The Eigen Risico: How the Dutch Health Insurance Deductible Actually Works
Every adult (18 and over) with Dutch health insurance pays the first 385 EUR of most healthcare costs themselves each year before the insurer covers the rest. This mandatory eigen risico has been frozen at 385 EUR since 2016, but on Budget Day (15 September 2026) the government announced it will rise to 400 EUR in 2027 through normal indexation, with a further 60 EUR increase postponed to 2028. The 2027 amount is still to be formally set by ministerial regulation. You can voluntarily raise it further, in steps of 100 EUR up to 500 EUR extra (885 EUR total in 2026, 900 EUR in 2027), for a lower monthly premium, worth up to roughly 282 EUR a year in 2026 depending on the insurer. GP visits, maternity and midwife care, district nursing, and all care for children under 18 are exempt and never count toward it. If your insurance starts partway through the year, which is the normal situation for most newcomers, insurers generally prorate the amount for the part of the year you're covered rather than charging the full 385 EUR (Zorginstituut Nederland confirms proration for people turning 18 mid-year, so check the exact amount with your insurer).
The Official Rule
Every adult with Dutch health insurance has a mandatory deductible, known as the eigen risico, on their basic package (basisverzekering). According to Rijksoverheid.nl, the government’s own portal, you pay the first 385 EUR of most healthcare costs yourself each calendar year before your insurer starts covering the rest. It resets every January 1, regardless of how much of it you used the year before.
This isn’t a new or unusual number. The mandatory deductible has been frozen at 385 EUR since 2016, making 2026 the eleventh consecutive year at the same level. That freeze is politically significant, and, as covered further down this page, it’s also about to end.
What Counts, and What’s Exempt
Not all healthcare spending touches your deductible. Zorginstituut Nederland, the official body that defines what’s covered under the basisverzekering, lists a specific set of exemptions that never count toward the 385 EUR, no matter how much you use them:
- GP (huisarts) visits and consultations
- Maternity and midwife care (verloskundige zorg, kraamzorg)
- District nursing (wijkverpleging)
- Chain care programs for chronic conditions like type 2 diabetes, COPD, and cardiovascular risk (ketenzorg)
- Smoking cessation programs
- Combined lifestyle interventions
- Psychiatric intake consultations
- Organ donation follow-up care and related travel costs
- All care for children under 18, across the board, not just specific services
Everything else in the basic package, hospital stays, specialist appointments, prescription medication, ambulance transport, and most diagnostic tests, does count. If you’re budgeting for your first year in the Netherlands, the practical takeaway is that seeing a GP costs you nothing toward the deductible, but a referral from that GP to a specialist likely does.
The 2026 Numbers, and Why 2027 Looks Different
| Deductible level | Total amount | Typical annual premium discount |
|---|---|---|
| Mandatory only (default) | 385 EUR | None, this is the baseline |
| Mandatory + 100 EUR voluntary | 485 EUR | Varies by insurer, a fraction of the maximum |
| Mandatory + 300 EUR voluntary | 685 EUR | Varies by insurer |
| Mandatory + 500 EUR voluntary (maximum) | 885 EUR | Up to about 282 EUR/year with some insurers, as low as 60 EUR/year with others |
You can raise your deductible voluntarily in steps of 100 EUR, up to a maximum of 500 EUR extra, bringing the ceiling to 885 EUR total. According to Overstappen.nl’s 2026 comparison of insurer discounts, the premium discount for taking the full 500 EUR increase is not standardized across insurers: it ranges from as little as 60 EUR a year with some providers up to roughly 282 EUR a year (about 23.50 EUR a month) with others, a gap of over 200 EUR a year for choosing the same deductible level with a different company.
The 385 EUR freeze is ending. According to the Dutch government’s Budget Day 2026 announcement, the mandatory deductible rises with inflation from 385 EUR to 400 EUR in 2027. The 2027 VWS budget says the cabinet has postponed its earlier plan for an extra 60 EUR increase to 2028, and that it is preparing to cap the deductible at 150 EUR per specialist-care treatment from 2028, so a single expensive procedure would not use up your whole deductible at once. The exact 2027 amount is still to be fixed by ministerial regulation before 1 January 2027, and the 2028 plans are announced intentions, not enacted rules, so treat them as a direction rather than a settled fact. The voluntary extra stays at up to 500 EUR, so the maximum total in 2027 would be 900 EUR.
Mandatory eigen risico by year, EUR (2027 is the government's announced amount, formal regulation pending)
Photo by Kindel Media on Pexels
If You Arrive Partway Through the Year
This is the detail that matters most for newcomers, and it’s genuinely good news: you generally don’t pay the full 385 EUR if your Dutch health insurance only starts partway through the calendar year. Zorginstituut Nederland confirms the deductible is calculated pro rata for people who turn 18 mid-year, and Dutch insurers’ policy terms apply the same days-based calculation when a policy starts partway through the year. Someone whose coverage starts in October, for example, is looking at roughly a quarter of the full amount for that first partial year, not the whole 385 EUR. Confirm the exact figure with your insurer.
