Eigen risico explained: the €385 deductible of Dutch health insurance, which care counts toward it, and why bills arrive months later

Dutch health insurance has two costs. The first is the monthly premium. The second is the eigen risico (mandatory deductible): the first part of your yearly care costs that you pay yourself. In 2026 that part is €385. Many newcomers first notice it when a surprise bill from their insurer arrives, months after a hospital visit. This guide explains how the eigen risico works, which care counts toward it, which care never counts, what a vrijwillig eigen risico (voluntary deductible) is, and how the eigen risico differs from an eigen bijdrage (statutory co-payment). It also covers what to do when €385 at once is too much. If you still need to take out insurance, the health insurance guide covers the policy itself and the 4-month deadline.

The verplicht eigen risico (mandatory deductible) is €385 per person in 2026. English insurer websites translate it as 'deductible' or 'excess'. It applies to everyone aged 18 or over with Dutch health insurance, and it runs per calendar year: from 1 January to 31 December. The first €385 of counting care costs in that year is yours. Above €385, the insurer pays covered care in full for the rest of the year. You only pay the eigen risico when you use care that counts, so in a year without such care you pay nothing.

An example. In March you have a blood test (€85) and in April a hospital consult (€500). You pay the €85 in full. Of the €500 bill you pay €300, because that fills your eigen risico to €385. Your insurer pays the remaining €200. From then until 31 December you pay no eigen risico, whatever counting care you use.

You do not pay the eigen risico at the hospital desk. The care provider sends its bill to your insurer. The insurer pays the provider and then charges your eigen risico share to you. That charge can arrive weeks or months after the care. The common problems section explains why the delay can be long.

Insured for only part of the year? Then your eigen risico for that year is lower. The Zorgverzekeringswet (Health Insurance Act) pro-rates it by the number of insured days. If your insurance starts on 1 August, you are insured for 153 of the 365 days of 2026, so your maximum for 2026 is about €161 instead of €385. Most newcomers' policies start partway through the year, so the first year's eigen risico is usually reduced.

The eigen risico only applies to care that the basisverzekering (basic package) pays for. Care outside the basic package, for example most dental care and physiotherapy for adults, is not insured under the basic policy at all. You pay the full price yourself, or a supplementary policy pays, and none of it touches your eigen risico. The coverage-gaps guide covers that side. Within the basic package, care that counts toward the eigen risico includes:

• Treatment in a hospital or clinic, including a visit to the spoedeisende hulp (emergency department)
• Medicines on prescription, including medicines your huisarts prescribes
• Blood tests and other lab tests, including tests your huisarts sends to a lab or hospital
• Care your huisarts refers you to, such as a medical specialist
• Mental healthcare (ggz), except the first exploratory conversation

A fixed list of basic-package care is exempt: it never uses your eigen risico. Rijksoverheid and Zorginstituut Nederland publish the list:

• Huisarts care, including the huisartsenpost (out-of-hours GP service)
• Verloskundige zorg (midwifery) and kraamzorg (maternity care); kraamzorg does carry an eigen bijdrage, explained below
• Wijkverpleging (district nursing at home)
• Ketenzorg (coordinated chronic care) for diabetes type 2, COPD and cardiovascular risk management
• The gecombineerde leefstijlinterventie (combined lifestyle intervention)
• A stop-smoking programme
• The verkennend gesprek (first exploratory conversation) in mental healthcare
• Follow-up checks and travel costs for organ donors
• All basic-package care for children under 18

Note the difference between the two urgent-care routes outside office hours. The huisartsenpost is huisarts care, so it is free of eigen risico. The hospital's emergency department is hospital care, so it does count. Call the huisartsenpost first for urgent problems when your own huisarts is closed. How the huisarts system and referrals work is covered in the huisarts guide.

You can raise the mandatory €385 with a vrijwillig eigen risico (voluntary deductible) of €100, €200, €300, €400 or €500. In return, the insurer gives a discount on the monthly premium of the basic insurance. With the maximum of €500 extra, your total risk is €885 per year: €385 mandatory plus €500 voluntary.

