How your health insurance works

Who decides what is covered under the general insurance? And why is the premium not the same for all general insurance policies? Allow us to explain how exactly your health insurance works.

General insurance is compulsory

Whether or not you see a doctor on a regular basis, you are required by law to take out a general insurance policy. Healthy people help fund healthcare for sick people. As a country, this system of solidarity is actually something we can be proud of, as it makes sure everyone has access to healthcare.

Premium payment from the age of 18

Everyone in the Netherlands is required by law to take out health insurance, and from the age of 18 onwards, everyone is subject to a premium payment obligation. This means that if you have children, they will start paying a premium for health insurance from their 18th birthday.

Every health insurer in the Netherlands has a duty to accept

You can take out a general insurance policy with any health insurer in the Netherlands. They all have a duty to accept you as a customer, regardless of your age or current health situation.

The government determines what is covered by the general insurance

Your general insurance policy covers your standard healthcare costs, such as costs incurred for GP visits, pharmacy services or hospital admissions. Every year, the government determines based on advice from ‘Zorginstituut Nederland’ what exactly is covered under your general insurance policy and how much you will be reimbursed. As a result, reimbursements under the general insurance are exactly the same for all general insurance policies, regardless of the health insurer.

Different premiums for general insurance policies

Since terms and conditions, as well as services, differ per general insurance policy, you will pay more premium for one general insurance policy than you would for another. The following choices determine how much premium you pay:

  • The health insurer you choose
    Every health insurer has negotiated its own price and quality agreements with healthcare providers. As a result, health insurers charge different premiums for their general insurance.
  • An in-kind policy or a refund policy
    With an in-kind policy, you only go to healthcare providers that are contracted to the health insurer. With a refund policy, on the other hand, you are free to choose which healthcare provider you go to, whereby reimbursement is capped at the market rate applicable in the Netherlands. An in-kind policy is always the cheaper option.
  • A higher or a lower deductible
    Everyone has a compulsory deductible. You can, however, choose to raise your deductible. The higher the deductible you choose, the lower your premium will be. CZ also lets you pay your compulsory deductible in 10 monthly advance instalments.
  • Paying in instalments or in full
    Most people pay their premium on a monthly basis, but if you choose to pay it in full in one single payment, you will get a discount on your premium.

Take a look at the premium overview for our health insurance policies

Additional insurance for healthcare not covered under the general insurance policy

You can choose to take out additional insurance to cover costs that are not covered under your general insurance policy, such as physiotherapy or dental costs. Reimbursements under an additional insurance package are not set off against your deductible. Additional insurance packages differ per health insurer, both in terms of the reimbursements and the premiums. Health insurers are furthermore free to set their own specific requirements for people who want to take out an additional insurance package with them. For comprehensive dental insurance, for example, you will need a dentist’s statement. Take a look at our additional insurance packages and dental insurance.

Negotiating about price and quality

Health insurers are increasingly involved in negotiations about the costs and quality of healthcare. One common misconception is that health insurers are always looking for the cheapest treatment. The fact is that we always seek to strike a balance between quality and cost. Poor healthcare will always be too expensive in the long run, as you will be sick for longer and may even need additional surgery. Good quality is always cheaper, both for CZ and for the people we insure.

CZ Customer Services