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Health insurance without a BSN in the Netherlands

## Health insurance and the BSN explained

When you move to the Netherlands, one of the first questions is how health insurance works and what role the **BSN (Burgerservicenummer)** plays.

The BSN is your Dutch **citizen service number**, similar to a social security number in other countries. You will need it for everyday things like paying taxes, opening a bank account, and arranging healthcare.

Because the BSN connects you to government systems, it is also required for taking out **basic Dutch health insurance (basisverzekering)**, the mandatory plan for most residents. It is also required to sign up with the Digital ID. Knowing why this number matters, and what to do if you do not have one yet, will help you avoid being uninsured.

## Do you need a BSN to get Dutch health insurance?

In most cases, yes. To apply for **Dutch basic health insurance**, you must have a BSN and be registered with your municipality (you do this right after arrival when you have your Dutch address). The BSN links your policy to government records so that contributions and benefits are tracked correctly.

The Dutch Health Insurance Act (**Zorgverzekeringswet**) requires you to arrange insurance within four months of moving or starting work. Your policy should start from the date your obligation begins, not from when you sign the contract.

Without a BSN, you cannot take out the mandatory basic plan. This is why many newcomers look for alternatives until they are fully registered.

## Who must take out Dutch health insurance?

Most people who live or work in the Netherlands must be insured. If you are registered as a resident or if you earn income here, you are usually obliged to arrange **Dutch health insurance with a BSN**.

- **EU citizens** may use an **EHIC (European Health Insurance Card)** or **S1 form** at first, but must switch if they stay long term.
- **Non EU citizens** are expected to arrange Dutch health insurance as soon as they register and receive a BSN.
- **Visitors staying under four months** often do not need Dutch insurance.

For everyone else, Dutch health insurance is required by law.

## What happens if you do not get a BSN on time?

The **CAK (Centraal Administratie Kantoor)** checks whether people have health insurance. If you are required to be insured but do not act, the CAK will send a letter.

- After three months, you can be fined around four hundred euros.
- If you still do not arrange insurance, the fine may be repeated.
- Eventually, the CAK can register you with a default insurer for twelve months and deduct premiums directly from your income.

Delaying BSN registration or insurance can therefore become very costly.
[Find out more information in this video](https://www.youtube.com/watch?v=EZt36Ciy5nA).

## Who cannot get Dutch health insurance?

Not everyone is simply delayed in the process of being able to sign up for the Dutch Basic. Some groups are **not eligible** for Dutch basic health insurance at all. Here are some examples

- Many international students are not seen as residents under the Dutch Health Insurance Act. Even if they have a BSN, they cannot take out the basic plan. They need private or student health insurance instead.
- Individuals on a orientation year Visa
- Individuals who spend more than 185 days a year outside of the Netherlands
- Others, such as job seekers or short term workers, may need temporary cover until they are fully registered.

As a rule of thumb, if you have if you pay have to income tax or social security contributions in the Netherlands you need to get on the Dutch Public Insurance. You can always confirm your exact status with your municipality or official sources like: 

- [WLZ](https://www.svb.nl/en/the-wlz-scheme/assessment-of-your-wlz-insurance-position/apply-for-an-assessment-of-your-wlz-insurance-position) : You can request an assessment of **your WlZ insurance position** (compulsory insurance under the Dutch long-term care scheme)
- [CAZ Website](https://www.hetcak.nl/en/uninsured/): fInd more detailed information on cases when you are uninsured**

In the meantime, some people choose **expat health insurance in the Netherlands** that does not require a BSN or registered address.

## What should you do if you cannot register your address?

To receive a BSN, you first need to register your address in the **BRP (Basisregistratie Personen or municipal registry)**. Without a registered address, you cannot get a BSN and you cannot take out Dutch basic health insurance.

The housing shortage in the Netherlands makes this a common issue. Many newcomers struggle to find permanent accommodation. If you already have a BSN but later lose your address, the municipality may **de-register you**, which can also affect your insurance.

