If Dutch insurance applies, arrange it within four months
If Dutch insurance law applies to you, take out a basisverzekering (basic health insurance) within four months of your duty starting. Your policy and premiums then run from that start date. After four months, cover and premiums start on the date you take out the policy. The earlier gap is uninsured. Students, posted workers and people waiting for a residence decision need to check their own rules.
Do I need Dutch basic health insurance?
If you live in the Netherlands, Dutch insurance usually applies. Registration with a gemeente (municipality) alone does not settle this. The Sociale Verzekeringsbank (External site, opens in a new tab) (SVB, Dutch social insurance bank) can check your insurance duty.
The four-month window starts when your duty begins. Use these starting points to check your residence and work situation.
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| Your situation | Insurance rule | What to do |
|---|---|---|
| You start a job with a Dutch employer, including a side job while studying | Your insurance duty starts on your first workday. An EHIC (European Health Insurance Card) or international policy is no longer enough | Take out insurance within four months to cover your first workday. If late, check the start date with your insurer |
| Your permanent residence permit comes into force | Take out insurance within four months. Cover and premiums run from the permit’s effective date | Check the effective date on your permit decision |
| You are a foreign student here only to study | Dutch basic insurance usually does not apply | Keep suitable alternative cover. Check with the SVB if you start work or an internship |
| You hold a zoekjaar (orientation-year) residence permit and do not work | You cannot take out Dutch basic insurance while you are not working | Keep alternative cover. Reassess when you start work |
| You are self-employed | Your duty depends on your work and residence situation | Request an SVB assessment if your duty is unclear |
| A foreign employer posts you here temporarily | You may stay insured in your home country. An A1-verklaring (social-insurance certificate) can prove this | Check with your employer and the home-country social-insurance authority |
Some students from the Dutch Caribbean may need Dutch basic insurance even without a job. Internships have separate rules. Check the SVB’s study and internship rules (External site, opens in a new tab) before choosing cover.
If you are waiting for a residence-permit decision, check Government.nl’s residence-permit insurance rules (External site, opens in a new tab) before buying a policy. If a CAK letter arrives while you await a permit decision or renewal, request a Wlz assessment first.
If you have temporary protection for displacement from Ukraine, a BSN and residence code 46, RMO (medical-care scheme for displaced people from Ukraine) covers qualifying healthcare without a premium or compulsory deductible, including when you work. Dutch basic insurance is not compulsory for you. If you work and voluntarily choose your own Dutch policy, its ordinary premiums, deductible and personal contributions apply.
How do I arrange insurance within four months?
Arrange basic insurance as soon as your duty begins. The four months are an enrolment window. When you take out insurance within that window, you pay premiums from the earlier start date. Government.nl (External site, opens in a new tab) explains this rule.
Once you have checked that Dutch basic insurance applies, follow these steps:
- Compare policies using the premium, care providers that have a contract with the insurer, and payments for care outside that network.
- Apply to your chosen insurer with the documents it needs. State the date your insurance duty began.
- Check the start date on your policy and the premiums due for the earlier months.
For example, your Dutch job starts on 1 July 2026 and you take out insurance on 1 September 2026. Your cover starts on 1 July. You also pay premiums for July and August. A permanent residence permit uses its effective date instead of a workday.
After four months, cover and premiums start on the date you take out the policy. The earlier gap is uninsured. You pay for care from that period yourself. The CAK may also contact you about being uninsured.
You may have thought another European country covered you. An authority may later decide that Dutch insurance law applied to that period. If this happens, ask the CAK about its separate reimbursement scheme. The official reimbursement rules (External site, opens in a new tab) cover certain cases involving the European Union, Iceland, Liechtenstein, Norway or the United Kingdom. Conditions apply. If the CAK grants reimbursement, you pay a contribution for eligible periods after the calendar month in which you turn 18.
What must I do after a CAK uninsured letter?
Within three months of the date on your CAK letter, take out basic insurance if the duty applies. If you think the duty does not apply, request a Wlz assessment instead. These are the CAK’s two routes.
The CAK fine process works as follows. The fine amounts below apply in 2026.
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| Stage | What happens | What to do |
|---|---|---|
| Uninsured letter | The CAK records you as uninsured | Within three months of the letter date: insure if the duty applies; request a Wlz assessment if you think it does not |
| First fine | No action within three months leads to a €529.74 fine in 2026 | Take out insurance within three months after the first fine |
| Second fine | Remaining uninsured leads to another €529.74 fine in 2026 | Arrange insurance. The duty still applies |
| CAK-arranged policy | If you remain uninsured after the second fine, the CAK takes out a policy for you | Follow its payment and policy instructions |
If your policy starts within three months of the original CAK letter date, the CAK automatically cancels the fine. This also applies if the fine has already been issued. The Centraal Justitieel Incassobureau (External site, opens in a new tab) (CJIB, central judicial collection agency) automatically refunds any amount you paid.
