Dutch basic health insurance is private but regulated: every insurer must accept you, at the same premium, whether you're 25 or 70, healthy or not. Average cost in 2026: €159.30 a month. For a 60-something American leaving the US market, that's the headline. Here's the rest.
Figures verified 8 July 2026Everyone who lives or works in the Netherlands must buy a basic policy (basisverzekering) from a private insurer. The government defines the package — GP care, hospital and specialist treatment, most prescription drugs, maternity, mental health — and insurers compete on price and service, not on risk selection. Quality is consistently among Europe's best. The full detail, including the sign-up process and what happens if you don't enrol, is in our step-by-step insurance guide.
The huisarts (family doctor) is the gatekeeper: no specialist, scan, or hospital referral happens without them, except in emergencies. Register with a practice near your address as soon as you arrive — some city practices have waiting lists, and unregistered patients are a poor fit for a system built around GP continuity. Expect a different style than North America: Dutch GPs are famously conservative with prescriptions and referrals. "Take a paracetamol and call back in two weeks" is a national cliché with real basis — and measurably good population outcomes.
The same as at 25 — that's the point. A couple pays roughly €319/month in premiums (2026 average), plus up to €385 each in deductible if you actually use specialist care or drugs, plus an income-related contribution (roughly 5–6% on pension or self-employment income up to a cap, billed by the Belastingdienst — exact rate depends on your situation). There is no Medicare-style enrolment window, no pre-existing-condition exclusion on the basic package, and no age cliff at 65. Supplementary dental and physio policies can apply their own acceptance rules — buy those early if you want them.
| Stage | What you need |
|---|---|
| Scouting visits (90/180) | Travel insurance from home. US Medicare does not cover you here; Canadian provincial plans pay little abroad. |
| First 4 months as a resident | Enrol in a basic policy — cover and premiums run retroactively from your registration date, so there's no gap and no reason to wait. |
| Settled resident | Basic policy (switchable every January), optional supplementary dental/physio, zorgtoeslag if your income qualifies. |
The 4-month rule, choosing among insurers, the €385 deductible, zorgtoeslag, and what basic cover excludes.
Read the guide →How registration works, waiting-list workarounds, and what to expect from Dutch GP culture.
What happens to your US Medicare when you leave, and why most people keep Part A.
Most visas require proof of cover before you apply. We'll match you with an expat health insurance specialist we've independently vetted for the Netherlands. Free, no obligation.