One possible solution is to ask about a **correspondence address (briefadres)**. This allows you to register at the address of a friend, family member, or even in some cases through the municipality itself. A correspondence address does not count as a permanent home, but it can help you keep your BSN active and avoid gaps in your health insurance.

The best advice is to stay in touch with your municipality, ask about temporary or correspondence registration, and keep your housing situation documented. While you wait for housing or re registration, you can stay protected by choosing **interim health insurance** that does not require a BSN or fixed address.

## How to get health insurance in the Netherlands

Here is the usual order of steps:

1. Register your address with the municipality.
2. Receive your BSN.
3. Apply for Dutch health insurance within four months of becoming obliged.

Prepare your passport, rental agreement, and work or study documents to speed up the process. If you are unsure whether you are required to take out Dutch insurance, consider temporary cover while you wait.

## How Feather helps expats stay covered

Arriving in the Netherlands without housing or waiting for registration can be stressful. **Feather offers expat health insurance** that you can take out without a BSN or permanent address.

It is designed for newcomers, students, freelancers, job seekers, and anyone in between. It provides EU wide protection, can be cancelled monthly, and can easily be upgraded to Dutch basic health insurance once you are eligible.

## Conclusion

Most people need a BSN to get Dutch health insurance. But delays, housing problems, or ineligibility can leave you without cover.

The key is to act early. Register as soon as you can, confirm your obligations, and avoid fines. If you are not yet eligible for Dutch basic insurance, an **expat health insurance plan in the Netherlands** can keep you protected until you are fully registered.

With the right steps, you can make sure you stay insured and start your life in the Netherlands with peace of mind.

Not sure if you are eligible? 

Strongly recommend for expats

Feather is the easiest platform to understand

I felt like I was in safe hands with Feather

[BP] Health insurance without BSN

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Dutch health insurance for freelancers (2026 guide)

Living and working as a freelancer in the Netherlands gives you a lot of freedom, but it also comes with responsibilities.

One of the most important ones is health insurance.

If you live here and earn income through self-employment, you are legally required to take out Dutch health insurance. It ensures you can access medical care when you need it and protects you from unexpected medical costs.

This guide explains everything clearly so you know exactly what is required, what it costs, and how to stay insured as a freelancer in the Netherlands.

**In this guide, you’ll learn:**

- Who counts as a freelancer in the Netherlands
- When freelancers must get Dutch health insurance
- Why some freelancers don’t need Dutch health insurance
- How to register step by step
- What coverage and costs to expect in 2026
- And how to choose a provider that fits your situation

## Who counts as a freelancer in the Netherlands?

In the Netherlands, a freelancer (*zelfstandige zonder personeel* or *zzp’er*) is anyone who works for themselves instead of an employer.

You are considered self-employed if you:

- Offer services or products independently
- Invoice clients directly
- Take financial and tax responsibility for your work

Common examples include consultants, designers, IT professionals, translators, and online creators.

To work legally as a freelancer, you need to:

- Register your business with the **Chamber of Commerce (KvK)**
- Pay income tax and VAT through the **Dutch Tax and Customs Administration**

Once you are registered, you are treated like any other resident when it comes to healthcare: you must take out at least basic health insurance within four months of moving or starting your business.

## Why freelancers need Dutch health insurance

Under Dutch law, known as the *Zorgverzekeringswet (Zvw)*, everyone who lives or works in the Netherlands must have at least basic health insurance (*basisverzekering*).

That includes freelancers, self-employed professionals, and independent contractors, even if you do not have a Dutch employer.

Health insurance is mandatory so that everyone contributes to and benefits from the same high-quality healthcare system. Without it, you would need to pay the full cost of any treatment yourself.

If you fail to register within four months of moving or starting your business, you may face fines and backdated premiums.

For a full overview of how the Dutch system works, see our [general guide](https://feather-insurance.com/en-nl/blog/health-insurance-netherlands-guide?utm_source=chatgpt.com).

## Why some freelancers don’t need Dutch health insurance

Not every freelancer is required to get Dutch health insurance immediately.

