare providers and no legal standing under Dutch insurance law.

Some employer-provided mutuelles have international coverage riders — check your policy terms. If yours does, it may provide limited supplementary benefit while you are abroad. But it cannot substitute for a Dutch zorgverzekering and Dutch providers will not bill it directly.

Once you are enrolled in Dutch basic insurance, review whether continuing your French mutuelle payments makes financial sense. In most cases, a Dutch aanvullende verzekering (supplementary insurance) will be more cost-effective and practically useful.

The Enrollment Timeline

Event	Deadline
Register at gemeente	4 months to enroll in Dutch insurance
Start working for Dutch employer	4 months from start date
Missed deadline	CAK assigns insurer + surcharge
Annual switching window	November–December each year

The 4-month window from gemeente registration is generous but not unlimited. If you miss it, the Dutch healthcare authority (CAK) assigns you an insurer — you lose the ability to compare and choose — and charges a retroactive surcharge. Your coverage is backdated, so you owe premiums from when you should have enrolled, plus the fine.

Step-by-step enrollment process:

1. Register at your local gemeente — receive your BSN (burgerservicenummer, equivalent to the French numéro de sécurité sociale for Dutch administrative purposes)
2. Open a Dutch bank account (requires BSN; most Dutch insurers require a Dutch IBAN for direct debit)
3. Compare Dutch health insurers and choose a plan
4. Enroll directly with your chosen insurer — online enrollment is standard
5. Apply for zorgtoeslag at Belastingdienst.nl if your income qualifies

What Dutch Basic Insurance Covers

The basisverzekering is defined by law. Every Dutch insurer — VGZ, Zilveren Kruis, CZ, Menzis, DSW, and others — must offer the same core package. You are comparing on price, service quality, and provider network, not on what is covered.

Included in the basic package:

• GP (huisarts) visits — always free, no deductible applies
• Hospital care and specialist consultations (requires GP referral)
• Prescription medication on the approved formulary (vergoedingslijst)
• Mental healthcare (GGZ, up to defined session limits)
• Maternity and obstetric care
• Emergency care
• Medical aids (limited categories)
• Children under 18 — free, no premium required

Not included in the basic package:

• Routine dental care for adults (beyond emergency extraction)
• Physiotherapy (beyond the first sessions for specific conditions)
• Glasses and contact lenses
• Alternative and complementary medicine
• Cosmetic procedures

For these, you add aanvullende verzekering (supplementary insurance) to your basic policy.

The Deductible: Eigen Risico vs. Ticket Modérateur

This is one of the most important structural differences between the French and Dutch systems, and it requires some mental adjustment.

In France, the ticket modérateur is the portion of medical costs not covered by Assurance Maladie — typically 20%–30% of the official tariff for most consultations and treatments. This is applied per visit and per prescription item. Your mutuelle usually covers the ticket modérateur, so in practice you often pay nothing at the point of care.

In the Netherlands, the concept is different. There is no percentage co-pay per service. Instead, there is a single annual lump-sum deductible — the eigen risico — of €385 per year in 2025.

Here is how it works:

• Each year, you pay the first €385 of eligible healthcare costs yourself
• Once you have paid €385, your insurer covers 100% of further eligible costs that year
• GP visits are always free — they do not count toward the deductible
• Children under 18 are fully covered — no premium and no deductible

The eigen risico applies to:

• Specialist consultations and hospital care
• Prescription medication
• Mental healthcare
• Ambulance transport

The practical impact: If you are healthy and only see your GP, you pay nothing beyond your monthly premium. If you need specialist care, you cover the first €385 yourself, then 100% is covered. Unlike the French system's ongoing percentage co-pays, the Dutch model has a ceiling — once you hit €385, your out-of-pocket costs stop.

You can voluntarily increase your deductible (up to €885/year) in exchange for a lower monthly premium. This is worth considering if you are young, healthy, and unlikely to need specialist care.

Zorgtoeslag: Government Premium Allowance

If your annual income falls below approximately €38,520 (2025 threshold, single person), you may be entitled to zorgtoeslag — a monthly government contribution toward your insurance premium.

The maximum benefit in 2025 is €127/month. For those on lower incomes, this can cover a significant portion of the monthly premium.

There is no French equivalent of zorgtoeslag — Assurance Maladie costs are embedded in social contributions (cotisations sociales) rather than paid as a visible premium, so the concept of an explicit premium subsidy is unfamiliar to many French expats. But it is real money: at maximum benefit, zorgtoeslag covers nearly the full cost of basic insurance.

Apply at belastingdienst.nl as soon as you have your BSN. It can be backdated within the calendar year, but do not delay — every month you miss is money you cannot recover.

