In this comparison of health insurance for expats netherlands vs germany 2025, you’ll explore eligibility criteria, coverage details, cost structures, and expat-focused considerations. As an international student planning for a January intake 2026 study visa, understanding how each system works will help you meet visa requirements, manage your budget, and access care when you need it. Both countries mandate health insurance for residents, but the Dutch and German models differ in funding, benefits, and administrative processes. By the end of this guide, you’ll have the insights you need to decide which plan aligns with your needs and circumstances.
Understanding your options
Before you choose a policy, it helps to grasp how each country’s health insurance system is structured. Both the Netherlands and Germany operate under universal coverage frameworks, but they achieve universality through distinct mechanisms.
Overview of the Dutch system
- Mandatory basic insurance (basisverzekering) is required for all residents, including expats who stay longer than 183 days [1].
- Private insurers provide the basisverzekering under government rules on benefits, premiums, and deductibles.
- Community-rated premiums apply, and subsidies are available based on your income.
- You can purchase supplementary (aanvullende) plans for dental, vision, and other secondary services.
Key features:
- Average monthly premium: €138.45 (~$150.79)
- Annual deductible (eigen risico): €385, excluding GP visits, maternity and children’s care
- Option for voluntary higher deductible in exchange for lower premiums
- Insurers must accept applicants regardless of pre-existing conditions
Overview of the German system
- Dual system combining statutory health insurance (Gesetzliche Krankenversicherung, GKV) and private health insurance (Private Krankenversicherung, PKV).
- Employees earning under €73,800 annually must join GKV, covering roughly 90% of residents [2].
- High earners, self-employed individuals, students, and civil servants may opt for PKV.
- GKV contributions are income-based and split between employer and employee.
- PKV premiums are risk-rated by age, health status, and chosen benefits.
Key features:
- GKV contribution rate: 17.05% of gross salary, up to a contribution ceiling of €66,150 annually [2]
- PKV premiums for a healthy 30-year-old start around €230 per month, rising with age and risk factors [3]
- Family members covered at no extra cost under GKV, while PKV requires separate policies for each dependent
Eligibility and enrollment
Meeting eligibility requirements and enrolling on time ensures you comply with visa rules and avoid penalties.
Who qualifies in the Netherlands
- Residents who stay more than 183 days per year, including students on a Dutch residence permit.
- Expat students must obtain basic insurance within four months of moving to the Netherlands, or face a fine of €402 for late enrollment [4].
- Certain exemptions apply for holders of residence permits with sustainable tie status, but most long-term students need standard coverage.
Who qualifies in Germany
- Anyone employed under a German contract and paying social security contributions joins GKV by default.
- Students under age 30 can enroll in a discounted student GKV plan, typically costing around €110 per month.
- Civil servants, high-earners (above €73,800), and self-employed persons earning at least €30,000 annually can choose PKV [5].
- You must secure coverage within your first month of residency or employment to comply with immigration rules [4].
Enrollment deadlines
- Netherlands: Deadline within four months of arrival.
- Germany: Deadline within one month of starting employment or obtaining your residence permit.
- Late enrollment can trigger fines or make you responsible for back premiums.
Coverage and benefits
Examining what each system covers helps you anticipate out-of-pocket costs and service access.
Basic coverage in the Netherlands
- Primary care: GP visits, vaccinations, hospital stays, emergency care
- Prescriptions: Standard medications included
- Mental health services: Covered under basic plan
- Maternity care: Included without counting against your deductible
You can buy supplémentaire plans for:
- Dental care (adult checkups, fillings, crowns)
- Vision care (glasses, contact lenses)
- Alternative therapies (physiotherapy, acupuncture)
Basic coverage in Germany
- GKV covers a comprehensive package: outpatient and inpatient services, prescriptions, preventive care, maternity and children’s health.
- Co-payments: typical co-pays include €10 per prescription and up to 10% of rehab costs [5].
- Vision and dental treatments may require additional co-pays or separate supplementary policies.
Supplementary and private plans
Germany:
- PKV plans offer private hospital rooms, faster specialist access, and expanded dental and vision benefits [6].
- Long-term care insurance (Pflegepflichtversicherung) is automatic under GKV but must be added to PKV plans.
Netherlands:
- Aanvullende verzekering covers services excluded from the basic package, with premiums from €10 to €80 per month.
- Many expats choose dental and vision add-ons, as basic insurance does not cover adult dental costs.
Cost comparison overview
Cost will likely influence your choice. Below is a breakdown of typical expenses.
| Cost element | Netherlands (2025) | Germany (2025) |
|---|---|---|
| Basic monthly premium | €138.45 [5] | 8.525% employee share of gross salary (half of 17.05%) up to €602 [2] |
| Annual deductible | €385 | €10–€20 prescription co-pays, up to 10% rehab |
| Student plan cost | Same as residents | ~€110 per month |
| Private plan starting premium | N/A | €230 monthly for a 30-year-old [3] |
| Family coverage | Free for dependents | Free under GKV, separate PKV policies |
| Supplementary plan range | €10–€80 | €30–€100+ monthly |
Premiums and contributions (NL)
- Community-rated premiums ensure fairness across age groups.
- Government subsidies reduce costs for low-income students and part-time workers.
