Taking out compulsory healthcare insurance

Anyone who lives or works in the Netherlands must take out healthcare insurance under the Healthcare Insurance Act (Zorgverzekeringswet, Zvw). This includes entrepreneurs and self-employed professionals. 

There are 2 types of healthcare insurance: 

• The mandatory basic package of the healthcare insurance. This will cover the default healthcare provided for instance by a general practitioner, hospital, or pharmacy.
• Additional insurance. You can take out additional coverage via your health insurer, if you want this. 

Mandatory risk excess 

Healthcare insurance in the Netherlands is subject to a mandatory risk excess (eigen risico). This means you pay the first part of the care you receive yourself. The excess rate is set annually by the government (in Dutch). Some healthcare is exempt from the excess rate. Such as care received from a general practitioner, or obstetric and maternity care. 

Healthcare benefit entitlement 

Healthcare benefit is a contribution to the costs of your healthcare insurance. Whether you are entitled to healthcare benefit depends on your income level, among other things. You can apply for healthcare benefit (zorgtoeslag, in Dutch) from the Netherlands Tax Administration (Belastingdienst). 

Employer’s contribution and contribution Zvw 

If you employ personnel, you pay the income-dependent contribution under the Healthcare Insurance Act (Zvw) to the Netherlands Tax Administration. This consists of:

• an employer’s contribution pursuant to the Healthcare Insurance Act (Zvw) (werkgeversheffing Zvw) which you may not deduct from your employee’s wage, and
• a contribution under the Healthcare Insurance Act (Zvw) (bijdrage Zvw) which you deduct from your employee’s wage and pay on behalf of your employee 

Self-employed professionals and Zvw 

If you are a self-employed professional and the Netherlands Tax Administration considers your income to be the result from other activities (in Dutch), you will have to pay a Zvw contribution. To this end they will send you an assessment after you have filed your tax return. 

Employing uninsured workers 

All employees in the Netherlands must take out Dutch healthcare insurance. If someone fails to do so, the Dutch Central Administration Office (CAK) will do this for them. If you employ someone without healthcare insurance, you must withhold the monthly insurance premium (in Dutch) from their regular wages and pay this to CAK.

Healthcare insurance for non-residents 

The Healthcare Insurance Act also applies if you work but do not live in the Netherlands. Because you work in the Netherlands you are insured under the Long-Term Care Act (Wet langdurige zorg, Wlz). Besides this, you may be entitled to healthcare benefit. 

If you live in one EU country and work in another, you can also apply for an S1 form.