Remote workers, freelancers and short stays: who must take out Dutch health insurance in 2026

Working from a laptop has become ordinary in the Netherlands. Some people keep a job with a company back home while living in Amsterdam or The Hague. Others register as freelancers with a client list spread across Europe. Others again stay for a few months before moving on. As work has become more mobile, one question keeps coming up: where should I be insured for healthcare?

The Dutch answer is simpler than it looks, and less forgiving than many newcomers expect. It does not matter whether you call yourself a digital nomad. What matters is where you live, where you physically work and which country's social security system you belong to. If you are required to have Dutch insurance and don't take it out, a government agency called the CAK will eventually send a letter, and then a fine.

The starting point here is Expatica's guide to digital nomad health insurance, updated on 1 October 2026. We compared it with coverage from IamExpat, DutchReview, NL Times, DutchNews, ACCESS, Xpat.nl and The Hague International Centre, then checked the figures against the government (Rijksoverheid), the CAK, the SVB, the tax authority (Belastingdienst), the National Health Care Institute (Zorginstituut) and the insurers' data body Vektis. All figures were checked on 21 October 2026.

Main sources for this article

• Expatica, "Digital nomad health insurance in the Netherlands" (updated 1 October 2026): situations, the CAK and the SVB
• Rijksoverheid, "Do I need health insurance if I work in the Netherlands?": the four-month rule and 2026 costs
• CAK, "I received a letter that I'm uninsured": the three-month deadline and 2026 fine

1. What's changing: no visa, rising costs

Two facts frame everything else: how residence works for remote workers, and where the costs are heading.

There is no digital nomad visa

Expatica's FAQ answers the question directly: the Netherlands does not currently have a digital nomad visa. That puts it apart from countries such as Spain or Portugal, which have created residence routes for remote workers.

EU, EEA and Swiss nationals can live and work here without a permit, but still register with their municipality if they stay longer than four months. Everyone else needs a residence permit from the IND, and remote work in itself is not a recognised purpose. You choose a route — self-employment, highly skilled migrant, partner, study, working holiday — and apply on that basis.

For self-employed applicants, there are two treaty-based shortcuts. US nationals can use the Dutch-American Friendship Treaty (DAFT), and Japanese nationals a comparable route under the Dutch-Japanese trade treaty. According to the IND's application form, both require proof that at least €4,500 of capital has been invested in a sole proprietorship, partnership or BV, and neither uses the points-based test that applies to other self-employed applicants (IND form 7524, IamExpat on DAFT).

The 2026 and 2027 numbers

Health insurance costs are set each autumn. Budget Day on 15 September 2026 and the first insurer announcement on 21 October have now given a fairly clear picture of 2027.

The direction is clear: both premiums and the deductible go up in 2027. DSW, traditionally the first insurer to publish, raised its premium by €14.75 a month (9.3%) and called it the largest increase it has ever had to make. That is above the government's forecast of €12.50 (NL Times). The other insurers must publish their 2027 premiums by 12 November.

A year of back-and-forth on the deductible

The 2027 deductible changed direction several times this year. In 2024, the previous government announced it would cut the deductible to €165 from 2027. In April 2026, DutchNews reported that the new cabinet was instead discussing a rise to around €455.

In the end, the September budget postponed a planned €60 increase by a year and let the deductible rise only with inflation, from €385 to €400 (IamExpat). Strictly speaking even that figure is still a proposal until parliament approves the budget.

2. Three facts decide, not your job title

Dutch basic health insurance is governed by the Health Insurance Act, the Zvw (Zorgverzekeringswet). Private insurers run the policies, but the government defines the package, and insurers may not refuse anyone for age or medical history.

Whether you have to take it out comes down to three facts. Expatica frames it the same way: the answer is not about whether you call yourself a digital nomad.

These rows are linked, because the obligation to take out Dutch basic insurance follows from being insured under the Wlz, the Long-term Care Act. The Wlz is a national insurance scheme for long-term care, and people who live here or work here and pay wage tax are normally covered automatically. If you are Wlz-insured, you must have Zvw basic insurance; if you are not, you don't. The body that decides your Wlz position is the SVB (Social Insurance Bank).

The official route to an answer

Expatica sets out four steps for checking your position. The diagram below summarises them.

The last step is the definitive one. You can request a Wlz assessment through My SVB or by post, but not more than eight weeks before your situation actually changes. The CAK says the assessment takes up to eight weeks.

