In this guide
The first question is not which insurer is better, but whether you are allowed to choose at all. For most people who come to live or work in the Netherlands, Dutch health insurance is compulsory, and an international plan does not replace it.
This page compares what the two insurers publish: ONVZ, a Dutch health insurer, and Aetna International, a global insurer that mainly works through employers and brokers. If you want the broader picture first, read the complete expat health insurance guide. The Health Insurance Wizard asks a few questions about your situation.
The Critical First Question: Do You Need Dutch Health Insurance?
Government.nl is direct about this: “If you come to live or work in the Netherlands, you are required to take out a health insurance policy with a Dutch insurer with coverage from the day you arrive. You have 4 months to take out the health insurance policy.” A policy taken out within those 4 months is backdated to the day you arrived. Take it out later and there is no backdating: you pay no premiums for the earlier months, but you are also not reimbursed for care in that period.
You must do this “even if you have insurance for medical expenses in the country you came from”. Government.nl names these situations:
- Your employer is outside the Netherlands. That is the only exception the government names; the insurance from your home country can then be enough. The Sociale Verzekeringsbank (SVB) assesses your situation.
- You work only for an EU institution. You are then covered by the EU’s Joint Sickness Insurance Scheme (JSIS) and cannot take out Dutch health insurance; if you also do other work in the Netherlands, Dutch insurance is required.
- You are a foreign student. Whether you need Dutch insurance depends on where you are from and what you do besides studying; Nuffic’s Studyinholland.nl explains it.
If you stay uninsured, the CAK sends a letter and then imposes a fine of EUR 529.74 (2026); after a second fine it takes out a policy for you and withholds an administrative premium of 110% of the standard premium for 12 months.
Who Are ONVZ and Aetna International?
ONVZ is a Dutch health insurer with an English-language website. It sells two ranges, ONVZ Vrije Keuze and ONVZ Bewuste Keuze, with a basic health-care plan and supplementary plans. ONVZ itself tells newcomers to contact the SVB if they do not know whether they need Dutch health insurance (onvz.nl/en, checked 5 October 2026).
Aetna International describes itself as combining “the combined resources of CVS Health® and Aetna®” and cites “provider network access in 200+ countries and territories” (aetnainternational.com, checked 5 October 2026). Its website is organised around members, employers, brokers and governments. On 5 October 2026 it did not list individual plan names, benefit schedules or prices. Earlier versions of this page named Aetna plans and prices; we could not verify them and have removed them.
Comparison Table: ONVZ vs Aetna International (2026)
| ONVZ | Aetna International | |
|---|---|---|
| Type | Dutch health insurer | Global insurer (part of CVS Health) |
| Dutch basic health insurance | Yes (ONVZ Vrije Keuze basic plan: €166.10 a month) | No |
| Individual plans and prices published | Yes, on onvz.nl/en | None found on aetnainternational.com |
| Cover abroad | Basic plan up to the Dutch rate; Wereldfit supplement (€3.50 a month) for emergency care worldwide up to the local rate | Network access in 200+ countries and territories, according to Aetna |
| How you get it | Directly from ONVZ | Through an employer or broker; ask whether a plan is available to you |
| Replaces the Dutch obligation? | It is the Dutch obligation | No |
Sources: onvz.nl/en (basic health-care plan and Wereldfit pages) and aetnainternational.com, checked 5 October 2026; government.nl, “When do I need to take out health insurance if I come to live in the Netherlands?”.
What ONVZ Publishes
Basic plan. The ONVZ Vrije Keuze basic health-care plan cost €166.10 a month on ONVZ’s English site on 5 October 2026. ONVZ lists 100% reimbursement at all hospitals in the Netherlands and at contracted independent treatment centres (limited reimbursement elsewhere). The contents of the basic package are set by the government; what differs between insurers is the premium, the contracted providers and the reimbursement for non-contracted care. The average basic premium in 2026 is €157 a month.
