Dutch health insurance for Australians

There's no Medicare-style free ride in the Netherlands: if you live or work here, you buy your own basic health insurance, and the clock starts ticking the day you arrive.

The short version

Anyone who lives or works in the Netherlands must take out Dutch basic health insurance (basisverzekering) within four months, backdated to the day the obligation started [1].
Every adult pays a compulsory excess (eigen risico) of up to €385 a year in 2026. GP visits and care for under-18s don't count towards it [1].
Low and middle earners can get a healthcare allowance (zorgtoeslag). In 2026 the income limit is €40,857 for singles and €51,142 combined for couples [2].
Skip insurance and the CAK will find you, fine you twice and then insure you itself, taking the premium straight from your pay [3][4].
Australia does have a Reciprocal Health Care Agreement with the Netherlands, but it's for visitors. Once you live here, it doesn't replace Dutch insurance [5][6].

Why Australians get caught out

At home, Medicare is funded through tax and the levy, and you only think about private cover for extras or to dodge the Medicare Levy Surcharge. The Dutch system flips that. Basic cover is private insurance, sold by competing insurers, but the contents of the basic package are set by law and every insurer must accept you, whatever your age or health.

So the big decisions are not whether you're covered for a GP or a hospital stay. They're which insurer, which policy type, whether you want extras, and how much of the excess you're willing to carry.

The other surprise is that the obligation applies to residents and workers, not just Dutch citizens. Kennismigrants, partners on a family visa, freelancers and working holiday makers who take a job here are all in the same boat [1][4].

The four-month deadline and what happens if you miss it

You have four months from when you start living or working in the Netherlands to take out a policy [1]. That isn't a grace period with free cover. If you sign up in month three, the policy is backdated and you pay premiums for the earlier months too [4]. Take it out on time and your cover should run from your first working day [1].

Miss the deadline and the process is fairly mechanical. The CAK, the public body that tracks uninsured people, matches population records against insurer records [3].

Stage	What happens
Letter from the CAK	You're told you appear to be uninsured and must act in time [3]
First fine	A fine that runs into hundreds of euros [4]
Second fine	A further fine if you still haven't insured [3][4]
CAK insures you	The CAK takes out a policy on your behalf and withholds the premium from your salary or benefits for 12 months [3]

On top of the fines, you'd still owe backdated premiums, and any care you used in the meantime may land on you [1]. Insuring in week one is much cheaper than any of that.

If you're only visiting first

Plenty of Australians do a recce trip before the move. This is where the Reciprocal Health Care Agreement helps. Smartraveller confirms that Australia has one with the Netherlands, and Services Australia says visitors can get essential care that can't wait until they get home, within 12 months of arrival [5][6].

To use it, you apply to Zilveren Kruis for an A111 Certificate of Eligibility, with a copy of your Medicare card and passport [6]. Adult non-specialist dental care and repatriation to Australia aren't covered, so you still want travel insurance [6]. Once you register as a resident and start work, you're in the Dutch system and must buy a Dutch policy.

What the basic policy covers and costs

Natura, restitutie or a mix

Every basic policy covers the same legal package: GP care, hospital and specialist care with a referral, maternity care, prescription medicines on the approved list, mental health care, physiotherapy for some conditions and more. Policies differ in how they pay:

Natura (in-kind): the cheapest type. Full cover at providers your insurer has contracts with. Go to a non-contracted provider and you pay part of the bill yourself [7].
Restitutie (reimbursement): costs more, but gives you a free choice of provider, up to market rates.
Combinatie: contracted providers in some areas, free choice in others.

In Amsterdam most hospitals and GPs contract with most big insurers, so a natura policy works fine for many people. Check your preferred hospital and any specialist you already see before you choose.

Premiums

Insurers set their own premiums each year and announce them in November. As one 2026 example, Glider's basic in-kind policy cost €166.80 a month [7]. Shop around: the price gap between insurers for the same legal package can be noticeable. Children under 18 are insured free on a parent's policy, but you still need to register them with the insurer [7].

Separately, employees pay an income-related health contribution through payroll. You'll see it on your payslip, and it's not the same as your monthly premium.

Extras (aanvullende verzekering)

Adult dental, more physiotherapy, glasses and some alternative therapies sit outside the basic package. You can buy add-ons from your insurer. If you had extras with an Australian fund, compare like for like: Dutch dental extras often cap at modest annual amounts.

The eigen risico: your annual excess

The eigen risico is the first slice of covered care you pay yourself each calendar year. In 2026 it's €385 [1]. Think of it as a gap you meet once a year, then you're covered for the rest of the basic package.

Care	Counts towards eigen risico?
GP visits	No [1]
Children under 18	No excess at all [1]
Maternity care (kraamzorg)	No, though a separate own contribution applies [8]
Hospital, specialists, lab tests, most medicines	Yes
Care you don't use	Nothing to pay [1]

You can also choose a voluntary higher excess, in fixed steps above the €385, for a lower premium. That only makes sense if you're healthy and have the cash on hand. One blood test or specialist visit can use up most of the standard €385.

Most insurers let you pay a large excess bill in instalments if it arrives all at once. Ask before it goes to collections.

Zorgtoeslag: the healthcare allowance

If your income is modest, the government helps with the premium through zorgtoeslag, paid monthly by the Belastingdienst's benefits office [1][2].

In 2026 you may qualify if your annual income is no more than €40,857, or €51,142 combined with an allowance partner [2]. There are other conditions, including your assets and your residence status, so use the official calculator before you claim.

Two warnings. First, it's paid in advance on an estimate. If your income ends up higher, you pay it back. Australians on a 30% ruling salary or a mid-year start often get this wrong. Second, you claim at toeslagen.nl with DigiD, so you need your BSN and login sorted first.

Getting covered: step by step

Register at the gemeente and get your BSN. Insurers need it, and so does the CAK's matching.
Decide policy type. Natura if you're happy with contracted providers; restitutie if you want free choice.
Compare insurers and extras. Use the insurers' own sites or independent comparison tools. Read what's actually in each add-on.
Sign up within four months. Choose a start date that matches the day you started living or working here [1].
Pick your excess. Standard €385 or a voluntary higher one [1].
Claim zorgtoeslag if eligible. Do it via toeslagen.nl with realistic income figures [2].
Register with a huisarts. Your policy is half the job. You also need a GP before you're sick.

Each year you can switch insurer around the year's end, after the new premiums come out [7].

The Australian side

Medicare is for Australian residents. Once you move to Amsterdam for good, your Medicare enrolment doesn't follow you, and you can't use it to pay Dutch bills. Services Australia's Reciprocal Health Care Agreement pages are about visits, not living abroad [6].

If you hold Australian private health insurance, look at suspending rather than cancelling it. Many funds let you pause cover while overseas and keep your waiting periods, which matters if you return. If you plan to come home one day, also read up on the Lifetime Health Cover loading before you drop hospital cover.

Want to know which insurer other Aussies picked and why? Ask in Cooee Netherlands, our Facebook group for Australians in the Netherlands. Members compare policies every November when the new premiums land.

For emergencies, the Netherlands uses 112, and the Australian Embassy is in The Hague [5].

Dutch health insurance: the basic policy, eigen risico and the four-month deadline