Expatica also lists the documents worth keeping together: your visa or residence permit, BRP registration, BSN, employment or internship contract, evidence of freelance work and of where you work, proof of travel medical cover used for a visa, and any letter from the CAK or decision from the SVB.

3. Short stays: when travel insurance is enough

Start with the simplest case: someone who visits without working.

Expatica's example is a six-week stay in Amsterdam with no Dutch employment or social security ties. In that situation, an EU citizen can rely on the EHIC (European Health Insurance Card, or the UK's GHIC) plus travel insurance, and a non-EU visitor on travel medical insurance. ACCESS adds that people staying less than four months generally cannot take out Dutch basic insurance at all, and should keep their home-country or travel cover (ACCESS).

Two thresholds: 90 days and four months

Two lines matter. One is the 90-day limit for visa-free or short-stay Schengen visits (90 days in any 180) for non-EU nationals. The other is four months, the point at which you must register as a resident in the Personal Records Database (BRP). The government says residents staying longer than four months must register within five days of arrival (government.nl). Shorter stays go into the non-resident register (RNI).

The important caveat is in the caption: these thresholds are for people who don't work here. If you work in the Netherlands, the obligation can start even on a short stay. The CAK lists "you are from abroad and work in the Netherlands" as a standard example of someone who must take out Dutch insurance.

Choosing travel cover for a short stay

Travel insurance is "enough" only when there is no legal obligation and the policy actually matches what a Dutch hospital might charge. Uninsured patients can receive large bills.

For visitors who need a Schengen visa, the policy must cover at least €30,000 of medical costs including repatriation, be in the applicant's name and be valid across the whole Schengen area (NetherlandsWorldwide). Even if you don't need a visa, that is a sensible minimum benchmark.

EHIC users: temporary means temporary

EU and EEA citizens are often told the EHIC covers them in the Netherlands. It does — for medically necessary care during a temporary stay, with public providers, and only to the level of the Dutch package. Expatica stresses that it does not replace Dutch insurance once that applies, and it does not cover repatriation. DutchReview makes the same point: the card is a stopgap for visitors and students who stay insured at home, not a long-term solution.

4. Remote employees of foreign companies

This is the group with the most questions and the most varied answers. Two people doing the same thing — working from a Dutch living room for an employer abroad — can end up in different systems, depending on whether they were sent here or chose to move.

Posted by your employer

Within the EU, EEA and Switzerland, EU coordination rules decide which country's social security applies, and a temporary posting is confirmed with an A1 certificate issued by the home country. Outside the EU, bilateral social security agreements do the same job. The Japan–Netherlands agreement, for example, keeps workers posted for up to five years in their home country's pension and health insurance systems, with a certificate of coverage requested by the employer (Japan's Ministry of Health, Labour and Welfare).

With such a certificate, you stay in your home system, are not Wlz-insured here, and do not need Dutch basic insurance. Keep the certificate safe — it is the document the SVB and the CAK will ask for.

Moved for your own reasons, still working remotely

Many remote employees are not posted at all. They moved with a Dutch partner, or simply wanted to live here, and their employer agreed to let them work remotely. Postings assume the employer sends you temporarily. If that doesn't describe your situation, the basic principle is that you are covered by the social security system of the country where you physically work — in this case, the Netherlands.

Official guidance is not perfectly consistent here. One Rijksoverheid page says that if you have a foreign employer you may keep your home-country insurance, subject to rules, and refers you to the SVB; another simply says that anyone working in the Netherlands must insure (Rijksoverheid). The CAK lists "you work for a foreign employer" as a reason to request an SVB assessment rather than assume either way.

The table shows why a foreign employment contract does not settle the question on its own. And if you do fall under Dutch social insurance, it raises employment questions too: how your employer handles payroll, contributions and tax for someone working in another country. Talk to HR and the SVB at the same time.

The income-related contribution

Dutch basic insurance comes with a second cost besides the premium: the income-related Zvw contribution (inkomensafhankelijke bijdrage). With a Dutch employer, the employer pays 6.10% of your salary in 2026. If a foreign employer doesn't run Dutch payroll, you may instead receive an assessment (aanslag) at 4.85% (Belastingdienst).

Cross-border telework

People who live in one EU country and work partly from home for an employer in another face specific rules on which country's social security applies. Expatica and the SVB both flag that cross-border teleworking can change your social insurance position, including your Wlz status. If you split your working week between countries, this is exactly the kind of case where an SVB assessment saves guesswork.

