Health Insurance Requirements for DAFT Application

Health insurance was one of the trickiest parts of our Dutch-American Friendship Treaty (DAFT) application. Not because it's complicated in theory, but because the timing creates a frustrating chicken-and-egg problem.

You need health insurance for your DAFT application, but many Dutch insurers want your BSN (citizen service number) before they'll enroll you. And you don't get your BSN until after you register at the municipality, which happens after you arrive.

Here's how to sort it all out.

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What the IND Requires

The IND requires proof of adequate health insurance as part of your DAFT application. Specifically, they want to see that you have coverage that meets Dutch standards.

The Netherlands has a mandatory health insurance system. Every resident must have at least basic health insurance (basisverzekering). This isn't optional—it's the law.

For your DAFT application, the IND wants to see:

• Proof of health insurance coverage in the Netherlands
• Coverage that meets the minimum standards of the Dutch Healthcare Insurance Act (Zorgverzekeringswet)
• Coverage effective from your arrival date

Reality Check: US health insurance plans (even good ones) generally don't satisfy the IND's requirements. You need Dutch-compliant health insurance, not just travel insurance or your existing US plan.

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When to Get Health Insurance

This is where the timing gets awkward. Here's the general sequence:

1. Before departure: Secure a provisional insurance arrangement or find an insurer that accepts applications without a BSN
2. After arrival: Register at the gemeente to get your BSN
3. With your BSN: Finalize your Dutch health insurance enrollment
4. For your IND appointment: Have proof of active coverage

Some Dutch consulates in the US accept a letter of intent from a Dutch insurer—proof that you've applied and will be covered once you arrive. Check with your specific consulate about what they accept.

The Gap Period

You'll likely have a gap between leaving the US (and potentially losing US coverage) and starting Dutch coverage. Many DAFT applicants use international travel insurance for this short period, typically 2-4 weeks.

Pro Tip: Don't cancel your US health insurance until your Dutch coverage is active. If your departure date shifts, you don't want to be uninsured. COBRA continuation coverage can bridge the gap if you're leaving employer-sponsored insurance.

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Recommended Providers for DAFT Applicants

Several Dutch insurers work well with DAFT applicants. Here are the ones we've seen recommended most often.

Dutch Basic Insurance Providers

Zilveren Kruis — One of the largest Dutch insurers. Straightforward enrollment process once you have a BSN. Good customer service and widely accepted by healthcare providers across Amsterdam, Rotterdam, The Hague, and beyond.

CZ — Another major insurer with solid coverage. Popular in the southern Netherlands, including Eindhoven and Maastricht.

VGZ — Well-regarded, competitive pricing. Good network throughout the country.

ONVZ — Slightly smaller but known for good customer service and English-language support, which is helpful when you're still learning Dutch.

For the Transition Period

Cigna Global or Allianz Care — International health insurance providers that can cover you during the transition from the US to the Netherlands. These can satisfy the IND's requirements initially, though you'll want to switch to Dutch basic insurance once you're settled (it's typically cheaper).

Aetna International — Another option for the transition period, though premiums tend to be higher.

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What Dutch Basic Insurance Covers

Dutch basic health insurance (basisverzekering) covers more than most Americans expect:

• GP (huisarts) visits
• Hospital care
• Prescription medications
• Mental health care
• Maternity care
• Dental care for children under 18
• Physical therapy (limited sessions)
• Medical devices and aids

The coverage is standardized by law—every insurer must offer the same basic package. The differences between insurers come down to premium price, customer service, and supplementary coverage options.

What It Doesn't Cover

• Dental care for adults (requires supplementary insurance)
• Physiotherapy for the first sessions (after the deductible)
• Cosmetic procedures
• Some alternative medicine

The Deductible (Eigen Risico)

Dutch health insurance has a mandatory annual deductible (eigen risico) of around 385 euros per year (2026). This means you pay the first 385 euros of most non-GP healthcare costs yourself each year.

GP visits, maternity care, and mental health care are exempt from the deductible, which is a significant difference from US healthcare where seemingly everything counts toward your deductible.

What We Wish We Knew: Dutch basic health insurance costs 120-180 euros per month. Coming from the US, where we paid over $600/month for a plan with a $5,000 deductible, this felt almost unbelievable. The coverage is genuinely good, and the system works.

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How Much It Costs

Here's a realistic breakdown of health insurance costs for DAFT applicants:

Coverage Type	Monthly Cost	Notes
Basic insurance (basisverzekering)	120-180 euros	Mandatory for all residents
Supplementary dental	15-40 euros	Optional, recommended for adults
Supplementary coverage	10-50 euros	Extras like physiotherapy, glasses
Typical total	140-220 euros	Per person

Healthcare Allowance (Zorgtoeslag)

If your income is below a certain threshold (which is common for DAFT applicants in their first year), you may qualify for zorgtoeslag—a monthly government subsidy to help pay your health insurance premium. This can be up to 120+ euros per month, making your effective premium very low.

You apply for zorgtoeslag through the Belastingdienst (Dutch tax authority) after you have your BSN and are registered with an insurer.

For a deeper comparison of US versus Dutch healthcare, read our post on healthcare in the Netherlands vs. the US.

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Step-by-Step: Getting Insured for DAFT

Here's the practical order we recommend:

2-3 Months Before Departure

• Research Dutch insurers
• Check with your Dutch consulate about exactly what proof they need
• If using international insurance for the transition, get quotes

1 Month Before Departure

• Apply for international transition insurance if needed
• Prepare to cancel or convert your US insurance
• Gather any existing medical records you want to bring

First Week After Arrival

• Register at your local gemeente to get your BSN
• Contact your chosen Dutch insurer and begin enrollment
• Provide your BSN, passport copy, and address

Within 4 Months of Arrival

• Dutch law requires you to have basic insurance within four months of becoming a resident
• If you delay beyond this, you'll face a fine and back-dated premiums
• Apply for zorgtoeslag if eligible

Pro Tip: Many Dutch insurance websites have English versions. Independer.nl is a popular comparison site that lets you compare premiums and coverage side by side.

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Common Questions

Can I keep my US health insurance instead?

No. Dutch law requires all residents to have Dutch basic health insurance. You can keep a US plan for supplementary coverage or for trips back to the US, but it doesn't replace the Dutch requirement.

What about pre-existing conditions?

Dutch insurers cannot deny you coverage or charge higher premiums based on pre-existing conditions for basic insurance. This is one of the strongest consumer protections in Dutch healthcare.

Does my spouse/partner need separate insurance?

Yes. Each adult needs their own health insurance policy. Children under 18 are covered under a parent's policy at no additional cost.

What if I travel frequently?

Most Dutch basic insurance plans include limited coverage for emergency care in EU countries. For travel outside the EU (including trips back to the US), you'll want travel insurance or supplementary coverage.

Check the full DAFT requirements checklist to see how health insurance fits into the overall application. And for more on getting started with Dutch health insurance specifically, see our Dutch health insurance for DAFT guide.

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