Health insurance when moving to the Netherlands: the checkpoints

The Netherlands regulates health insurance through statutory basic insurance (basisverzekering) that you take out with an insurer (zorgverzekeraar); the state determines the content and scope of the benefits package. An insurer must accept every person required to be insured for the basic insurance (acceptance obligation, acceptatieplicht).

Insured persons aged 18 and over bear a statutory deductible (verplicht eigen risico) per calendar year. Supplementary insurance (aanvullende verzekering) is voluntary; insurers set their own terms and reimbursements.

Ask the insurer how you get access to a GP and which benefits the basic package lists.

Basic insurance is compulsory for anyone insured under the Wet langdurige zorg (Wlz, Dutch long-term care act), that is, anyone who lives in the Netherlands or, without living there, is subject to wage tax in the Netherlands as an employee.

Under EU law, you are generally subject to the law of the state where you work, and otherwise to the law of your state of residence.

An insurer does not conclude basic insurance as long as the address given is not registered as a place of residence in the Dutch population register (BRP); exceptions apply where wage tax liability from work in the Netherlands is proven or where the SVB has issued a certificate. How you register with the municipality is something you clarify there.

If the basic insurance starts within four months of the start of the obligation, it takes effect retroactively from the start of the obligation. If someone is required to be insured but is not, the CAK (the Dutch collection body for health insurance) writes to them asking them to take out insurance within three months; after that come fines and finally an insurance contract concluded by the CAK.

EU citizens do not need a residence permit in the Netherlands and generally do not have to register with the IND (Dutch immigration authority); a valid passport or identity card proves lawful residence.

For a right of residence of more than three months, the Vreemdelingenbesluit (Dutch Aliens Decree) requires EU citizens who do not work to have sufficient means and insurance that fully covers medical costs in the Netherlands. Whether and how the municipality or the IND actually checks proof is something you clarify there before the move.

None of the sources read states which foreign policy is sufficient as a replacement; the SVB decides case by case. More on the policy at international health insurance.

Before you deregister (Abmeldung) in Germany, you clarify in writing what happens to your current insurance. The questions below apply to any destination country. They are questions, not legal advice: the answers are in your contract documents or come from the body you ask.

Three Netherlands topics you clarify in advance with your health insurer (Krankenkasse): the EHIC, a possible S1 (form for entitlement in the new country of residence) and the day your cover in Germany ends. The European Health Insurance Card (EHIC) applies only during a temporary stay in another EU country and only for public providers; when the habitual place of residence is transferred, the European Commission names the S1 form instead.

If you have statutory insurance: questions for your Krankenkasse

• What happens to my membership when I deregister in Germany, and on what date does it end?
• Can I suspend the membership or take it up again later, and under what conditions?
• What confirmation of my previous insurance periods do I receive, and how quickly?
• What applies to co-insured family members: who stays insured and who does not?
• Is an S1 an option for me, and who issues it?
• Until which day does my cover apply, so that there is no gap between Germany and the Netherlands?

If you have private insurance: questions for your insurer

• Does my contract end with the move, is it suspended or does it continue?
• Is there an Anwartschaft (a German option to keep certain rights in private insurance while abroad), and what is preserved under it? Ask about the difference between the small and the large Anwartschaft, and whether a new health assessment would be needed on a return.
• Does my contract apply in the destination country, and for how long at a stretch?
• Which documents do I receive in writing before I cancel?
• Does the policy apply in the Netherlands for the whole length of stay?
• Does the insurer confirm in writing until which day the cover runs?

Do not cancel any contract before it is clarified in writing what applies afterwards. We explain the connections on the pages Health insurance when emigrating and PKV and Anwartschaft. For families, there is more at Health insurance for the family abroad.

1. Waiting with the basic insurance

   If the basic insurance starts within four months of the start of the obligation, it takes effect retroactively from the start of the obligation. Ask the insurer in good time about the start date.

2. EHIC as a permanent solution

   The EHIC applies only to a temporary stay. Ask your health insurer (Krankenkasse) about the route for a change of residence.

3. Accepting a policy from Germany as a replacement

   Only cancel an existing insurance once the SVB has replied and you have the reply in writing. The sources are in the section “Options”.

4. Trying to get insurance before registering in the population register

   Clarify the order between the municipality and the insurer before you request the contract. The rule is in the section “Obligation and access”.