5. Freelancers (ZZP): not an exception, just more visible costs

A ZZP'er (zelfstandige zonder personeel, a self-employed person without staff) is treated like any other resident for insurance purposes. If you live and work here, you take out basic insurance. Serving clients abroad doesn't change that; what counts is where you do the work.

The difference is that every cost is visible to you. The income-related contribution that an employer pays for staff, a freelancer pays personally, based on profit.

2026 rates and ceiling

The Belastingdienst table for 2026 shows rates down and the income ceiling up compared with 2025.

The maximum is simply the ceiling multiplied by the rate. With €50,000 of profit in 2026, the contribution comes to about €2,425. Add the premium (an average €1,884 a year) and, if you use care, up to €385 of deductible.

Other insurance to think about

ACCESS's guide for self-employed professionals recommends looking beyond health insurance to disability or income-protection cover, accident insurance, business and professional liability, and a supplementary pension, because a freelancer earns nothing while ill (ACCESS).

In an explainer published by The Hague International Centre, insurer OHRA notes that some insurers offer discounts of up to 10% for self-employed people, students and members of sports associations (The Hague International Centre). Group (collective) discounts are worth checking every switching season.

The healthcare allowance (zorgtoeslag) is available in 2026 if your income is no more than €40,857 as a single person, or €51,142 with a partner. In a first trading year with modest profit, it can make a real difference. Our guide to Dutch allowances covers how it works and how to avoid repayments.

6. Students, working holidays and family

Not everyone fits neatly into "employee" or "freelancer". Three other situations come up often.

Students

Students who only study are often not Wlz-insured and therefore have no obligation to take out Dutch basic insurance. EU students can use their EHIC; many non-EU students need a specific student policy for their residence permit. But the CAK is explicit: working alongside your studies, even a few hours a week or on a zero-hours contract, means you need Dutch basic insurance. The four-month clock starts with the first shift.

Working holiday

The Netherlands runs working holiday schemes with a number of countries (IND). You need insurance to get the permit, but once you start working here you are in the same position as any other worker. A practical sequence is to arrive on travel cover and switch to Dutch basic insurance within four months of starting a job.

Family members

Children under 18 are insured free of charge — no premium and no deductible — once registered with a parent's insurer. From 18 they need their own policy. A partner's position is assessed separately: a partner who doesn't work here may stay in your home system if you are posted, but as soon as they start working here the answer can change.

7. International, travel and Dutch basic cover compared

By now it is clear that the right cover depends on the person. The next question is what each type actually does.

What basic insurance covers — and what it doesn't

The basic package includes GP care (huisarts), hospital treatment, much mental healthcare and many prescription medicines. Adult dental care, physiotherapy, repatriation and unrestricted treatment worldwide are not part of the standard package.

For care abroad, the Zorginstituut is clear: care is only covered if the same care is covered in the Netherlands, and reimbursement is capped at normal Dutch rates (Zorginstituut). The deductible applies abroad as well. ACCESS notes that in high-cost countries such as the US, this cap can leave a large gap.

The first row is the core of this article. The CAK states that international or private policies such as Aon, OOM, Cigna or Allianz do not count as Dutch basic insurance. However generous your plan, if you are obliged to have Dutch cover and only hold international cover, you are treated as uninsured.

Comparing international plans

For situations where international cover is the right choice, Expatica suggests comparing area of cover, inpatient and outpatient care, emergency evacuation, pre-existing conditions, deductibles, mental health, sports exclusions, the claims process, direct billing and visa documents. It names Allianz Care, Cigna Global, APRIL International and Feather as examples.

If you are obliged to have Dutch insurance but travel a lot, the realistic combination is basic insurance plus supplementary cover (aanvullende verzekering), with travel insurance on top. Travel cover fills the gap between Dutch rates and local prices, and pays for repatriation.

8. When the CAK writes: deadlines and fines

If you are registered with a municipality but not with an insurer, the CAK (Centraal Administratie Kantoor) sends a letter. Ignoring it turns a paperwork problem into a series of fines.

Choose A or B within three months

According to the CAK, you have three months from the letter to do one of two things.

If the SVB decides you are not Wlz-insured, the CAK closes your file. If it decides you are, take out basic insurance straight away. While you wait, the CAK still lists you as uninsured.

