Healthcare in the Netherlands is not free. Every resident is legally required to purchase private health insurance, paying a monthly premium of roughly €159, plus an annual deductible of €385 before most coverage kicks in. However, the system is heavily regulated and subsidized, so the cost to individuals varies significantly based on income. Children under 18 are fully covered at no cost.
How the Dutch System Works
The Netherlands uses a mandatory private insurance model rather than a government-run healthcare service. Under the Health Insurance Act (known as the Zorgverzekeringswet), everyone who lives or works in the country must buy a basic health insurance policy from a private insurer. The government decides exactly what this basic package covers, and every insurer is required to offer the same standard set of benefits. No one can be denied coverage.
On top of the monthly premium you pay directly to your insurer, your employer contributes 6.51% of your salary toward the healthcare system. A separate income-based tax funds long-term care for people with chronic illnesses or disabilities. So while you never see a bill labeled “healthcare tax,” a meaningful share of your earnings goes toward the system before you ever visit a doctor.
What the Basic Package Covers
The standard package is broad. It includes general practitioner consultations, hospital treatment, prescription medication, maternity care, mental healthcare, and geriatric care. The government’s National Health Care Institute reviews which treatments and medications belong in the package, and the Minister of Health makes final decisions on additions.
There are notable gaps. Routine dental checkups and most dental treatments for adults over 18 are not covered. Surgical dental procedures, x-rays, and removable dentures are included, but if you want coverage for regular cleanings or fillings, you need supplementary insurance. Physiotherapy, glasses, and some other services also fall outside the basic package or are only partially covered.
What You Actually Pay Out of Pocket
Three costs hit your wallet directly: the monthly premium, the annual deductible, and anything not covered by your plan.
The average monthly premium for basic insurance is around €159 as of 2025. You can choose a higher voluntary deductible to lower this premium, but the mandatory deductible set by the government is €385 per year. That means you pay the first €385 of covered care costs yourself before your insurer starts reimbursing.
One important exception: GP visits are completely exempt from the deductible. You can see your general practitioner without paying anything beyond your monthly premium. However, if your GP orders a blood test or refers you for diagnostics, those costs do count toward your deductible. Hospital stays, specialist visits, and prescription drugs all draw from the deductible first.
Financial Help for Lower Incomes
The Dutch government offers a healthcare allowance (zorgtoeslag) to offset premium costs for people with lower incomes. In 2026, you qualify if your annual gross income is below €40,857 as a single person, or below €51,142 combined if you have a partner. The allowance is paid monthly and can cover a significant portion of your premium, though it rarely covers the full amount.
Student financing doesn’t count toward your income for this calculation, which means most students qualify. Holiday pay and received child maintenance do count.
Coverage for Children
Children under 18 pay no premiums and have no deductible. Parents are required to register their child with a health insurer by the time the child is four months old, but the insurer cannot charge for the child’s coverage. This makes healthcare effectively free for minors in the Netherlands. Once a child turns 18, they must arrange and pay for their own basic insurance policy.
Supplementary Insurance
Many Dutch residents purchase additional coverage on top of the basic package. Supplementary policies cover things like adult dental care, extra physiotherapy sessions, alternative medicine, or better coverage for glasses and contact lenses. Unlike the basic package, insurers can set their own terms for supplementary plans, including the option to reject applicants. Premiums vary widely depending on the level of coverage you choose, typically adding anywhere from €10 to €80 per month.
How It Compares to “Free” Healthcare
Countries like the UK or Canada fund healthcare primarily through general taxation, so residents never see a separate insurance bill. The Netherlands takes a different approach: you pay a visible monthly premium to a private company, face an annual deductible, and may need extra coverage for dental or other services. The tradeoff is relatively short wait times, a wide choice of providers, and a regulated market where insurers compete on price and service quality while offering identical core benefits. The system isn’t free, but it’s designed so that cost is proportional to income, with subsidies filling the gap for those who earn less.