These are the changes to health insurance cover from 2026

The government has announced the following changes to the general insurance for 2026:

• Personal contributions and maximum reimbursements
  The government is adjusting the personal contributions and maximum reimbursements. You can find the new rates here.
  
  
• Quit smoking course
  From 2026, support and the associated medicines to help you quit smoking will be reimbursed no more than three times a year. In 2025, this is reimbursed once a year.
  
  
• No deductible for general practitioner’s joint consultation or joint advice
  General practitioners can ask other healthcare providers to provide input or join a consultation to arrive at a suitable diagnosis, treatment or referral. There will be no deductible for this from 2026, but the deductible does still apply in 2025.  
  
  
• Exercise therapy for axSpA
  From 2026, insured persons from the age of 18 with severe limitations due to axSpA, a form of rheumatoid arthritis, will be reimbursed for long-term exercise therapy. A referral from the rheumatologist is needed for this. For each year of treatment, permission from CZ is needed from the 42nd session. In 2025, this type of healthcare is reimbursed as conditional healthcare.  
  
  
• Permission for exercise therapy in case of rheumatoid arthritis
  As of 2025, long-term exercise therapy for rheumatoid arthritis is reimbursed. From 2026, permission from CZ is needed from the 40th session in each year of treatment.  
  
  
• Addiction specialist as a referring doctor for specialist medical care
  From 2026, addiction specialists (mental healthcare) will be new referring doctors for specialist medical care.  
  
  
• Specialist medical rehabilitation in a hospital or rehabilitation centre
  From 2026, you will only be able to receive specialist medical rehabilitation treatment from a rehabilitation doctor at a hospital or a rehabilitation centre that employs at least two rehabilitation doctors. A rehabilitation centre can also be a hospital.  
  
  
• Reimbursement for electricity costs and tracheal cannulas
  The reimbursement for other stoma protectors used with tracheostomy tubes (e.g. scarves and bibs) is being increased due to rising prices. This will be reimbursed up to three times a year. The reimbursement for 2026 will be €88.20 per year. In 2025, the reimbursement is €60.00 per year.

• ‘Jongeren’ additional insurance package
  Dentist and dental hygienist
  The maximum reimbursement for dentists and dental hygienists will be lowered from €450 (2025) to €350 (2026).
  
  Physiotherapy and exercise therapy
  The maximum reimbursement for physiotherapy and exercise therapy will be lowered from 9 sessions (2025) to 8 sessions (2026).
  
  Orthodontic care
  From 2026, a waiting period of 365 days will apply to the reimbursement for orthodontic care. The waiting period will start from the moment the ‘Jongeren’ additional insurance package is taken out.
  
  Read more about the ‘Jongeren’ additional insurance package.
  
  

• Carer relief
  From 2026, the maximum reimbursement for carer relief will be reduced from €2,250 (2025) to €1,250 (2026) in the following additional insurance packages: ‘Basis’, ‘Basis Collectief’, ‘ComfortPakket’, ‘IdeaalPakket’, ‘Jongeren’ and ‘50+’. In the ‘Plus’ and ‘Plus Collectief’ additional insurance packages, the maximum reimbursement for carer relief will be lowered from €2,250 (2025) to €1,750 (2026).  



• No referral required for ear position correction surgery, sterilisation or reversal of sterilisation
  From now on, you will no longer need a referral for ear position correction surgery or for sterilisation of the seminal ducts or fallopian tubes (or reversal thereof). This type of healthcare will be reimbursed by various additional insurance packages.  



• ‘BasisExtra Collectief’, ‘PlusExtra Collectief’, ‘TopExtra Collectief’ and ‘TandStart’ additional insurance packages
  Various additional insurance packages will be renamed from 2026. Your new policy document will also state the new name.
  
  The ‘BasisExtra Collectief’ additional insurance package (2025) will become ‘Basis Collectief’ (2026).
  The ‘PlusExtra Collectief’ additional insurance package (2025) will become ‘Plus Collectief’ (2026).
  The ‘TopExtra Collectief’ additional insurance package (2025) will become ‘Top Collectief’ (2026).
  The ‘TandStart’ additional insurance package (2025) will become ‘Compact Tandarts Collectief’ (2026).