Fines and CAK-arranged insurance

If you do nothing, costs build up in the sequence below. Fines are collected by the CJIB, the central fine collection agency.

The €529.74 fine is three times a monthly amount of €176.58, which the CAK derives from the average premium (€157) plus the expected average deductible (€19.58 a month). It is indexed every year. Paying the fine does not end the obligation. DutchReview describes the fine only as "several hundred euros", and older guides carry different figures, so check the CAK's current page for the amount.

Backdating: ask your insurer

Official sources describe the start date differently. The government's page for workers says you pay premium from the moment you take out the policy and are covered from then on; The Hague International Centre's explainer also says cover starts on the date you apply. Another government page, written for a specific group of permit holders, describes backdating to the start date of the permit. When you apply, ask your insurer exactly when your cover begins.

9. 2026 costs: why the "average premium" differs by source

The "average premium" depends on which figure you read. Comparing sources shows a spread.

The differences come down to whether discounts are included, whether the figure is an estimate or an outcome, and when it was written. Before Budget Day, NL Times reported a government estimate of €1,908 for 2026 and €2,028 for 2027 (NL Times), while the current Rijksoverheid figure is €1,884. Vektis found the 2026 nominal premium almost unchanged at €1,879, up €3 (0.2%), with individual policies (€1,845) slightly cheaper than group policies (€1,868) (Vektis). About 1.15 million people, 6.4% of the insured, switched insurer.

For budgeting, use the government's €157 a month for 2026 and assume around €170 for 2027. The ACCESS figure is well below current levels.

Voluntary deductible

You can raise the deductible voluntarily by €100 to €500, to a maximum of €885, in exchange for a lower premium. In March 2026 DutchNews reported that this could cut premiums by up to around €25 a month. It suits healthy people with few appointments, but an unexpected hospital stay means paying the full amount.

10. Common mistakes

These are the misunderstandings that come up most often. Each is avoidable once you know the rule.

Another frequent problem is forgetting to deregister. The CAK tells people who have moved abroad but are still registered to deregister with their former municipality. Otherwise the uninsured letters keep coming.

Rounded numbers

Some figures are rounded in media coverage. DutchReview gives the healthcare allowance income limits as about €41,000 for a single person and €51,500 with a partner; the Belastingdienst's exact figures are €40,857 and €51,142 (Belastingdienst). If you are close to the limit, use the official numbers.

11. How the Dutch model differs from what you may know

Many newcomers come from systems where residence automatically brings health cover — a national health service funded by tax, or a public insurer you join by registering. The Dutch model is different in one practical respect: you have to sign a contract yourself.

The table explains why so many people miss the deadline. Registering at the town hall feels like the final step, but it only starts the clock. Insurance is a separate application, made by you, with your BSN, Dutch address and bank details.

Switching each year

Insurers publish new premiums by 12 November. You can switch insurer once a year: cancel by 31 December and take out a new policy by 31 January, with cover backdated to 1 January (NL Times). For freelancers and remote workers, this is also the moment to revisit group discounts and supplementary cover.

12. What to do next

Here is the order to work through your own situation.

1. Write down your situation: when you arrived, how long you will stay, which permit you hold, and whether you work here as an employee, a freelancer or a remote worker
2. Gather documents: residence permit, BRP registration, BSN, employment contract or KVK (Chamber of Commerce) registration, and any A1 or treaty certificate
3. If posted, ask your employer whether a certificate of coverage has been issued and for how long
4. If unsure, ask the SVB: request a Wlz assessment through My SVB, no more than eight weeks before your situation changes
5. If obliged, insure within four months: apply with your BSN, address and bank details, and confirm the start date
6. Decide on supplementary and travel cover: dental, physiotherapy, trips home
7. Freelancers: budget the contribution — 4.85% of profit in 2026, up to €79,409
8. Check the healthcare allowance if your income is at or below €40,857 (single)
9. Open CAK letters immediately: choose option A or B within three months
10. Review every November–December: compare 2027 premiums once they are all published

13. Example cases (fictional)

The following people are fictional examples to show how the answer changes. Always confirm your own situation with the SVB and your insurer.

Case 1: A posted engineer from Germany

Lena's German employer has posted her to its Dutch subsidiary for two years and obtained an A1 certificate. She stays in the German system, is not Wlz-insured here and doesn't need Dutch basic insurance. Her German insurer's EHIC covers necessary care.

