In this guide
The eigen risico confuses newcomers, and not because the concept is difficult. A deductible is a familiar idea in most countries. What surprises people is the pattern of what it applies to: you can see your GP repeatedly at no cost, and then receive a bill for the blood test that same GP ordered.
That is not an anomaly. It is the design. Once you understand which categories sit inside the deductible and which sit outside it, Dutch healthcare bills become predictable — and the decision about whether to raise your deductible voluntarily becomes a calculation rather than a guess.
Disclosure: this article contains affiliate links to a.s.r. and SafetyWing, both approved partners of ours. If you sign up via them we may earn a commission at no extra cost to you. The premium you pay is the same as going direct. This is general information, not insurance advice.
The basics: €385 per adult, per year
For 2026, the verplicht eigen risico — the mandatory deductible — is €385. It has been held at that figure for several years, and it works as follows:
- It applies per person, per calendar year, and resets on 1 January.
- It applies to adults only. Care for children under 18 carries no deductible.
- It applies to care under the basisverzekering, not to supplementary cover. Reimbursements from an aanvullende package are paid without touching your deductible.
- It is charged after the fact. Your insurer receives the invoice from the provider, reimburses it, and then invoices you for the part that falls within your unused deductible.
- It is a maximum, not a fee. Use no care and you pay nothing. Use €120 of qualifying care and you pay €120. Use €4,000 and you pay €385.
That last point deserves emphasis because it is the part that reassures people: the deductible is a ceiling on what a bad year costs you within the basic package, not a charge you incur automatically.
For context on the other half of your annual cost: the government puts the average basic premium for 2026 at €1,884 a year, about €157 a month (rijksoverheid.nl, checked 24 September 2026). What you actually pay depends on insurer, policy type and deductible.
What does not count towards the deductible
This is the list to memorise, because it explains most of the apparent inconsistencies:
- GP care (huisarts). Consultations with your own GP, and out-of-hours GP posts, are exempt. The system deliberately keeps the front door free.
- Obstetric and maternity care. Midwife care and kraamzorg are outside the deductible. A separate personal contribution (eigen bijdrage) applies to some maternity care instead — a different mechanism with different amounts.
- District nursing (wijkverpleging). Personal nursing and care at home is exempt.
- Care for children under 18. No deductible at all.
- Care funded through the Wlz or Wmo. Long-term care and municipal social support run through different laws with their own contribution rules.
Some insurers additionally waive or reduce the deductible for care from specific preferred providers or for particular chronic-care programmes, as a steering incentive. That is a policy-level choice rather than a legal rule, so check your own conditions — our policy reading checklist shows where to look.
What does count — including the things people assume are free
Everything else within the basic package is charged against your deductible until it is exhausted. In practice, the items that generate surprise are:
- Laboratory tests and diagnostics ordered by your GP. The consultation was free; the blood panel, urine culture or swab usually is not.
- Imaging. X-rays, ultrasound, MRI and CT scans.
- Prescription medication within the reimbursement system. Note that some medicines also carry a separate personal contribution on top, if the price exceeds the reimbursement limit for that group.
- Hospital and specialist care. Outpatient appointments, day treatment, admissions and surgery.
- Emergency department and ambulance transport. An A&E visit that follows a GP referral still counts.
- Mental healthcare within the statutory scheme. Care delivered through the practice nurse at your GP surgery (POH-GGZ) is generally treated as GP care and exempt, while specialist mental healthcare counts. That boundary is worth checking before starting a trajectory.
- Medical aids and devices from the reimbursed list.
- Care abroad. Urgent treatment during a trip is reimbursed up to Dutch tariffs and still runs through your deductible. See travel insurance versus health insurance.
One timing detail worth knowing: hospital care is invoiced per treatment pathway, and the pathway is charged against the year in which it started. A pathway beginning in November can therefore produce an invoice months later that is charged against the previous year’s deductible — and if it runs across the year boundary, you can find yourself using two years of deductible for what feels like one episode of illness.
