Expat insurance and health insurance in the Netherlands

The Netherlands has no public social security system for healthcare in the French sense: since the 2006 reform, anyone who resides or works in the country must take out basic health insurance (zorgverzekering, or basisverzekering) with an approved private insurer (Zilveren Kruis, VGZ, CZ, Menzis, among others). These insurers are required to accept any applicant for the basic care package, at an identical rate for all policyholders of the same contract, with no selection based on health status: the Dutch Healthcare Authority (NZa) oversees this regulated competitive framework.

The GP (huisarts) is the mandatory entry point into the system: any specialist consultation at a hospital in principle requires a prior referral, except in an emergency. GP consultations are exempt from the annual deductible. The CAK (Centraal Administratie Kantoor) is the public body responsible for checking that every resident is properly insured and for managing cases of missing cover; municipalities in parallel manage public health and prevention at local level. Dental and optical care remain outside the basic package for adults (under-18s are covered), as does part of physiotherapy.

• EU citizen: no visa required. Registering with the municipality (BRP register) upon settling in practice triggers the insurance obligation.
• Taking out zorgverzekering: mandatory within 4 months of starting residency or employment in the Netherlands. If taken out within this deadline, cover applies retroactively to the affiliation date, with no loss of rights; beyond this deadline, no retroactivity is granted.
• Lack of insurance: the CAK first sends a formal notice giving 3 months to regularise the situation. Without a response, a first fine of €529.74 (2026) is applied, then a second identical fine after a further 3 months. Still without cover, the CAK enrols the person automatically for 12 months, at a premium increased by 120% of the standard premium (≈€172.70/month in 2026), deducted directly from salary or a benefit. Care received during the uncovered period remains entirely at the patient's expense, with no possible retroactive reimbursement.
• Seconded employee: for up to 24 months (extendable), stays on the French scheme via the A1 form, exempt from Dutch zorgverzekering during the secondment.
• Student: the EHIC is enough for a temporary stay (such as Erasmus); for a long-term enrolment, cover valid for the entire length of stay is required and an student insurance on top is in practice recommended depending on status.
• Retiree: S1 form from your French pension fund before departure, for cover by a Dutch insurer with no new contribution of your own.
• Zorgtoeslag (healthcare allowance): a state contribution towards the premium, up to €129/month for a single person or €246/month with a qualifying partner (2026), subject to income conditions (≤€40,857 alone, ≤€51,142 as a couple) and assets.

As the Netherlands is an EU member, there is no classic bilateral agreement with France: coordination runs through EU regulations 883/2004 and 987/2009, as with other member states.

• Temporary stay: the EHIC allows care to be covered under Dutch rules; the healthcare provider is not obliged to bill the insurer directly, so paying upfront and being reimbursed later remains possible.
• Secondment: A1 form, staying on the French scheme for up to 24 months (extendable), exempt from Dutch zorgverzekering.
• Long-term move: mandatory switch to zorgverzekering; S1 form for a retiree, with no new contribution of their own.
• The EHIC covers neither repatriation, nor planned care, nor a long-term move.

1. Before departure: notify the French agencies of your departure (CPAM, CAF, France Travail, pension funds).
2. Seconded employee: request the A1 form from your French fund before departure.
3. Retiree: request the S1 form from your pension fund before departure.
4. On arrival: register with the municipality (Basisregistratie Personen, BRP), in practice a prerequisite for affiliation.
5. Within 4 months of settling: take out a basic zorgverzekering with an approved insurer, to keep the retroactive effect.
6. Check eligibility for the zorgtoeslag with the Belastingdienst (Dienst Toeslagen), subject to income conditions.
7. Register with a local huisarts (GP), the system's entry point.
8. Register with the roll of French nationals living abroad (Consulate General in Amsterdam or Embassy in The Hague).