Health insurance in the Netherlands: the four-month rule

Who must insure

Everyone who lives or works in the Netherlands is legally obliged to take out standard health insurance, the basisverzekering (Government of the Netherlands). The standard package covers visits to the general practitioner, hospital treatment and prescription medicines. It is set by the government and is the same at every insurer, so the cover is the same whichever insurer you choose.

Extras are optional. Physiotherapy or dental care, for example, belong to additional insurance that you may add and that the law does not require.

When you must enrol

SKGZ, whose English pages explain Dutch health insurance for people coming from abroad, gives two rules (SKGZ, read 6 Oct 2026):

• anyone legally obliged to take out Dutch health insurance must enrol with an insurer within four months of arriving in the Netherlands;
• for employment, the basic Dutch cover must start on the first day of work.

If you are moving for a job, the second rule is the one that counts. Do not wait four months because the general rule allows it. Ask your employer which insurer and which date it expects, and arrange the policy before your start date.

Children

Children under 18 do not pay a premium for the standard package, but their parents must still register them with an insurer. For a newborn, the parents have four months from the birth to do it (Government of the Netherlands).

Help with the cost

People on a low income may be eligible for the healthcare allowance, which helps to pay for health insurance. The government’s page does not give the conditions, and we did not research the thresholds, so this guide does not print them.

What happens if you do not insure

The Central Administration Office, the CAK, tracks down people without insurance. The government’s page describes the sequence (Government of the Netherlands, people with no health insurance):

1. You get warnings and then two fines.
2. If you are still uninsured, the CAK takes out insurance for you and registers you with an insurer.
3. The standard premium is withheld from your salary, benefits or other income for 12 months.
4. If your income is irregular, you receive monthly payment forms.

There is no premium with retroactive effect, but you remain responsible for the costs of any medical care you had while you were uninsured. The page does not give the amounts of the fines, so we do not either.

If you stop paying

If you fall six months behind on premiums, the insurer reports you to the CAK. SKGZ says the CAK premium is then EUR 172.70 a month in 2026, which is more than a regular basic policy costs. The CAK deducts it from your wages or your healthcare allowance. Two more points matter:

• paying the CAK premium does not reduce what you owe the insurer;
• leaving the Netherlands does not end the obligation.

The conclusion is simple: set up the payment as a direct debit and keep your address and bank details current with the insurer.

A first-month checklist

1. Confirm the date your employer needs cover to start, and choose an insurer before it.
2. Register any children with an insurer and note the four-month deadline for newborns.
3. Check whether you qualify for the healthcare allowance.
4. Register your address with the municipality within five days of arriving (see our guide to registering in the Netherlands).
5. Keep proof of your policy with your other papers.

What we could not source

We did not find an official statement on whether a policy from your home country satisfies the Dutch duty, so this guide gives no view on it. We also did not research how insurers differ, and we did not look at the rules for short stays or students, which have their own conditions. ReloFinder does not give insurance advice. Ask SKGZ, your insurer or your employer.