Case 2: A remote employee who moved for a partner

Marcus moved from Canada on a partner permit and kept his job with a Toronto firm, working from home in Utrecht. He was not posted and has no certificate. Living and working here, the SVB assessed him as Wlz-insured, so he needed Dutch basic insurance — and his employer had to look again at payroll.

Case 3: A US freelancer on DAFT

Priya came on a DAFT permit, registered a sole proprietorship with the KVK and works for clients in the US and Europe. She took out basic insurance within four months of registering. In her first year her profit was low enough for the healthcare allowance; she now sets aside about 5% of profit for the Zvw assessment.

Case 4: A three-month visitor

Tomás, a Brazilian photographer, spends ten weeks in Rotterdam without Dutch clients or registration, then moves on. No Dutch obligation applies; he relies on an international plan with repatriation cover.

Cases 1 and 2 show how two people with foreign employers can end up with opposite answers.

14. What not to do

15. Summary

• The Netherlands has no digital nomad visa; long stays need a purpose-based permit
• The obligation depends on where you live, where you work and which social security system covers you, and follows Wlz insurance
• People who work here or live here under Dutch social insurance must insure within four months — freelancers included
• Travel or international cover is enough mainly for short, non-working stays, transition periods and posted workers with a certificate
• In 2026 the deductible is €385 and the average premium about €157 a month; 2027 points to €400 and around €169
• Three months after a CAK letter comes a €529.74 fine; after a second fine, the CAK enrols you at €172.70 a month
• Registering with the municipality is not the same as being insured: the insurance application is yours to make

Sources

Expat and news media

• Digital nomad health insurance in the Netherlands — Expatica: starting article (updated 1 October 2026)
• Dutch basic health insurance — IamExpat: 2026 deductible, €159.30 average premium (Zorgwijzer)
• Prinsjesdag 2026: What's proposed, postponed & scrapped — IamExpat: €400 deductible for 2027
• DAFT: How U.S. freelancers can live and work in the Netherlands — IamExpat: treaty route and €4,500 capital
• 9 things you need to know about Dutch health insurance as an international — DutchReview: CAK grace period, EHIC, allowance limits
• DSW announces record premium increase for 2027 — NL Times: DSW's €173.25 premium, switching deadlines
• Budget Day leak: premiums set to rise — NL Times: pre-budget estimates
• Cabinet to discuss raising healthcare own risk after all — DutchNews: April 2026 deductible debate
• Health insurance costs could fall €25 a month with higher excess — DutchNews: voluntary deductible
• What insurances should I consider as a self-employed professional? — ACCESS: freelancer insurance checklist
• Can I use my Dutch health insurance abroad? — ACCESS: care abroad, short stays
• Health insurance for expats — Xpat.nl: basic and supplementary cover
• Dutch health care insurance explained by OHRA — The Hague International Centre: four-month deadline, discounts

Official sources

• Moet ik een zorgverzekering afsluiten als ik in Nederland ga werken? — Rijksoverheid: obligation for workers
• Wat kost het om een zorgverzekering af te sluiten? — Rijksoverheid: 2026 average premium and deductible
• Prinsjesdag 2026: Zorg — Rijksoverheid: 2027 forecasts
• I received a letter that I'm uninsured — CAK: options A and B, international policies
• I received a fine — CAK: fine calculation
• Zorgpremie 2026 regeling onverzekerden — CAK: €172.70 a month
• Apply for an assessment of your Wlz insurance position — SVB: Wlz assessment
• Percentages inkomensafhankelijke bijdrage Zvw — Belastingdienst: 2026 rates and ceiling
• Maximum income for healthcare allowance — Belastingdienst: allowance limits
• Buitenland en zorg (Zvw) — Zorginstituut Nederland: care abroad at Dutch rates
• Zorgthermometer 2026 — Vektis: nominal premium, switching rate
• Application form 7524 — IND: treaty-based self-employment
• Residence permit Working Holiday — IND: working holiday permits
• When should I register with the BRP? — government.nl: four-month registration rule
• Insurance for a Schengen visa — NetherlandsWorldwide: €30,000 minimum
• Japan–Netherlands social security agreement — MHLW: example of a bilateral agreement

All sources were checked on 21 October 2026. Rules and amounts change every year, so confirm the latest figures on official sites before you apply.

Original article

Digital nomad health insurance in the Netherlands — Expatica