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.