Dutch Eigen Risico (Own Risk) Deductible Explained

The eigen risico tripped us up our first year in the Netherlands. We thought our health insurance covered everything after the monthly premium. Then we got a bill for a specialist visit and realized we had missed a key piece of the puzzle.

The eigen risico (literally "own risk") is the Dutch health insurance deductible. If you are coming from the US on a Dutch-American Friendship Treaty (DAFT) visa, here is everything you need to know about it.

What Is the Eigen Risico?

The eigen risico is a mandatory annual deductible of 385 euros (2026). Every adult with Dutch health insurance pays this before their insurance fully covers most care.

Think of it like a US deductible, except simpler:

• It is the same amount for everyone
• It resets every January 1
• It only applies to certain types of care
• Children under 18 are exempt

After you have paid 385 euros in eligible healthcare costs during the year, your insurance covers everything else at 100%. No copays, no coinsurance, no surprise bills.

What Counts Toward Your Eigen Risico

These costs count toward your 385 euro deductible:

• Specialist visits (with referral from your huisarts)
• Hospital care and treatments
• Most prescription medications
• Mental health care
• Ambulance transport
• Medical devices and aids
• Lab tests ordered by specialists

When you receive care that counts toward the eigen risico, you do not pay at the point of service. Your insurance processes the claim, and you get a bill later for your portion (up to 385 euros total for the year).

What Does NOT Count

These are exempt from the eigen risico:

• GP (huisarts) visits
• Maternity and obstetric care
• Care for children under 18
• District nursing
• Certain chronic care programs
• Dental care for those under 18

Pro Tip: GP visits being exempt is a big deal. You can see your huisarts as often as needed without it touching your deductible. This is another reason to start with your GP for any health concern rather than going straight to a specialist.

This means your most frequent healthcare interactions -- regular GP visits, check-ups, and basic care -- cost you nothing beyond your monthly premium.

How the Eigen Risico Works in Practice

Here is a real example:

January: You visit a specialist for a knee issue. The visit costs 150 euros. You get a bill for 150 euros (applied to your eigen risico). Remaining: 235 euros.

March: Your GP prescribes medication that costs 40 euros. You get a bill for 40 euros. Remaining: 195 euros.

June: You need an MRI costing 300 euros. You get a bill for 195 euros (the remainder of your eigen risico). Insurance covers the other 105 euros. Your eigen risico is now met.

September: Another specialist visit costs 200 euros. Insurance covers all of it. You pay nothing.

January 1 next year: Your eigen risico resets to 385 euros.

Can You Change Your Eigen Risico?

Yes. You can voluntarily raise your eigen risico up to 885 euros (adding up to 500 euros on top of the mandatory 385). In exchange, your monthly premium drops.

Should you do this? It depends on your situation:

Higher eigen risico makes sense if:

• You are young and healthy
• You rarely visit specialists
• You want to save on monthly premiums
• You can handle an unexpected 885 euro bill

Stick with the standard 385 if:

• You have ongoing health conditions
• You regularly see specialists
• You take expensive prescription medications
• You prefer predictable costs

Reality Check: The monthly savings from raising your deductible are modest -- maybe 15-25 euros per month depending on your insurer. If you end up needing specialist care, you could quickly wipe out a full year of savings. Most people stick with 385.

Timing Your Care Strategically

Here is something nobody tells you: the eigen risico resets every January 1. This creates a practical consideration for non-urgent care.

If it is November or December and you have not used your eigen risico, consider whether non-urgent appointments (like that specialist follow-up or elective procedure) can wait until January. Starting fresh means those costs apply to next year's deductible.

If you have already met your eigen risico for the year, schedule any pending specialist visits or procedures before December 31. Everything will be fully covered.

This is not gaming the system. It is basic planning that Dutch people do all the time.

Eigen Risico and Your DAFT Business

As a DAFT entrepreneur, you are paying for health insurance out of your own pocket. The eigen risico is an additional cost to factor into your annual budget.

Budget tip: Set aside 35 euros per month (385 / 11 months, giving yourself a buffer). This way, if you need specialist care, the money is there and it does not feel like a sudden hit.

If your income is low enough, you might qualify for zorgtoeslag (healthcare allowance), which helps offset your premium costs. You will need your DigiD to apply through the Belastingdienst.

Eigen Risico vs. US Deductibles

For perspective, here is how the Dutch eigen risico compares to typical US deductibles:

	Netherlands	US (typical)
Annual deductible	385 euros	$1,500 - $8,000+
After deductible	100% covered	70-90% covered (coinsurance)
Out-of-pocket max	385 euros	$8,000 - $16,000+
GP visits	Exempt from deductible	Subject to deductible
Surprise bills	Not possible	Common

The difference is staggering. Even in the worst case, your maximum out-of-pocket for covered care in the Netherlands is 885 euros per year (if you chose the highest voluntary deductible). In the US, that number can be tens of thousands.

Frequently Asked Questions

Q: Do I pay the eigen risico if I only visit my huisarts? A: No. GP visits are completely exempt from the eigen risico. You can visit your huisarts as often as needed without any deductible costs. Only specialist care, hospital visits, and most prescriptions count.

Q: What happens if I do not pay my eigen risico bill? A: Your insurer will send reminders and eventually involve a collection agency. Unpaid medical bills can also affect your ability to get certain government benefits. Always pay on time or contact your insurer to arrange a payment plan if needed.

Q: Does the eigen risico apply to my children? A: No. Children under 18 are exempt from the eigen risico entirely. They are covered under your insurance at no additional premium and no deductible. This is one of the many family-friendly aspects of the Dutch system. Read more about having a baby in the Netherlands for additional details.

---

We're not immigration lawyers -- just Americans who did this. Requirements change, so verify with official sources.