What Dutch health insurance does not cover: adult dental care, most physiotherapy, glasses — and how to decide on supplementary insurance

The Dutch basisverzekering (basic health insurance) is broad. It pays for your huisarts (GP), for hospital treatment and for most prescription medicines. It does not pay for most dental care after your 18th birthday, for most physiotherapy or for glasses. Many newcomers find this out at the dentist, when the bill arrives. This guide covers what the basic package does include, the gaps in detail with real 2026 prices, the aanvullende verzekering (supplementary insurance) that can fill some of them, and the year-end window in which you can change your cover. Taking out insurance in your first months, the 4-month deadline and zorgtoeslag (healthcare benefit) are covered in the health insurance guide.

The government decides which care is in the basic package. Every insurer must offer that same package, and every insurer must accept you for it, whatever your age or health. An insurer sets its own premium, so the monthly price differs per insurer. Within one policy, the premium is the same for every customer. Children under 18 pay no premium at all. Comparing basic policies is therefore about price and service, not about the content of the package.

The package covers the care you are most likely to use. Care from your huisarts is covered in full and does not count toward the eigen risico (compulsory excess). Hospital care is covered: staying in hospital, operations and emergency care. Seeing a medical specialist is covered too, but you always need a referral from a doctor first, usually your huisarts. The package also covers most prescription medicines, mental health care (GGZ), care from a verloskundige (midwife) and kraamzorg (maternity home care). For children under 18 it covers regular dental care as well.

Covered does not always mean free. For most care other than the huisarts, the first €385 per year comes out of your own pocket through the eigen risico (the 2026 amount). That mechanism has its own guide: how the eigen risico works. This article is about a different kind of cost: care that the basic package does not pay for at all, and covered care that carries a fixed statutory contribution.

For children under 18, the basic package covers a wide set of treatments: the periodic check-up, tartar removal, fillings and surgical dental care. Braces are the main exception. Orthodontics falls under special dental care (bijzondere tandheelkunde), which the basic package only covers when there is a serious disorder or abnormality of the mouth. Braces for common crooked teeth are not covered; parents pay themselves or use a supplementary package.

From your 18th birthday, most dental care is no longer reimbursed. The periodic check-up is not in the basic package for adults, and neither are fillings or cleaning at your regular dentist. The basic package keeps three things for adults: surgical dental care (kaakchirurgie), x-ray examinations and removable dentures (kunstgebit). Even the dentures carry a statutory personal contribution (eigen bijdrage): you pay 25% of the cost of a full removable denture yourself, and 10% (lower jaw) or 8% (upper jaw) for a click denture on implants. Special dental care exists for adults too, again only for serious disorders or abnormalities of the mouth.

Dutch dental prices are regulated. The NZa (Nederlandse Zorgautoriteit, the Dutch Healthcare Authority) sets a maximum tariff for every treatment code, and a dentist may not charge more. Every dental bill lists these codes, so you can check any bill against the official list. The 2026 maximums for the most common treatments:

These maximums keep routine care affordable without insurance. One visit with a check-up, two small x-rays and 15 minutes of cleaning costs at most about €121. A year with two check-ups and one 15-minute cleaning costs at most about €107. One filling adds €60 to €79. Keep these numbers in mind for the supplementary-insurance decision later in this guide.

For adults, the basic package covers physiotherapy and exercise therapy (oefentherapie) in one main situation: your diagnosis is on the government's list of chronic conditions. The list names specific diagnoses, for example MS, Parkinson's disease, recovery after a stroke, and lymphedema. The list is about the diagnosis, not about how long a complaint lasts. Long-lasting back pain or muscle pain is not automatically on it. Your physiotherapist or insurer can tell you whether your diagnosis counts.

Even when your diagnosis is on the list, you pay the first 20 sessions per condition yourself. The basic package starts paying at session 21. According to the Consumentenbond (the Dutch consumers' association), a session costs about €43 when you pay it yourself. The first 20 sessions then come to about €860. For children under 18 the rules are milder: the basic package covers the first 9 sessions, the insurer can add up to 9 more if those are not enough, and children with a condition on the chronic list get all sessions covered.

A short list of conditions gets covered exercise therapy from the first session:

• Hip or knee osteoarthritis (artrose): at most the first 12 sessions of supervised exercise therapy.
• Claudicatio intermittens (leg pain from narrowed arteries): at most the first 37 sessions.
• Urine incontinence: at most the first 9 sessions of pelvic physiotherapy.
• COPD stage 2 or higher: all sessions of supervised exercise therapy are covered.
• Severe rheumatoid arthritis and severe axial spondyloarthritis (axSpA): long-term personalised exercise therapy is fully covered.

Outside these rules, physiotherapy is your own cost or a job for a supplementary package. Supplementary packages cover a fixed number of sessions per year, for example 6, 9, 12 or 20, depending on the package. The package stops paying when you reach that number.