It depends on:

- Where you live
- Where you pay taxes
- And where you run your business

### If your business is based abroad

If your company and tax residence are outside the Netherlands and you only spend short periods here, you may not need Dutch health insurance. In that case, you can stay covered under your current plan or use a flexible international option like Feather expat insurance.

### If you are not yet officially registered

If you do not have a BSN (Citizen Service Number) or residence permit, insurers will not let you sign up for Dutch health insurance. While you wait, expat health insurance such as [**Feather**](https://feather-insurance.com/) keeps you covered. It is designed for freelancers and digital nomads who are temporarily living in the Netherlands and can be cancelled anytime once your Dutch plan begins.

### If you work across multiple countries

If you work across borders, your insurance depends on where your main business activity takes place. The Dutch social insurance office (SVB) can confirm which country’s system applies to you.

When in doubt, it is best to start with international coverage to avoid gaps, then switch to Dutch insurance once your status becomes official.

Sign up for expat health insurance

### Do you need Dutch health insurance if you freelance for foreign clients?

You usually need Dutch health insurance if you:

- Live primarily in the Netherlands
- Are registered with the Chamber of Commerce
- Pay Dutch income tax

If your main work or tax residence is abroad, you may stay insured there instead. The SVB can confirm which system applies to your situation.

If you are unsure or waiting for registration, stay covered through Feather expat insurance until you qualify for Dutch insurance.

If you live and pay taxes in the Netherlands, you need Dutch insurance. If not, confirm your situation before switching.

And if you have any questions, [contact us](https://wa.me/31653287826).
## How Dutch public health insurance works

The Dutch basic health insurance plan (*basisverzekering*) is the foundation of the healthcare system. It is required for anyone living or working in the Netherlands and guarantees access to essential medical care.

Every insurer must accept you for this plan, regardless of your age, income, or health history. The coverage is defined by the government each year, so all insurers provide the same core benefits — the only differences are in price, customer service, and how they process claims.

The Dutch healthcare system works on a **mixed model**:

- The government decides what is covered in the basic package and monitors quality.
- Private insurers handle administration and compete on price and service.
- Everyone pays a monthly premium and a small income-based contribution, which together fund the national system.

### What it covers

The basic plan always includes care that is considered essential and medically necessary:

- Visits to your general practitioner (GP)
- Specialist and hospital care
- Prescription medicines
- Mental health services
- Maternity and newborn care
- Emergency care and ambulance transport

This ensures that everyone in the Netherlands — including freelancers — can access doctors, hospitals, and medication without major financial risk.

### What you pay

- A monthly premium of around **€155–€165** in 2026
- An annual deductible (*eigen risico*) of **€385**, which you pay for certain treatments before your insurer covers the rest
- GP visits, maternity care, and all care for children under 18 are **exempt from the deductible**

You can choose a **higher deductible** (up to €885 in 2026) to lower your monthly premium. This is common among healthy freelancers who rarely visit the doctor, but it means you pay more out of pocket if you need hospital or specialist care.

If you receive treatment, the insurer usually pays the provider directly. You only pay the portion within your deductible.
### Supplemental insurance

Supplemental insurance (*aanvullende verzekering*) is optional coverage that adds extra benefits not included in the basic plan. You can choose it when you apply for health insurance or add it later, usually at the start of a new calendar year.

Common add-ons include:

- **Dental care for adults:** routine checkups, cleanings, and fillings (not covered under the basic plan)
- **Physiotherapy:** useful if you need regular treatment for back or joint issues
- **Optical care:** partial reimbursement for glasses, lenses, or eye exams
- **Alternative treatments:** such as acupuncture or chiropractic care
- **Extended maternity or birth-related care:** additional home visits or recovery support

Each insurer offers different combinations of these add-ons. Prices vary depending on what you include, your age, and your health status.

It is important to know that insurers are not required to accept everyone for supplemental insurance. They may ask health-related questions or decline applications if they consider you higher risk.

Freelancers often choose a modest supplemental package, for example one that covers basic dental care and a few physiotherapy sessions each year, and skip higher-cost extras they are unlikely to use.