Comparing the Systems: France vs. Netherlands

	France (Assurance Maladie + Mutuelle)	Netherlands
How it's funded	Social contributions (cotisations sociales)	Individual monthly premium
Who arranges it?	Employer (for employees); CPAM	You, individually
Basic coverage rate	70–80% of official tariff	Defined package (100% after deductible)
GP visits	Reimbursed by AM (after ticket modérateur)	Free — no deductible applies
Patient co-pay	Ticket modérateur per service	Eigen risico: €385 lump sum/year
Supplementary	Mutuelle (often employer-provided)	Aanvullende verzekering (optional)
Annual deductible	None (percentage per service instead)	€385 mandatory
Monthly cost	Hidden in payslip cotisations	€135–€160 visible premium
Switching window	Varies by mutuelle terms	November–December each year
Children	Covered by family Assurance Maladie	Free — no premium
Dental (adult)	Partially covered by AM + mutuelle	Not covered in basic package

Dental Coverage: A Gap to Plan For

In France, adult dental care is partially covered by Assurance Maladie, with most of the remaining cost picked up by a good mutuelle. The 100% Santé reform introduced in 2019 means many dental prostheses are now fully covered with no remaining charge (reste à charge zéro) for patients with a mutuelle.

In the Netherlands, adult dental care is not included in the basic package. A standard check-up costs €80–€150 out of pocket. Fillings, crowns, and other work are priced individually and can be significant.

If you see a dentist regularly — which you should — add a tandartsverzekering (dental insurance module) to your Dutch policy. These typically cost €15–€35/month and cover routine check-ups, cleaning, and partial costs for more complex procedures. This is especially important in the first year when you may be catching up on care.

Posted Workers and the A1 Certificate: Détachement

If you are a French national employed by a French company and temporarily posted (détaché) to the Netherlands — on a defined assignment with a planned return — you may be able to remain in the French social security system under the A1 certificate (certificat A1).

The A1 is issued by the French authorities (URSSAF or the relevant social security body) and confirms that you remain affiliated to the French system during your posting. With a valid A1:

• You stay in French Assurance Maladie
• Your employer continues paying French social contributions
• You are exempt from Dutch health insurance for the posting period
• Your Carte Vitale remains valid for care received in France during visits home

Conditions: The A1 applies to temporary postings, typically up to 24 months (extendable in some cases). The posting must be genuine — you must be employed and paid by the French entity, working temporarily in the Netherlands, with the intention to return. If the posting becomes permanent, or you transfer to a Dutch employment contract, the exemption ends.

Your employer's HR or payroll team should arrange the A1 through URSSAF before you begin working in the Netherlands. If you are already posted without one, apply retroactively — it can be backdated but requires documentation.

Supplementary Insurance (Aanvullende Verzekering)

French expats accustomed to comprehensive mutuelle coverage often find the Dutch basic package thinner in specific areas. The most common gaps:

Gap in basic package	Dutch supplementary option	Approximate cost
Routine dental	Tandartsverzekering module	€15–€35/month
Physiotherapy (beyond limits)	Fysiotherapie add-on	€5–€15/month
Glasses / contact lenses	Included in many mid-tier plans	Included in many plans
Extended mental health	Some plans	Varies
Alternative medicine (acupuncture, ostéopathie)	Some comprehensive plans	Varies

Supplementary insurance is purchased alongside your basic policy — usually from the same insurer, though you are not required to use the same provider. It can be changed during the annual November–December enrollment window.

Think of aanvullende verzekering as your Dutch replacement for the mutuelle. It is not identical in structure — it supplements a mandatory basic insurance rather than topping up a reimbursement scheme — but it serves the same purpose of covering what the core package does not.

Common Mistakes French Expats Make

1. Assuming CPAM affiliation continues automatically. Assurance Maladie coverage is based on French residence. Once you are a Dutch resident, you have no right to reimbursement from CPAM for routine care. Many French expats only discover this when they submit a claim and receive a refusal.

2. Using the EHIC as resident coverage. The European Health Insurance Card on your Carte Vitale covers emergency care during temporary visits to other EU countries. It is not valid for residents. Dutch healthcare providers will not accept it as insurance for ongoing care.

3. Not notifying CPAM of departure. If you do not formally notify CPAM that you have left France, your situation becomes administratively murky. Notify them via ameli.fr or by letter, and keep confirmation of your deregistration.

4. Expecting the mutuelle to work in the Netherlands. No Dutch provider has a contract with French mutuelles. You will be billed directly for care, and French mutuelle reimbursement for Netherlands-based care is either not covered or extremely limited.

5. Missing the zorgtoeslag application. The healthcare allowance is worth up to €127/month and many French expats on moderate incomes qualify. It is not automatic — you must apply. Many people miss months of entitlement because they do not know it exists.