Cover abroad. ONVZ explains that the basic plan only covers care abroad up to the Dutch rate. Its Wereldfit supplement (€3.50 a month on 5 October 2026) reimburses emergency care worldwide up to the usual local rate, covers repatriation in case of serious illness or accident, and applies to trips abroad of up to 1 year.
For a side-by-side of two other Dutch insurers, see Zilveren Kruis vs CZ.
What Aetna International Publishes
Aetna International’s public site gives no individual prices, so we cannot tell you what an Aetna plan costs or what it covers. What it does say:
- it is part of CVS Health and cites network access in 200+ countries and territories;
- members use a member website and telehealth services;
- employers and brokers have their own entry points, including quoting tools for brokers.
If your employer offers Aetna International cover, ask for the benefit schedule: the area of cover, the deductible, maternity, mental health, dental and repatriation, and which Dutch hospitals bill Aetna directly. If you are buying for yourself, ask a broker whether Aetna offers you a plan at all.
Who Each Option Fits
ONVZ (or another Dutch insurer) fits anyone who must hold Dutch health insurance, which is most people who live or work here. You can add supplementary plans for cover the basic package does not include, such as Wereldfit for emergency care abroad.
Aetna International is relevant if you are in one of the situations above where Dutch insurance is not required, typically when your employer is outside the Netherlands, and your employer or broker offers it. Some people with Dutch health insurance also keep an international plan through their employer; check what it adds before paying for overlapping cover.
The Insurance Chooser tool helps you work out which policies your situation calls for, and the expat insurance overview covers the other insurance types.
What about budget temporary coverage?
For travel when you are temporarily outside the Netherlands, SafetyWing Nomad Insurance is designed for digital nomads and internationally mobile people, and starts from USD 62.72 per 4 weeks (Essential, ages 10–39, safetywing.com, 31 October 2026). It does not satisfy the Dutch legal requirement to hold health insurance, and because a Dutch policy taken out within 4 months is backdated to your arrival, you do not need it to bridge your first months here.
See SafetyWing travel cover from USD 62.72 per 4 weeks →
Related Guides
- Health Insurance for Expats in the Netherlands: The Complete Guide 2026
- Expat Insurance in the Netherlands: All Your Options 2026
- Cigna vs Aetna International Health Insurance for Expats 2026
- Zilveren Kruis vs CZ: Dutch Health Insurance Compared 2026
- Health Insurance Wizard — Get a Personalised Match
- Insurance Chooser Tool
Frequently Asked Questions
Do I have to take Dutch health insurance (zorgverzekering) or can I use Aetna International instead?
If you come to live or work in the Netherlands, you must take out health insurance with a Dutch insurer, even if you already have medical insurance from the country you came from. Government.nl names one exception: your employer is outside the Netherlands, in which case your insurance from home can be enough (the SVB assesses this). People who work only for an EU institution are covered by the EU scheme JSIS instead. An Aetna International plan does not replace Dutch health insurance for anyone else.
What is the premium difference between ONVZ and Aetna International?
ONVZ publishes its prices: on 5 October 2026 its English site listed the ONVZ Vrije Keuze basic health-care plan at €166.10 a month and the Wereldfit supplement for emergency care abroad at €3.50 a month. Aetna International did not publish individual plan names or prices on its website on that date; its site is organised around employers, brokers and members. A price comparison is therefore not possible without a quote.
Does ONVZ cover me if I travel outside the Netherlands?
The Dutch basic plan reimburses care abroad up to the Dutch rate. ONVZ's Wereldfit supplement (€3.50 a month on 5 October 2026) reimburses emergency care worldwide up to the usual local rate, includes repatriation in case of serious illness or accident, and applies to trips of up to 1 year.
Can I see a specialist in the Netherlands without a GP referral?
In the Dutch system the GP (huisarts) normally refers you to a specialist, whichever insurer you have. If you have international cover through an employer, ask the insurer and the clinic before treatment whether a referral is needed and whether they bill each other directly.