Zilveren Kruis vs CZ for Expats: Health Insurance Compared 2026

When I arrived in the Netherlands from the UK over a decade ago, the Dutch healthcare system was one of the things that confused me most. Back home, you simply registered with the NHS and that was that. Here, you have to actively choose a private insurer, pay a monthly premium, deal with a mandatory deductible — and there are dozens of providers to choose from. I spent hours comparing options during my first open enrolment period and ended up with Zilveren Kruis almost by accident, because a Dutch colleague swore by them. A few years later, I switched to CZ. Then I switched back.

Having now been through both insurers properly — not just as a newcomer who signed up quickly to tick a box, but as someone who actually made claims, contacted customer service, used the apps, and scrutinised dental reimbursements line by line — I feel qualified to compare them honestly for other expats.

This is not a generic overview. I will give you real 2026 premium figures, specific policy differences, and a clear opinion on who should choose which.

If you want a broader look at all your options, start with my Dutch health insurance guide first, or use the Health Insurance Wizard tool to get a personalised recommendation before reading further.

Quick Verdict

Before I walk through everything in detail, here is my short answer:

Choose Zilveren Kruis if:

• You want the most established, widely recognised insurer in the Netherlands
• English-language customer service matters to you
• You want a restitutie (reimbursement) policy with maximum flexibility on providers
• You are based in a major city and want broad specialist access

Choose CZ if:

• You want a slightly lower base premium on natura policies
• You are in the south of the Netherlands, where CZ’s network is historically strongest
• You prioritise physiotherapy coverage in the supplementary package
• You want a no-frills, reliable option without paying for extras you will not use

Neither is dramatically better than the other for basic coverage. The Dutch basisverzekering is regulated by the government, so the core package is identical regardless of which insurer you choose. Where they differ is in price, supplementary add-ons, network size, and how easy they are to deal with when things go wrong.

Understanding Dutch Health Insurance: The Basics for Expats

If you are new to the system, a quick primer. The Dutch healthcare system is built on three layers:

1. Basisverzekering (basic insurance) This is mandatory for everyone living or working in the Netherlands. It covers GP visits, hospital care, most specialist consultations, maternity care, mental health, and a range of medications. The government defines exactly what is covered — every insurer offers the same core package. What differs is the premium, the type of policy (see below), and the contracted care network.

2. Aanvullende verzekering (supplementary insurance) Optional add-ons for things not covered by the basic package: dental care for adults, physiotherapy beyond the covered sessions, glasses, alternative medicine, and more. This is where Zilveren Kruis and CZ differ significantly.

3. Eigen risico (own risk / deductible) In 2026, the mandatory eigen risico is EUR 385 per year. This means the first EUR 385 of your eligible healthcare costs each year comes out of your pocket before your insurer pays. You can voluntarily increase this to EUR 485, 585, 685, 785, or 885 in exchange for a lower monthly premium — but only make that trade-off if you are genuinely healthy and rarely use healthcare. GP visits and maternity care are completely exempt from the eigen risico, which is worth knowing.

For a full breakdown of how to register, get your BSN, and start your coverage, see my guides on BSN registration and moving to the Netherlands.

Comparison Table: Zilveren Kruis vs CZ at a Glance (2026)

Premiums are approximate for 2026 and vary by specific policy and voluntary eigen risico choice.

Basisverzekering Compared: Policy Types

Both Zilveren Kruis and CZ offer three main types of basic policy. Understanding these is critical because they affect which doctors and hospitals you can use — and how much you pay if you go outside the network.

Natura Policy

With a natura (in-kind) policy, your insurer has contracts with specific healthcare providers. You must use contracted providers to get full reimbursement. If you go to a non-contracted provider, you will only be reimbursed at a lower rate — typically 75-80% of the contracted rate, which can leave you with a significant bill for anything expensive.

