Everyone who lives or works in the Netherlands is required to contract at least the basic health insurance package from a health insurer. Health insurers must accept every applicant for the basic health insurance package. Three groups are not required to contract health insurance: those with conscientious objections, those performing military service and foreign students aged 18 to 30 who are not in paid employment. No premium is charged for the basic package for children aged up to 18. You can contract supplementary insurance on a voluntary basis: insurers have no obligation to accept your application for this.
Health insurance premiums consist of two elements: the premium paid to the health insurer and an income-dependent contribution paid via the tax authorities. People with low incomes receive a compensatory care allowance.
The premiums paid to the health insurer are known as the ‘nominal premiums’. You pay this element direct to your health insurer. Every health insurer fixes its own premium charges. The premium consists of an element for the basic package, plus an element for the supplementary package, if applicable. The premium for the basic package is independent of age, gender and state of health.
All employees and benefit claimants also pay an income-dependent contribution. This is automatically deducted via your employer or social insurance implementing organisation. The contribution is deducted from a maximum income limit of €57,232 (2020). The self-employed will receive a tax assessment from the tax authorities. If you have income through both employment and through self-employment, the income-dependent contribution will be charged via both the employer and the tax authorities.
Foreign students aged 18 to 30 who are unemployed are not required to take out insurance under the Health Insurance Act. They can keep their own insurance.