This matters because most of SettledIn’s readers fall into exactly this situation: you’re required to arrange Dutch health insurance within 4 months of registering in the BRP, and for most newcomers that registration happens well after January 1. Don’t assume you owe the full annual figure when you sign up mid-year, and don’t let an insurer’s estimate go unquestioned if it looks like they’ve charged you the full 385 EUR for a partial year.
What Real People Flag
Expat-focused resources describe two recurring points of confusion that are worth knowing before your first bill arrives. First, per Healthcare for Internationals’ explainer, insurers don’t always proactively itemize which portion of a bill is deductible versus insurer-covered, so it’s worth requesting a detailed breakdown if a bill looks larger than expected rather than assuming the full amount is correct. Second, unplanned care like an ambulance callout or an emergency room visit still counts toward the deductible even though it wasn’t a choice you made in advance, which catches people off guard if they were mentally budgeting only for planned appointments.
The broader, low-stress version of this advice from Dutch comparison sites and insurers alike: track your own healthcare spending loosely across the year, because once you’ve hit 385 EUR (or your voluntary ceiling), everything else covered by the basisverzekering is free until January 1 resets the count.
Step by Step
- Check your current deductible level when you sign up for or review your zorgverzekering. The default is the mandatory 385 EUR unless you’ve actively opted into a higher voluntary amount.
- If you’re arriving mid-year, ask your insurer to confirm your prorated amount rather than assuming you owe the full 385 EUR for a partial first year.
- Decide whether raising it voluntarily makes sense for you, weighing your expected healthcare use against the premium discount, which varies meaningfully between insurers for the same 500 EUR increase.
- Remember GP visits, maternity care, district nursing, and all under-18 care are exempt when you’re estimating what you’ll actually pay out of pocket in a typical year.
- If you switch insurers mid-year, settle any deductible balance you still owe with your previous insurer rather than assuming it disappears.
- Note the 2027 change if you’re planning multi-year budgeting: the government has announced 400 EUR for 2027, with the formal regulation still to follow.
What You’ll Need
- A BSN and an active Dutch basisverzekering policy, since the eigen risico only applies once you’re enrolled.
- Your insurer’s app or online portal (most major insurers offer one) to track how much of your deductible you’ve used during the year.
- Documentation of your arrival or BRP registration date, useful if you need to confirm a prorated first-year amount with your insurer.
Compliance Note
This page explains the general eigen risico framework, 2026 figures, and the announced 2027 change as published by Dutch government sources, current as of October 2026. It is not personal financial or medical advice, and the 2027 figure is the government’s announced amount and the 2028 plans are announced intentions, so they may still change. Confirm your own deductible level, prorated amount, and any bill you’re questioning directly with your health insurer or the Zorginstituut Nederland before relying on any figure here.
FAQ & Common Pitfalls
Does the eigen risico apply to dental care or physiotherapy?
Not directly, because those aren't part of the standard basisverzekering for adults in the first place. Adult dental care and physiotherapy are only covered if you've bought optional supplementary insurance (aanvullende verzekering), and that supplementary coverage has its own separate terms, it isn't subject to the Zvw eigen risico at all. What the eigen risico does apply to is most basic-package care: hospital treatment, specialist visits, prescription medication, and ambulance transport are common examples.
If I only use 100 EUR of care this year, do I get the rest of the 385 EUR back?
No. The eigen risico isn't a deposit you get refunded, it's simply the ceiling on what you pay yourself. If your actual eligible healthcare costs for the year come to 100 EUR, you pay that 100 EUR and nothing more, the insurer covers everything after that point for the rest of the year. You only "use" as much of the 385 EUR as your actual costs require.
I'm arriving in the Netherlands in October. Do I really only pay part of the 385 EUR?
Generally yes. Zorginstituut Nederland confirms that the deductible is prorated for people who turn 18 partway through the year, and Dutch insurers' policy terms apply the same days-based calculation when a policy starts or ends mid-year. In practice this means an October arrival is looking at roughly a quarter of the 385 EUR figure for that partial first year, though you should confirm the exact amount with your chosen insurer when you sign up.
Can I switch insurers to avoid paying a deductible I already owe?
No. If you've used part of your deductible with your current insurer and still owe money for it, switching to a new insurer doesn't erase that debt, your old insurer still collects what you owe, usually with a payment plan available if needed. What does happen automatically is the reverse case: if it turns out you paid more eigen risico than your actual care required, you get the overpaid amount refunded.
Is raising my voluntary deductible actually worth it?
It depends entirely on how much healthcare you expect to use. If you're healthy, rarely see a specialist, and have savings to cover an unexpected 885 EUR bill, the premium discount, worth up to roughly 282 EUR a year with some insurers in 2026, can be a straightforward win. If you have a chronic condition, take regular prescription medication, or would struggle to cover an 885 EUR bill in a bad year, the lower monthly premium usually isn't worth the risk. Comparison sites note the discount itself varies significantly between insurers for the same 500 EUR increase, so it's worth checking your specific insurer's offer rather than assuming a flat rate.