If your policy starts later, the fine remains payable. The payment request explains how to pay in instalments. The SVB may find that you did not need Dutch insurance when fined. The CAK then cancels the fine. The CJIB refunds any amount you paid.
For help checking digital government post, use the MijnOverheid (government account) and Berichtenbox (message box) guide.
Compare policies, deductibles and financial help
How do basic insurance policies differ?
Every insurer must offer the government-defined basic package. Insurers must accept people who are required to have basic insurance, regardless of age or health. Policies still differ in monthly premium, care providers with a contract, payments for care outside the insurer’s network and customer service.
How much is the eigen risico?
In 2026, adults aged 18 or older pay the first €385 of care costs that fall under the compulsory eigen risico (deductible). Care from a huisarts (general practitioner, or GP) is exempt. The Rijksoverheid (External site, opens in a new tab) (Dutch government) lists the other exemptions.
How do I insure children under 18?
If Dutch basic insurance applies, a parent or guardian must register the child with an insurer. Children under 18 pay no basic-insurance premium and no compulsory deductible.
Can I get zorgtoeslag?
Zorgtoeslag helps you pay for health insurance. You must be at least 18, have Dutch basic health insurance, and meet the income and asset conditions. Check the Dienst Toeslagen (External site, opens in a new tab) (benefits agency) conditions, including the residence rules for newcomers.
The following limits apply in 2026. A toeslagpartner (benefit partner) is someone whose income or assets count with yours under benefit rules.
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| 2026 limit | Without a benefit partner | With a benefit partner |
|---|---|---|
| Annual income used for benefits | €40,857 | €51,142 combined |
| Assets on 1 January 2026 | €146,011 | €184,633 combined |
If you have a benefit partner for only part of the year, their assets do not count for that year. The assets you have on 1 January decide your eligibility for the whole year. If they are above the limit then, reducing them later does not restore that year’s benefit.
The benefit falls as your income rises. If you have bijzonder vermogen (special assets), such as certain compensation payments, do not use the proefberekening (trial calculation) (External site, opens in a new tab) to estimate your zorgtoeslag. Read the special-assets guidance (External site, opens in a new tab) instead. Otherwise, use the trial calculation to estimate your amount.
How do I apply for zorgtoeslag?
Apply through Mijn Toeslagen (External site, opens in a new tab) (benefits portal). The portal is in Dutch. You need a BSN (citizen service number). Log in with DigiD (External site, opens in a new tab) (Dutch digital identity). Residents of the EU (European Union) can also use European inlog (European login).
If you cannot use DigiD, the BelastingTelefoon (External site, opens in a new tab) (Tax Information Line) can arrange help at a tax office or benefits service point.
You can apply for 2026 healthcare benefit until 31 December 2027. A granted extension for filing your Dutch income tax return extends this deadline to the end of that extension. Applying sooner lets you receive monthly support sooner.
Report changes that affect your benefit, including income or partner changes. Check your assets on 1 January for each new benefit year.
What if I cannot get insured on time?
What if my BSN has not arrived?
The SKGZ (health insurance complaints body) application checklist (External site, opens in a new tab) lists a BSN, a bank account and registration with a Dutch municipality. A delayed BSN does not automatically move your insurance start date. Complete your registration and contact the insurer before the deadline. Ask which documents it needs to use the correct start date.
What if four months have already passed?
If the insurance duty applies, take out a policy now. After four months, cover and premiums start on the date you take out the policy. The earlier gap is uninsured. If you received a CAK letter, check its three-month deadline. If your policy starts within three months of the letter date, the CAK automatically cancels the fine.
What should I do once I am insured?
If you cannot afford the premium, check whether you can get zorgtoeslag. Premiums remain due. Contact your insurer about a payment arrangement (External site, opens in a new tab) before missing payments.
The first 90 days checklist places insurance alongside registration, your BSN and your bank account.