• Zilveren Kruis natura: ~EUR 142/month. Large contracted network including most major hospitals. Good for people who are happy to stay within a wide network.
• CZ natura: ~EUR 140/month. Slightly cheaper. Strong network in Zeeland, Noord-Brabant, and Limburg. In Randstad cities (Amsterdam, Rotterdam, The Hague, Utrecht), the network is still solid but historically a touch smaller.

Combinatie (Combination) Policy

A middle ground. You use contracted providers for certain care types but have more flexibility for others. Both insurers offer this, though the exact terms vary by specific product. Premiums sit between natura and restitutie.

Restitutie Policy

With a restitutie (reimbursement) policy, you can go to any registered Dutch healthcare provider — contracted or not — and your insurer reimburses you based on the NZa (Dutch Healthcare Authority) tariff. This gives you maximum freedom. It costs more: roughly EUR 10-12/month extra.

• Zilveren Kruis restitutie: ~EUR 153/month. Their “Zilveren Kruis Restitutie” product is popular among expats who travel frequently, work with internationally connected hospitals, or simply want no surprises about provider access.
• CZ restitutie: ~EUR 151/month. Available as “CZ Zorgbewust Restitutie.” Similar flexibility.

My recommendation for expats: Unless you have a specific specialist or clinic you are attached to that is outside the contracted network, the natura policy is perfectly fine. The network for both insurers covers the vast majority of Dutch hospitals and GPs. Save the EUR 10/month and put it toward dental cover instead.

Aanvullende Verzekering: Supplementary Insurance

This is where real differences emerge. Supplementary insurance is entirely optional but genuinely useful for expats who want dental cover, more physiotherapy, glasses, or alternative treatments. Neither insurer is obliged to accept you for supplementary cover (they can reject you based on health history), so apply at the same time as your basic insurance rather than adding it later.

Dental Coverage

Adult dental care is not included in the basic package. Both insurers sell dental add-ons at different tiers.

Zilveren Kruis dental tiers (2026 approximate):

• Tandverzekering Basis (~EUR 10/month): covers check-ups and basic treatments up to ~EUR 250/year
• Tandverzekering Extra (~EUR 18/month): covers more treatments including fillings and extractions up to ~EUR 500/year
• Tandverzekering Compleet (~EUR 26/month): crowns, bridges, orthodontics up to ~EUR 1,500/year
• Tandverzekering Compleet Plus (~EUR 35/month): up to EUR 2,500/year, implants partially covered

CZ dental tiers (2026 approximate):

• Tand Basis (~EUR 8/month): check-ups and basic treatments up to EUR 200/year
• Tand Uitgebreid (~EUR 16/month): fillings, extractions up to EUR 400/year
• Tand Compleet (~EUR 22/month): crowns, bridges up to EUR 1,000/year
• Tand Compleet Plus (~EUR 30/month): up to EUR 2,000/year

CZ is marginally cheaper across the tiers, but Zilveren Kruis offers higher coverage ceilings at the top end. If you anticipate significant dental work — crowns, implants, orthodontics — the Zilveren Kruis Compleet Plus advantage can outweigh the higher monthly premium. For routine check-ups and the occasional filling, either will do.

I go into this in much more detail in the dental section below.

Physiotherapy

The basisverzekering covers physiotherapy only from session 21 onwards (for chronic conditions on the government list) or for a limited number of sessions for acute issues. For most people, the first 9-20 sessions of physio for a non-listed condition come out of your eigen risico and then your own pocket.

Both insurers offer physio add-ons:

• Zilveren Kruis: From ~EUR 5/month for 9 extra sessions, up to ~EUR 13/month for 27 additional sessions per year
• CZ: From ~EUR 6/month for 9 extra sessions, up to ~EUR 15/month for 27 additional sessions per year

Zilveren Kruis is marginally cheaper here, and their contracted physio network is large. If you run regularly, play sport, or have a physically demanding job, this add-on pays for itself quickly.

Alternative Medicine

Both offer add-ons covering acupuncture, homeopathy, osteopathy, and similar treatments. These are niche, but some expats — particularly those coming from countries where alternative medicine is mainstream — value them.