Paying in instalments (gespreid betalen)
Most insurers let you prepay the mandatory deductible in monthly instalments alongside your premium instead of waiting for an invoice after treatment. If you end up using less care than you prepaid, the difference comes back after the year is settled.
This changes nothing about the amount you owe. What it changes is the shape of the cost: roughly €32 a month instead of an unpredictable invoice for up to €385 landing three months after a hospital visit. For anyone who budgets tightly, or who has just arrived and does not yet have a Dutch financial buffer, that predictability is worth having. For someone who rarely uses care, it is money sitting with the insurer for a year.
You usually choose this when taking out or renewing the policy, so it is a switching-season decision rather than something to arrange mid-crisis.
The voluntary deductible: when the trade works
On top of the mandatory €385 you may agree a vrijwillig eigen risico of up to €500 extra, in steps, in exchange for a discount on your monthly basic premium. At the maximum, a bad year could cost you €885 in deductible instead of €385.
The arithmetic is unusually clean: the discount is a published amount per step, so you can calculate exactly. Our guide to the voluntary deductible works through the break-even in more detail.
- Note the monthly discount for the step you are considering and multiply by twelve. That is your guaranteed annual saving.
- Compare it with the additional deductible you are accepting. That is your worst case.
- Ask how many years out of five you expect to hit the additional amount.
If the annual discount is a meaningful fraction of the extra exposure and you genuinely use very little care, the bet is reasonable. If the discount is modest relative to the extra risk, you are being paid little to take on a lot.
Situations where it usually works: you are young or healthy, have no chronic condition, take no ongoing medication, are not in any treatment pathway, and have €885 available without it hurting.
Situations where it usually does not: you have a chronic condition or regular specialist care; you are planning a pregnancy (much maternity care is exempt, but surrounding care is not); you have a condition where diagnostics are routine; you cannot absorb the full amount comfortably; or you simply prefer certainty. And a note for people with children: a voluntary deductible is a per-adult choice, so it does nothing about children’s care, which carries no deductible anyway.
Every insurer shows the discount per step when you request a quote. You can, for example, set the deductible level in a quote at a.s.r. and watch the premium move, then decide whether the annual difference is worth the extra exposure to you.
How the Dutch deductible differs from an expat policy deductible
If you arrived holding an international, travel-medical or nomad policy, do not port your mental model across. The two structures differ in three ways that matter:
- Per year versus per claim. The Dutch deductible is one annual amount per person across all qualifying care. International and travel-medical products commonly apply a deductible per claim, per illness or per policy period — so several unrelated problems in one year can mean several deductibles.
- Defined by law versus defined by the insurer. The €385 and the exemption list come from Dutch legislation and are identical at every insurer. On a private international policy, both the amount and what it applies to are contractual and vary by product.
- What it interacts with. The Dutch deductible sits on top of a standardised basic package; a private policy’s deductible sits on top of whatever that policy happens to cover.
The practical consequence for anyone holding both — a Dutch basisverzekering plus travel cover for trips, for instance — is that a single incident abroad can involve two deductibles under two definitions. If you are in a genuinely mobile situation rather than settled here, take a current quote from a travel-medical provider such as SafetyWing and read its deductible definition alongside your Dutch conditions before assuming they interlock neatly. If you are a resident subject to the Dutch insurance obligation, note that such policies are not a substitute for the basisverzekering.
Five practical habits
Ask “does this count?” before agreeing to diagnostics. Not to refuse care — to know what is coming. Providers and insurer helpdesks answer this question routinely.
Check your deductible balance in the app before a planned treatment. If you have already used the full €385 this year, additional care within the basic package costs you nothing further, which occasionally makes the timing of elective treatment worth thinking about.
Watch the year boundary. A treatment pathway starting in December may be charged to the old year, and continuing care in January to the new one. Where a procedure is genuinely elective and the calendar is flexible, this is worth a question to the provider.