6. Overlooking the huisarts requirement. In France, you can self-refer to many specialists (though going through your médecin traitant gives better reimbursement rates). In the Netherlands, you cannot self-refer at all. Your GP (huisarts) must refer you to any specialist. Register with a GP immediately — practices have patient limits.

7. Not comparing insurers. All Dutch insurers offer identical basic coverage by law. But premiums, service, digital experience, and network type (natura vs. restitutie) vary. A restitutie plan reimburses care from any licensed Dutch provider — useful if you want to see French-speaking doctors or use specific clinics.

Frequently Asked Questions

Does my French health insurance (Assurance Maladie) cover me when I live in the Netherlands?

No. CPAM affiliation is based on French residence. Once you are registered as a resident in the Netherlands, you are no longer entitled to Assurance Maladie coverage for care received in the Netherlands. Your Carte Vitale is not valid at Dutch healthcare providers. You must notify CPAM of your departure and take out Dutch health insurance.

Can I use my Carte Vitale at Dutch doctors or hospitals?

No. Dutch healthcare providers do not have agreements with CPAM. Your Carte Vitale will not be recognised as valid insurance in the Netherlands. If you present it at a Dutch provider, you will be billed directly and at full cost. You need a Dutch zorgverzekering.

What should I do about my numéro de sécurité sociale when I leave France?

Keep it — it is yours permanently and will never be reassigned. You will need it if you return to France and re-enter the French system, or for French pension calculations. You do not lose it by leaving France. Store it somewhere safe with your other key documents.

My employer provides a mutuelle in France — does it extend to the Netherlands?

Almost certainly not for routine Dutch care. Some employer mutuelles have international coverage riders, but they are not a legal substitute for Dutch zorgverzekering and Dutch providers will not accept them as insurance. Check your mutuelle policy terms carefully, then purchase Dutch basic insurance as required. Inform your HR department of your move so they can adjust your benefits package.

What is the difference between the ticket modérateur and the eigen risico?

The French ticket modérateur is a percentage co-pay applied per medical service — typically 20%–30% of the official tariff — which your mutuelle usually covers. The Dutch eigen risico is a lump-sum annual deductible of €385. You pay the first €385 of specialist care, hospital costs, and prescriptions yourself each year; after that, your insurer covers 100%. GP visits are always free and do not count toward the deductible. The Dutch model has a ceiling on annual out-of-pocket costs; the French model applies ongoing co-pays per service.

I'm being posted to the Netherlands by my French employer — do I need Dutch insurance?

Possibly not, if you have a valid A1 certificate. French employees on official temporary postings (détachement) to the Netherlands can remain in the French social security system, including Assurance Maladie, using an A1 form issued by URSSAF. Your employer must apply for the A1 before the posting begins. If you do not have an A1, or if your posting is not a formal détachement, you need Dutch insurance. Check with your HR department or a social security specialist.

How does zorgtoeslag work and do I qualify as a French national?

Zorgtoeslag is a monthly government subsidy toward your health insurance premium, available to residents of the Netherlands regardless of nationality. You qualify based on your income and household situation, not your citizenship. In 2025, the income threshold for a single person is approximately €38,520/year. The maximum benefit is €127/month. Apply at belastingdienst.nl using your BSN as soon as you are registered.

When can I switch Dutch health insurers?

Every year during the open enrollment period in November and December. Your new policy takes effect on 1 January. You can switch your basic insurer, your supplementary coverage, or both. If you are enrolling for the first time mid-year, you stay with your chosen insurer until the next switching window.

Do I need to register with a Dutch GP (huisarts) separately from getting insurance?

Yes. In the Netherlands, your GP is your mandatory gateway to specialist care. You cannot self-refer to a specialist, even if you know what you need. Register with a local huisarts as soon as you arrive — practices have patient limits and can fill up. Many urban practices have French-speaking doctors or experience with French patients. You register directly with the practice, not through your insurer.

Your Next Steps

1. Notify CPAM of your departure from France via ameli.fr — formally close your French residency-based coverage
2. Register at your gemeente — this gives you your BSN and starts the 4-month enrollment clock
3. Check A1 eligibility if you are posted by a French employer — contact HR and URSSAF before starting work in the Netherlands
4. Compare Dutch health insurers at CareCompare, paying attention to natura vs. restitutie plan types
5. Apply for zorgtoeslag at Belastingdienst.nl if your income is below €38,520/year
6. Register with a local GP (huisarts) in your first week
7. Add supplementary dental cover — adult dental care is not in the basic package
8. Cancel or suspend your French mutuelle once your Dutch coverage is active

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