• Zilveren Kruis: Included in some higher-tier aanvullende packages
• CZ: Available as a separate add-on at ~EUR 4-6/month

Glasses and Contact Lenses

Neither basic policy covers glasses for adults. Supplementary options exist at both insurers, typically reimbursing EUR 100-200 every two years depending on the tier. Honestly, these add-ons are rarely worth the premium cost unless you buy expensive frames — a basic pair from a Dutch optician costs EUR 100-150 all in.

Network and Contracted Care

This is practical and often overlooked by expats who assume all Dutch insurers give access to the same hospitals. They do not.

Zilveren Kruis has contracts with virtually all major academic medical centres (UMC’s), including Amsterdam UMC, Erasmus MC, and UMCG. They are the largest insurer in the Netherlands by market share, which gives them strong negotiating power and broad network coverage. For expats in Amsterdam or Utrecht in particular, I have never had a provider tell me they do not accept Zilveren Kruis.

CZ has strong contracts in the south: St. Antonius Ziekenhuis, Catharina Ziekenhuis, Elisabeth-TweeSteden Ziekenhuis, Maastricht UMC+. In the Randstad, their network is solid but occasionally a specific clinic or specialist practice will not be contracted. Before you sign up, always check CZ’s online zorgzoeker (care finder) to verify that your preferred GP practice and any specialists you already use are in network.

Practical advice: If you already have a GP (huisarts), check their contract status with both insurers before choosing. Switching GPs after moving is common anyway, but if you are settled with a particular practice, this matters.

English Language Support and Expat Friendliness

Neither Zilveren Kruis nor CZ is a purpose-built expat insurer. They are Dutch companies serving a Dutch market that happens to include a large international population. That said, they differ meaningfully in how accessible they are to non-Dutch speakers.

Zilveren Kruis:

• Customer service: English-speaking agents available, though you may have to ask specifically or wait longer
• Website: Key sections available in English, including policy summaries and claim forms
• App (Mijn Zilveren Kruis): Dutch only, but functional and intuitive enough that basic navigation is not difficult
• Letter correspondence: In Dutch. Use DeepL — it handles Dutch medical/insurance terminology reasonably well

CZ:

• Customer service: Limited English. Most agents speak Dutch only, though younger staff often manage basic English
• Website: Primarily Dutch
• App (Mijn CZ): Dutch only
• Letter correspondence: Dutch

If English support is a dealbreaker for you, neither is ideal. For a genuinely English-first experience, look at Cigna or Allianz Care as international health insurers (though they are significantly more expensive). The expat insurance guide covers those options.

For most expats who have basic Dutch or are willing to use translation tools, Zilveren Kruis edges ahead. When I had a complex claim dispute over a specialist referral a few years ago, being able to explain my situation in English to a Zilveren Kruis agent made a real difference to how quickly it was resolved.

Claims Process and Apps

Zilveren Kruis App (Mijn Zilveren Kruis)

The app is functional and covers the basics well:

• View your policy and coverage details
• Submit and track claims (declaraties)
• Check your eigen risico progress
• Request referral authorisations
• Find contracted providers

One feature I find genuinely useful: you can photograph a receipt directly in the app and submit a claim in under two minutes. Reimbursements for smaller claims (physio, glasses, dental) typically arrive in my account within 5-7 working days.

CZ App (Mijn CZ)

Comparable functionality, slightly cleaner interface in my experience. CZ introduced a feature that lets you see in real time how much of your eigen risico has been consumed — this is helpful when you are tracking whether it makes sense to push through more care within the calendar year or wait until January.

Larger claims (hospital stays, specialist courses of treatment) take 2-4 weeks to process at both insurers, which is normal. The insurer pays the hospital directly in most cases when you use a contracted provider — you will only need to submit a claim yourself for non-contracted care or reimbursable expenses like physiotherapy and dental.