For benefits and care after enrolment, use these guides:
- Author
- By Inburgering.org team
- Reviewer
- Reviewed by Kirill Svavolia
Official Sources
- Government.nl: When newcomers need compulsory health insurance (External site, opens in a new tab) - explains the four-month enrolment window, retroactive cover within it, and the uninsured gap if a policy is taken out after four months
- SKGZ: Dutch health insurance in English (External site, opens in a new tab) - explains who may or must take out Dutch basic insurance, the work and study routes, the 2026 deductible and the rules for children
- Government.nl: Health insurance and residence permit (External site, opens in a new tab) - sets the four-month deadline and retroactive premium rule for a permanent residence permit and explains cover while a permit decision is pending
- CAK: I received a letter that I am uninsured (External site, opens in a new tab) - gives the two actions after an uninsured letter, the three-month response period and the 2026 fine of €529.74
- CAK: I received a fine (External site, opens in a new tab) - explains the second fine, automatic revocation when insurance starts in time and insurance arranged by the CAK after continued inaction
- Rijksoverheid: Compulsory deductible for health insurance (External site, opens in a new tab) - sets the compulsory deductible at €385 for 2026 and lists care exempt from it, including GP care
- Dienst Toeslagen: Maximum income for healthcare benefit (External site, opens in a new tab) - sets the 2026 income limits at €40,857 alone and €51,142 combined with a benefit partner
- Dienst Toeslagen: Maximum assets for healthcare benefit (External site, opens in a new tab) - sets the 1 January 2026 asset limits at €146,011 alone and €184,633 combined with a benefit partner
- Dienst Toeslagen: Apply for a benefit (External site, opens in a new tab) - explains the BSN and DigiD requirements, help without DigiD and the application deadline of 31 December of the following year
- SVB: Living in the Netherlands (External site, opens in a new tab) - explains why living in the Netherlands usually brings Wlz insurance, but address registration alone does not establish it
- SVB: Studying or doing an internship (External site, opens in a new tab) - explains foreign-student exceptions, Dutch Caribbean students and separate internship rules
- SVB: Apply for an insurance assessment (External site, opens in a new tab) - explains Wlz assessments, applications after a CAK letter and the processing time of up to eight weeks
- Rijksoverheid: Health insurance when working in the Netherlands (External site, opens in a new tab) - explains the insurance duty for Dutch employment and checking the duty when moving without working
- Rijksoverheid: Working for a foreign employer (External site, opens in a new tab) - explains the posted-worker exception and an A1 certificate from the home-country social-insurance authority
- SKGZ: Health insurance application checklist (External site, opens in a new tab) - lists the BSN, bank account and municipality registration needed to apply, plus differences between policy types
- CAK: Fine rules in Dutch (External site, opens in a new tab) - confirms the letter-date deadline, fine refunds and the duty to pay while an assessment or objection is pending
- Dienst Toeslagen: Healthcare-benefit conditions (External site, opens in a new tab) - lists the age, insurance, income and asset conditions and links to residence rules
- Dienst Toeslagen: Healthcare-benefit amounts (External site, opens in a new tab) - explains how the benefit falls as income rises
- Dienst Toeslagen: Trial calculation (External site, opens in a new tab) - provides a benefit estimate and explains that the tool does not account for certain special assets
- Dienst Toeslagen: Log in to Mijn toeslagen (External site, opens in a new tab) - explains the application portal and DigiD or European login options
- DigiD: Digital identity (External site, opens in a new tab) - provides the official digital identity service and login information
- Official gazette: Four-month rule and retrospective cross-border cover (External site, opens in a new tab) - confirms the four-month backdating rule and the separate reimbursement scheme for certain retrospective European insurance-status decisions from 1 January 2025
- Official gazette: Insurance duty under the Wlz (External site, opens in a new tab) - explains the legal link between Wlz insurance status and the duty to hold Dutch basic health insurance
- CAK: Uninsured-letter rules in Dutch (External site, opens in a new tab) - explains the two response routes and requesting a Wlz assessment while a residence-permit or renewal decision is pending
- CJIB: Fine payment services (External site, opens in a new tab) - official collection agency for fine payments and payment arrangements; the CAK fine rules explain its refund role
- Rijksoverheid: Unpaid health-insurance premiums (External site, opens in a new tab) - explains payment reminders, insurer payment arrangements and continued premium debts
- Dienst Toeslagen: Special assets (External site, opens in a new tab) - explains which special assets may be excluded and how to request an exclusion
- Dienst Toeslagen: Contact about benefits (External site, opens in a new tab) - provides official telephone contact and appointment routes for benefit help
- CAK: About us (External site, opens in a new tab) - explains the public body’s duties and confirms that CAK has not officially been an abbreviation since 2013
- Rijksoverheid: Als zorgverlener kosten declareren voor zorg aan vluchtelingen uit Oekraïne (External site, opens in a new tab) - If you have temporary protection for displacement from Ukraine, a BSN and residence code 46, RMO (medical-care scheme for displaced people from Ukraine) covers qualifying healthcare without a premium or compulsory deductible, including when you work. Dutch basic insurance is not compulsory for you. If you work and voluntarily choose your own Dutch policy, its ordinary premiums, deductible and personal contributions apply.