Glasses are not reimbursed from the basic package. That applies to the lenses and to the frame. Contact lenses are only covered with a medical indication, for example a prescription above 10 dioptres or the eye condition keratoconus. Even then you pay a statutory contribution of €66 per lens. Children under 18 can get glasses lenses partly reimbursed in a small set of medical situations. A normal pair of glasses for near-sightedness is your own cost, or something a supplementary package can partly pay.

Contraception follows an age rule. Under 21, contraceptives such as the pill are covered by the basic package. From age 18 the cost first counts toward your eigen risico. From your 21st birthday you pay for contraception yourself. Narrow medical exceptions exist, for example endometriosis or anaemia caused by heavy menstrual bleeding.

Next to care that is simply not covered, some covered care carries an eigen bijdrage. This is a separate mechanism from the eigen risico. The eigen bijdrage is a fixed share or amount for specific care, set by the government. You pay it first; the rest of the bill can then also count toward your eigen risico. The main amounts for 2026, from the official list kept by Zorginstituut Nederland:

When you read a policy, keep three cost types apart. Some care is not covered at all: adult dentistry, most physiotherapy, glasses. Some covered care has an eigen bijdrage: the table above. And most covered care first counts toward the eigen risico of €385.

An aanvullende verzekering is a separate, voluntary contract next to your basic policy. Insurers offer packages for dental care, physiotherapy and other care the basic package leaves out. Each insurer decides the content and the premium of its own packages, and how much a package reimburses differs per insurer. You do not have to buy the supplementary package at the same insurer as your basic policy. And if you move your basic policy to another insurer, your old insurer may not cancel your supplementary policy for that reason.

The acceptance rules are the big difference with the basic package. For the basic package, every insurer must accept you. For supplementary packages there is no acceptance duty: an insurer may refuse you, may ask about your health before accepting you, and may apply a waiting period before some cover starts. This matters for timing: an application made after a treatment is already planned can be refused. The common problems section returns to this.

Decide with two numbers side by side: the yearly premium of the package, and the price of the care you expect to use. The NZa maximum tariffs make the dental side easy. Two check-ups plus one 15-minute cleaning cost about €107 per year at 2026 tariffs. If a dental package costs more than that per year and your teeth are healthy, paying the dentist directly is cheaper. Insurance starts to make sense when you expect real costs: crowns, root canal treatments, many physiotherapy sessions. Check the package's yearly reimbursement maximum against those expected costs, because a package never pays more than its maximum.

Health insurance runs per calendar year, and the guaranteed change moment is the year end. Cancel your current policy by 31 December at the latest. You then have until 1 February to take out a new policy, and the new policy works retroactively from 1 January, so no gap appears. Insurers also offer an overstapservice (switching service): take out the new policy by 31 December and the new insurer cancels the old one for you. For supplementary packages the insurer sets its own conditions, so do not count on adding or upgrading a package in the middle of the year.

For questions about how the system works, or for a complaint about an insurer, the SKGZ (the impartial complaints and disputes body for health insurance) provides information in English and handles disputes with insurers. Phone from the Netherlands: 0800 64 64 644.

In many countries, the public insurance that covers the hospital also covers the dentist. The Dutch basic package does not, from age 18, so the first check-up after arrival produces a real bill. The bill is normally correct. What you can check: every treatment on a Dutch dental bill has a code, and the NZa maximum tariff for that code is the most the dentist may charge. For children the situation is different: check-ups, fillings and tartar removal are covered until 18, and children pay no premium.

Two rules cause this. A supplementary package pays for a fixed number of sessions per year, so session 13 of a 12-session package is fully your own cost. Ask your insurer how many covered sessions you have left before you start a series of treatments. The second rule is the chronic list. If your diagnosis is not on it, the basic package pays nothing, however long the complaint lasts. If it is on it, you still pay the first 20 sessions of that condition yourself, and the basic package only starts paying at session 21.

An insurer may refuse you for a supplementary package, ask health questions first, or apply a waiting period. A dental package taken out in December is therefore not a reliable way to pay for implants your dentist planned in November. Supplementary insurance works for costs you do not know about yet. For a treatment that is already planned, ask the insurer directly whether it would be covered and from when, and compare the price of paying yourself before you sign anything.

Emergency dental care for adults follows the normal dental rules. The basic package only covers surgical dental care, x-ray examinations and dentures. An evening visit to an emergency dental clinic for a broken or infected tooth is therefore your own bill, unless a supplementary dental package pays part of it. Hospital care is different. Emergency care at the hospital (spoedeisende hulp) is covered by the basic package, and so is surgical dental care after, for example, an accident. For that hospital care you pay the eigen risico, not the full bill.

Three related guides continue from here. The huisarts guide explains how GP care and referrals work in practice. The eigen risico guide explains the €385 excess that applies to most covered care. And if money is tight, check the toeslagen overview: zorgtoeslag helps pay the monthly premium of the basic package, though it does not change what the package covers.