Health insurance

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Health insurance


Last modified: 23 April 2015

On 1 January 2006, the Health Care Insurance Act (Zorgverzekeringswet) entered into force. This new act has put an end to the difference in premiums paid under the Compulsory Health Insurance Act (Ziekenfondswet) and private insurance schemes. Anyone who is insured under the Exceptional Medical Expenses Act (Algemene Wet Bijzondere Ziektekosten, AWBZ), with the exception of military personnel in active service and conscientious objectors for the purposes of the AWBZ, will be obliged to take out basic insurance with a care insurer. Basically this means that if you are insured for social security in the Netherlands, that you also fall under the Dutch health insurance regulations. You are not insured if you have an A1 declaration showing that you remain insured in the country where you were transfered from by your (foreign) employer and you work in the Netherlands temporarily,


For the basic insurance you will have to pay a premium to the insurer. This is known as the nominal premium. Depending on your income and family situation, you may be eligible for an allowance in respect of this premium: the health care allowance.

In addition to the nominal premium, an income-related contribution will be charged (from the employer). The Tax authorities have been designated as the administration agency imposing and collecting the income-related contribution.

If you do not live in the Netherlands

The Health Care Insurance Act will also apply if you do not live in the Netherlands, but are insured under the AWBZ in the Netherlands. If this is the case, you are obliged to take out basic insurance, for which you have to pay the nominal premium and the income-related contribution. In addition, you may be entitled to a health care allowance. If any members of your family are insured under the AWBZ, they, too, will be obliged to take out insurance under the Health Care Insurance Act. This only concerns persons who are covered by the Dutch social security system by virtue of the Compulsory Insurance (Additional Categories of Persons) Decree (Besluit uitbreiding en beperking verzekeringsplicht), such as the families of members of the Dutch Diplomatic Service abroad or the families of other seconded Dutch civil servants.

If you are not compulsorily insured under the AWBZ in the Netherlands, an international social security regulation may be applicable. The Netherlands has agreed international social security regulations with the EU Member States, Bosnia-Herzegovina, Cape Verde, Croatia, Iceland, Liechtenstein, Macedonia, Morocco, Norway, Serbia-Montenegro, Switzerland, Tunisia and Turkey. In that case, you will be entitled to medical care in your country of residence, which country may pass on the costs of this care to the Netherlands. The Netherlands may subsequently ask you for a contribution. This also applies to any members of your family who are not compulsorily insured under the AWBZ. If an international social security regulation applies to you, you and your family members (if any) should report to the Health Care Insurance Board (College voor Zorgverzekeringen, CvZ). The CvZ will take care of registration and impose and collect the contribution.

The income-related contribution: on what income is it calculated?

The income-related contribution is calculated on the so-called "contribution income" (hereafter: income). This income is the total amount you receive in:

  • Taxable wages: if you are employed or receive social security benefits, pension benefits or annuity benefits from which payroll tax is withheld.
  • Taxable profits from business activities: if you run a business.
  • Taxable revenue from other activities: if you work as a freelancer, for example.
  • Taxable periodic benefits in money and kind: if you receive taxable periodic benefits in money and kind, such as alimony from your ex-partner or annuity benefits, from which no payroll tax is withheld.

Other income is not included in the contribution income. This means, for instance, that income from capital such as interest and dividends, and annuity benefits falling within Box 3 for income tax purposes, will be disregarded in determining the contribution income.

The income-related contribution

The income-related contribution is a percentage of your income. The contribution is calculated on income up to € 51,976. The premium is 6.95%, up to a maximum of € 2,520 per annum.

If you are employed your employer will pay the premium. If you have other sources of income, like freelance income you will have to pay the premium yourself. If you have to pay the premium yourself the percentage is reduced to 4.85%. A combination of premium paid by your employer and by yourself is possible, but this depends on how high the income from employment is compared to the maximum premium income of € 51,976. If the income from employment reaches this amount then you don't have to pay additional premium on for example your freelance income.

If you live abroad and are insured under the exceptional medical expenses insurance scheme (AWBZ), the percentage is the same as for a person living and working in the Netherlands.