Dental Coverage Deep Dive

Dental is the most common question I get from newly arrived expats, and understandably so. Dutch dental care is excellent but expensive. A routine check-up costs EUR 25-50. A filling runs EUR 60-150 depending on complexity. A crown can be EUR 600-1,200. An implant: EUR 1,500-2,500 per tooth.

Without supplementary dental cover, you pay all of this yourself (minus eigen risico contributions where applicable). Here is how to think about which insurer’s dental add-on makes sense for you:

For Light Users (annual check-up, occasional filling)

Recommended: CZ Tand Basis (~EUR 8/month = EUR 96/year)

If your dental health is good and you only go once a year for a check-up plus maybe one filling every few years, the CZ Tand Basis is sufficient. You will get your check-up covered, and the add-on pays for itself if you have any treatment at all. The EUR 200/year ceiling is adequate for light users.

For Moderate Users (regular check-ups, multiple fillings, potential crowns in coming years)

Recommended: Zilveren Kruis Tandverzekering Extra (~EUR 18/month = EUR 216/year)

The EUR 500/year ceiling and broader treatment coverage makes this worthwhile if you need anything beyond basic check-ups. With one crown every few years, this add-on easily covers its cost.

For Heavy Users (orthodontics, implants, multiple major restorations)

Recommended: Zilveren Kruis Tandverzekering Compleet Plus (~EUR 35/month = EUR 420/year)

The EUR 2,500/year ceiling and partial implant coverage is the best available from either insurer for major dental work. If you know you have significant work coming — say, your Dutch dentist has flagged multiple teeth that need crowns — getting this add-on in January before the work starts can save you thousands.

One important rule: Both insurers apply a waiting period of typically 3-6 months before certain dental treatments are reimbursed. Do not sign up for dental add-on cover the week before you need an expensive procedure and expect it to be covered. Check the policy terms carefully.

Mental Health Coverage

Mental health care (GGZ — Geestelijke Gezondheidszorg) is included in the basisverzekering for both insurers, but with some nuance that expats often miss.

What is covered in the basic package:

• Specialised mental health care (gespecialiseerde GGZ): depression, anxiety disorders, PTSD, eating disorders, personality disorders — when referred by your GP and provided by a contracted GGZ provider
• The eigen risico applies to mental health care (EUR 385)
• GP consultations about mental health are eigen risico exempt

What is not covered:

• General counselling or life coaching
• Relationship therapy
• Expat-specific adjustment issues that do not meet clinical diagnosis thresholds
• Self-help apps and programmes

Practical reality for expats: Mental health difficulties related to relocation, loneliness, culture shock, and language isolation are extremely common and very real. But getting a referral through the Dutch system for these issues can be slow — waiting lists for contracted GGZ providers in Amsterdam can be 6-12 months. Neither Zilveren Kruis nor CZ has a structural advantage here; the problem is systemic, not insurer-specific.

Both insurers cover a small number of sessions with a POH-GGZ (a mental health nurse attached to your GP practice) within the basic package, without hitting your eigen risico. This is often the fastest first step.

If you want access to private English-speaking therapists without long waits, you will typically pay out of pocket — EUR 80-120 per session — as private practice therapists are often not contracted. Some expats budget for this separately.

Pros and Cons Summary

Zilveren Kruis

Pros:

• Largest insurer in the Netherlands — strong negotiating position and broad network
• Best English-language support among Dutch domestic insurers
• Higher dental reimbursement ceilings at premium tiers
• Slightly better physiotherapy add-on pricing
• Widely recognised — rarely encounter a provider who does not accept them
• Good app with photo claim submission
• Restitutie policy among the most flexible available

Cons:

• Marginally higher premiums across most policy types
• Customer service wait times can be long during peak periods (January, after open enrolment)
• Website can be complex to work through when looking for specific policy details
• Letters and communications remain Dutch-only

CZ

Pros:

• Slightly lower natura premiums — EUR 2-5/month difference adds up
• Excellent coverage in south Netherlands (Noord-Brabant, Zeeland, Limburg)
• Clean, intuitive app with real-time eigen risico tracking
• Slightly lower dental add-on premiums at entry/mid tiers
• Reliable claims processing

Cons:

• Limited English customer service — can be frustrating for complex queries
• Network not as strong in Randstad cities for certain specialist areas
• Lower dental reimbursement ceilings at top tier versus Zilveren Kruis
• Less expat-oriented overall

How to Sign Up

The most practical way to compare and sign up for either Zilveren Kruis or CZ is through Compare on Independer. Independer is the Netherlands’ largest insurance comparison platform, and they are accustomed to expat users. You can filter by insurer, policy type, and supplementary packages, and the sign-up process is handled in one place.

Why use a comparison platform rather than going direct?

1. You see side-by-side pricing for the current year — insurer websites can be confusing about which package includes what
2. Independer has Dutch expat-friendly FAQ content
3. If you are eligible for zorgtoeslag (healthcare allowance), Independer shows your estimated net cost after the subsidy
4. You can sign up for basic and supplementary insurance together in one transaction

Am I eligible for zorgtoeslag?

Zorgtoeslag is a government subsidy for people on lower to mid incomes. In 2026, if your annual income is below approximately EUR 38,000 (single) or EUR 48,000 (partners), you are likely eligible for a monthly contribution of EUR 50-130 toward your premium. You apply through the Belastingdienst (Dutch tax authority), not through your insurer. If you are on the 30% ruling, your taxable income figure used for zorgtoeslag calculations changes — check my 30% ruling guide for detail on how that interacts.

Timeline for new expats:

You must arrange health insurance within 4 months of registering in the Netherlands (i.e., within 4 months of getting your BSN and registering with a gemeente). Coverage is backdated to your registration date if you sign up within this window. Do not leave it until the last day — backdated premiums for several months will be invoiced at once, which can be a shock.

If you want a tool to match your situation to the best policy, try the Insurance Chooser tool — it asks a few questions and gives you a filtered recommendation.

Compare Zilveren Kruis and CZ on Independer

My Overall Take

After going back and forth between both, I currently use Zilveren Kruis with their Combinatie policy and the Tandverzekering Extra add-on. The English customer service has saved me real time on two separate claim disputes. The dental coverage ceiling is better for my situation — I needed two crowns in 2024 and the higher reimbursement limit made a meaningful difference.

If I were based in Eindhoven or Tilburg, or if my budget were tighter and English support mattered less, I would give CZ a serious look. The EUR 2-5/month premium difference is small on its own but adds up over years, and CZ’s network in the south is genuinely excellent.

The honest answer is that both are solid choices. The Dutch healthcare system, whatever its quirks and waiting lists, delivers good outcomes — and either of these two large, established insurers will cover you properly for the things that matter most.

Where most expats go wrong is not on the choice between Zilveren Kruis and CZ — it is on skipping supplementary dental cover and then being hit with a EUR 800 crown bill they had not budgeted for. Sort that before worrying too much about the base premium difference.

One situation where neither Zilveren Kruis nor CZ is the right answer: the gap before your Dutch registration is complete, or a short visit before you become a legal resident. Both require you to be registered to sign up. For that interim window — or if you are travelling outside the Netherlands for an extended period — SafetyWing Nomad Insurance offers temporary emergency medical coverage from around $45/month. It is not a substitute for Dutch basisverzekering (and cannot legally replace it once you are a resident), but as a stop-gap or travel layer it does the job at a fraction of the cost of a full international plan.

Get SafetyWing temporary coverage from $45/month →

Related Guides

• Dutch Health Insurance: The Complete Expat Guide 2026
• Best Expat Insurance Options in the Netherlands 2026
• Health Insurance Wizard — Get a Personalised Match
• The 30% Ruling: What Expats Need to Know
• Moving to the Netherlands: The Complete Guide
• BSN Registration Guide for Expats

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