basisverzekering

Basisverzekering is the Dutch mandatory health insurance for residents, established under the Zorgverzekeringswet. It covers the essential medical care that Nederlandse residents need and is offered by private health insurers but regulated by the government. The basic package is standardized, ensuring a minimum level of coverage, while insurers may differ in service, premiums, provider networks, and the availability of supplementary (aanvullende) insurance.

Coverage and limitations: The basisverzekering generally includes general practitioner care, hospital care, specialist treatment, maternity care, ambulance transport, and access to essential medicines. It may also cover certain mental health services and preventive care, depending on the policy. Most dental care for adults is not included in the basic package; dental coverage is typically provided through supplementary insurance or separate arrangements. Some services, such as visits to the GP and most maternity-related care, are often exempt from the annual deductible.

Costs and financial assistance: Policyholders pay a monthly premium to their chosen insurer. In addition, there is an annual deductible (eigen risico) that must be paid before most basic-care reimbursements kick in; some services are exempt from the deductible. The deductible amount is set annually by the government and can change. Low-income households may receive zorgtoeslag, a government contribution to help with premium costs.

Switching and administration: Residents must have basisverzekering and can switch insurers or policies annually, typically aligned with the calendar year. Insurers must offer the basic package, and the government oversees compliance and pricing to preserve access to essential care.