If you prefer simplicity, you can start with only the basic plan and add supplemental coverage later once you know what kind of care you need.
## **What’s the difference in health insurance payments for employees and freelancers?**

Everyone in the Netherlands is covered under the same health system — but how you pay for it depends on how you work.

### **If you’re employed**

Your health contributions are handled automatically through your salary.

Your employer pays a percentage straight to the tax authority on your behalf, and you only pay the monthly premium for your basic plan directly to your insurer.

So, in short:

- Contributions are managed through payroll
- You don’t need to take extra action
- Your employer covers the income-based part

### **If you’re self-employed or freelance**

You handle everything yourself. That means you pay:

- A monthly premium to your chosen insurer
- An income-based contribution (*inkomensafhankelijke bijdrage*) of around **5.5%**, calculated on your profit (up to a set maximum)

The Tax and Customs Administration (*Belastingdienst*) works this out through your annual tax return and adds it to your income tax assessment.

Because freelancers don’t have an employer to pay this contribution, the total cost can feel a bit higher.

That said, you can deduct part of your health insurance and related costs when calculating taxable income — which helps balance things out.
## Deadlines and the four-month rule

If you become a resident or start freelancing in the Netherlands, you have four months to take out health insurance.

If you apply within that period, your coverage can be **backdated** to your arrival or start date. Apply later, and coverage only starts from your application date.
## How to get Dutch health insurance (step by step)

### 1. Register with the Chamber of Commerce (KvK)

Register your business with the **Kamer van Koophandel (KvK)**. This connects you to the Dutch Tax and Customs Administration.

### 2. Obtain your citizen service number (BSN)

Register your address with your local municipality (*gemeente*) to receive your BSN. You need this number before you can apply for insurance.

### 3. Compare and choose a provider

Compare insurers using [Zorgwijzer.nl](https://www.zorgwijzer.nl/) or [Independer.nl](https://www.independer.nl/). Every provider offers the same basic benefits but differs in:

- Monthly premium
- Deductible options
- Digital tools and English support
- Policy type (*natura* or *restitutie*)

### 4. Apply for coverage

Apply online with your BSN, address, and bank details. Remember the four-month rule.

### 5. Register with a general practitioner (GP)

Once your policy starts, choose a GP. They are your first contact for most health issues and referrals. If practices are full, your insurer can help you find one.

### 6. Stay insured while waiting for eligibility

If your registration is still being processed, you cannot yet join the Dutch public system. During this time, [**Feather expat insurance**](https://feather-insurance.com/) keeps you covered until your Dutch plan starts.

## Health insurance costs for freelancers in 2026

| Type | Details |
| --- | --- |
| **Monthly premium** | €155–€165 (average) |
| **Annual deductible** | €385 standard, up to €885 optional |
| **Income-based contribution** | Around 5.5% of taxable profit |
| **Supplemental insurance** | €5–€40 per month, depending on your package |

As a freelancer in the Netherlands, you’ll make two separate payments toward the healthcare system your **monthly premium** and your **income-based contribution**.

Your **monthly premium** is paid directly to your insurer. It covers your basic plan and varies depending on which insurer you choose and the deductible you set.

Your **income-based contribution** (*inkomensafhankelijke bijdrage*) is collected by the **Belastingdienst** (Tax and Customs Administration) through your annual tax return. It’s roughly **5.5% of your taxable profit**, up to a set income ceiling.

Together, these two payments keep the system running:

- your **premium** funds your personal policy, and
- your **contribution** supports the national pool that pays healthcare providers.

If your income is below **about €37,500**, you might qualify for a **healthcare allowance** (*zorgtoeslag*). This monthly benefit helps cover part of your premium. You can apply at toeslagen.nl.

## Next steps

- Register your business and get your BSN
- Take out basic insurance within four months
- Adjust your deductible to manage costs
- Add supplemental coverage if needed
- Use expat insurance if you are still waiting for registration

If you are unsure what applies to you, you can always reach out to us — we are here to help.

Staying insured from your first day in the Netherlands helps you avoid fines and stress so you can focus on growing your freelance business.