Do not confuse the deductible with a personal contribution. Eigen bijdrage is a separate, unavoidable share for specific items — certain medicines above the reimbursement limit, some maternity care, some aids. It is not offset by having used up your deductible.
Remember zorgtoeslag does not cover it. The healthcare allowance offsets premium, not the deductible — see zorgtoeslag explained.
What happens to the deductible in 2027
Be careful with headlines here, because an earlier, higher figure is still circulating.
The figure for 2026 is €385. For 2027, the government announced on Prinsjesdag (15 September 2026) that the mandatory deductible rises with indexation to €400: “Het verplicht eigen risico gaat in 2027 met de inflatie mee en stijgt van € 385 naar € 400” (rijksoverheid.nl, Prinsjesdag 2026, zorg; checked 24 September 2026). The larger increase to about €455 that was in bill 36943 has been postponed and is not part of the 2027 figures. A cap on the deductible charged per treatment in specialist care has also been discussed for a later year; we will cover it once the amount and start date are settled. For everything else known about 2027, see Dutch health insurance in 2027: what we know.
Final thoughts
The eigen risico is a €385 annual ceiling with a specific list of exemptions, and almost everything people find confusing about it comes from not knowing the list. GP care free, the tests it generates not free; children exempt, adults not; maternity care outside it, hospital care inside it.
Once that is clear, the only real decision left is the voluntary one — and that is a calculation you can do in five minutes with the premium table in front of you. Do it in November, when next year’s premiums are published, rather than in the middle of a treatment.
Related reading: how to read your Dutch health insurance policy, how to switch health insurance step by step, what Dutch health insurance covers, and best Dutch health insurance plans.
Frequently Asked Questions
How much is the eigen risico in 2026?
The mandatory deductible (verplicht eigen risico) is €385 for 2026, the same figure it has been for several years. It applies per person per calendar year and only to adults — care for children under 18 is exempt. On top of that you may voluntarily agree an additional deductible of up to €500, bringing the theoretical maximum to €885 in a year for someone who chose the highest voluntary amount.
Does a GP visit count towards the eigen risico?
No. Care provided by your huisarts is exempt, which is deliberate: the Dutch system wants the GP to be the first point of contact and does not want cost to discourage that. The exemption covers the consultation itself. What the GP orders afterwards is a different matter — laboratory tests, imaging and prescription medication are generally charged against your deductible even though the GP requested them, which is the most common source of an unexpected bill.
What does not count towards the deductible?
GP care, obstetric and maternity care (which has its own separate personal contribution instead), district nursing at home, care for children under 18, and care funded through the Wlz or Wmo rather than through your health insurance. Everything else within the basic package — hospital treatment, specialist care, most prescription medication, ambulance transport, diagnostics, mental healthcare — is charged against the deductible until it is used up.
Can I pay the eigen risico in monthly instalments?
Yes, most insurers offer gespreid betalen, where you pay the mandatory deductible in advance in monthly instalments alongside your premium rather than facing an invoice after treatment. If you use less care than the amount you prepaid, the difference is refunded after the year is settled. It does not reduce what you owe — it just makes it predictable, which is why it suits people who dislike unexpected invoices more than people who rarely use care.
Is a voluntary eigen risico worth it?
It is a bet with known odds. Each step of voluntary deductible reduces your monthly premium by a set amount, so you can calculate the annual saving exactly and compare it with the extra exposure. If the discount over twelve months exceeds the additional deductible you took on, you are ahead only in years where you use little care. It suits people with no chronic condition, no ongoing treatment and enough cash to absorb the full amount without stress — and it is a poor fit for anyone whose care use is predictable.
How is this different from the deductible on an expat or nomad policy?
Structurally, yes, and it matters. The Dutch deductible is an annual amount per person, fixed by law at €385 for 2026, applying across all the care that counts towards it. Travel-medical and international policies typically apply their own deductible per claim, per illness or per policy period, and they define what it applies to themselves. If you hold both types of cover, read each definition separately rather than assuming the Dutch logic carries across.