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.

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 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.

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.

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 or 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 keeps you covered until your Dutch plan starts.

Health insurance costs for freelancers in 2026

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.