Whether this is a good deal depends on the care you expect. SKGZ, the official complaints and disputes body for health insurance, advises choosing a voluntary deductible only if you expect few care costs and can pay the full amount without problems. It is a poor fit if you use medicines every month, expect hospital care, or have no savings buffer: one unexpected treatment can cost you the full €885. Add up the premium discount for 12 months and compare it with the extra €500 you must pay if you do need care. When you compare policies, also check whether an attractive premium already includes a voluntary deductible.

Some care also has an eigen bijdrage (statutory co-payment). That is a different payment with a different rule. The eigen risico is one yearly amount that stops after €385. An eigen bijdrage is a share of the price of specific care, and it does not stop: you also pay it when your eigen risico is already used up. Rijksoverheid explains the difference with examples of care that carries an eigen bijdrage: kraamzorg, dentures (kunstgebit) and some medicines. For medicines, the eigen bijdrage is the part of the price above the reimbursement limit, capped at €250 per person per year.

When one bill carries both payments, the order is fixed. You pay the eigen bijdrage first. The rest of the bill then counts toward your eigen risico. The eigen bijdrage itself never fills your eigen risico. Kraamzorg is an example of the split: it is exempt from the eigen risico, but it does carry an eigen bijdrage.

There is no separate eigen risico bill in advance. Your insurer charges it after you use counting care, once it has received and paid the provider's bill. If €385 in one letter is a problem, call your insurer. Two arrangements are common. The first is a betalingsregeling (payment plan): you agree with the insurer to pay an existing eigen risico bill in instalments. The second is gespreid betalen (spread payment): you pay a fixed part of the eigen risico every month through the year, and the insurer refunds whatever you did not use. You arrange both directly with your insurer.

For planned care you can also know the cost in advance. Care providers must tell you before a treatment which tariff they charge and whether your eigen risico will be used; the NZa (Dutch Healthcare Authority) sets this information duty. So ask at the desk or during the consult: does this fall under my eigen risico?

Hospitals do not bill per visit. They bill per dbc (diagnose-behandelcombinatie): one package of all care for one diagnosis, from the first consult to the checks afterward. A dbc stays open for up to 120 days. Only after it closes does the hospital send the bill to your insurer, and only then does the insurer charge your eigen risico share. So the letter for a January visit can reach you in May or later. This is normal, not a mistake. Check the treatment date on the bill to see which visit it covers, and keep €385 reserved until the bills for a treatment have arrived.

Which year's eigen risico a hospital treatment uses depends on the start date of the dbc, not on the dates of your visits. Patiëntenfederatie Nederland (the national patient federation) states the rule: if the first dbc starts in 2025 and a follow-up dbc (vervolg-dbc) starts in 2026, the first counts toward your 2025 eigen risico and the follow-up toward 2026. This has two practical consequences. An appointment in February 2026 can fall under your 2025 eigen risico, because the dbc opened in December 2025. And a long treatment that crosses New Year can use your eigen risico in both years, when a follow-up dbc starts in the new year. If a bill seems to charge the wrong year, compare the dbc start date on the bill with the calendar year, and ask your insurer to explain before you dispute it.

A visit to the huisarts never uses your eigen risico. But what the huisarts orders is separate care with its own bill. The official page on huisarts costs gives blood tests as the example: the visit is free, and the blood test falls under your eigen risico. The same applies to medicines the huisarts prescribes, to tests the huisarts has done outside the practice, and to all care the huisarts refers you to, such as a hospital specialist. If costs matter to you, say so during the consult and ask whether the test or medicine falls under the eigen risico.

The eigen risico is one amount per calendar year, not per treatment, per condition or per hospital. Every counting bill draws from the same €385 until it is used up. After that, you pay no eigen risico for the rest of the year, including for new and unrelated care. On 1 January a new €385 starts. For hospital care that crosses New Year, the dbc start-date rule above decides which year is charged.

Three related guides continue from here. What Dutch health insurance does not cover covers the gaps in the basic package, such as adult dental care and physiotherapy: costs that are not eigen risico but simply uninsured. The huisarts guide explains registering with a GP and how referrals work. And the toeslagen overview explains zorgtoeslag (healthcare benefit), the monthly benefit toward your premium.