Premiums and contributions (DE)
- Income-based contributions scale with salary, providing predictability.
- Employer covers half of the GKV contribution.
- PKV premiums depend on individual risk factors, which can be attractive for healthy young students.
Family coverage costs
- Netherlands covers children and partners only through separate plans.
- Germany’s GKV includes family members at no extra cost, a major advantage for single-earner households.
Deductibles and co-pays
- Dutch deductible applies to most services except primary care and maternity.
- German co-payments are service-specific, generally low but adding up for multiple prescriptions or therapies.
Expat-specific factors
As an international student, you face unique considerations beyond basic cost and coverage.
International health insurance
- Short-term expat plans can bridge the gap until you enroll in national schemes.
- Providers like Allianz Care, APRIL International, and Cigna Global offer plans covering routine care, emergencies, dental, vision, and mental health [7].
- Costs vary by age, medical history, and whether you exclude coverage in high-cost regions like the United States.
Language and accessibility
- Netherlands: 95% of healthcare workers speak English, and major digital portals support English [4].
- Germany: Approximately 62% English proficiency in healthcare settings, though large hospitals provide English departments and interpreters.
Waiting times and network
- Netherlands: Specialist wait times average 2–4 weeks, generally reasonable under basic plans.
- Germany: GKV holders wait longer for specialists, while PKV members get appointments up to three times faster [4].
- Both systems leverage extensive provider networks, but private plans often expand your choice of practitioners.
Making your decision
Weigh your priorities against the features of each system. Use this checklist to guide your choice.
Key decision criteria
- Coverage needs: Do you require extensive dental or vision care?
- Family status: Will you insure dependents under your plan?
- Budget constraints: Can you afford risk-based premiums or prefer income-based contributions?
- Language comfort: Do you feel confident navigating care in Dutch or German?
- Specialist access: Is faster scheduling a top priority?
Checklist for students
- Verify student visa health insurance requirements [8].
- Compare basic plan premiums and deductibles.
- Estimate additional costs for supplementary or private coverage.
- Check enrollment deadlines to avoid fines.
- Explore short-term international plans for transition periods [9].
Further reading and internal resources
- Affordable health insurance Germany for international students 2026: link
- Cheapest expat health insurance Europe 2025 for non EU citizens: link
- Best healthcare systems in Europe for expats 2025: link
FAQs and resources
Common expat questions
Do I need health insurance before I arrive?
You must show proof of coverage to secure your visa and register at a municipality. An interim expat plan can satisfy immigration rules until you enroll in the national system.
Can I switch plans once I’m enrolled?
Netherlands: You can change insurers once a year in December.
Germany: You can switch GKV providers at any time, but PKV plans are long-term and often require medical underwriting.
What if I only stay for less than four months?
Short-term stays may be covered under the European Health Insurance Card (EHIC) or international travel insurance, but check specific visa requirements.
Useful external links
- Connected Financial Planning: German GKV and PKV breakdown [2]
- Bright!Tax overview of Dutch health insurance [5]
- Expatica guide to expat health insurance in Europe [7]
Further reading
- Compare university application deadlines for January intake: 2026 university application deadlines Europe international students
- Explore bachelor and master programmes for January intake 2026: bachelor programmes Europe January intake 2026, january intake masters Europe for international students
With a clear understanding of costs, coverage, and expat considerations, you’re ready to select the health insurance that fits your study plans. Review this comparison, consult the resources above, and secure the right plan well before your arrival.
My name is Amine i want to study in Europe my il live in morroco i want to study an do a sports my am athlete of amateur boxing
Hi, great comparison article! I was particularly interested in the section about international health insurance as a bridge for students before enrolling in national schemes. It got me thinking about how this process might work in other popular destinations for expats and students.
I’m currently researching options for a friend who is considering a move to Southeast Asia, and I came across a detailed guide about medical insurance in Thailand. Sorry to drop a link here, but it really helps to illustrate the kind of comprehensive, country-specific information that would be so useful. For example, this guide breaks down costs, mandatory visa requirements, and even covers specific scenarios like motorcycle accidents, which seem to be a common issue there.
My question is: based on your research for EU countries, how transferable are these risk assessment principles? For instance, would a student who opts for a higher deductible in the Netherlands be making a similar risk calculation to a digital nomad in Thailand choosing a plan with limited direct billing hospitals? I’m trying to understand if the core concepts of balancing cost versus coverage and access are universal, or if each region presents completely unique insurance challenges that require a totally different mindset. Thanks for the insightful article!
Olá! Excelente comparação entre os sistemas de saúde da Holanda e Alemanha para expatriados. Muito útil para quem planeja estudar ou morar na UE em 2026.
Uma dúvida que surgiu ao ler a seção sobre prazos de inscrição e documentação: como esse processo de registro e obtenção do cartão de saúde se compara ao da Espanha? Li recentemente um guia detalhado sobre o registro no sistema público de saúde espanhol e a obtenção da Tarjeta Sanitaria em https://e-residency.com/blog/spanish-public-healthcare-registration-how-to-get-your-health-card/, que menciona a importância do empadronamiento e do NIE.
Para estudantes que estão considerando múltiplos destinos na Europa, vocês teriam insights sobre como a burocracia e os requisitos de documentação se comparam entre esses três países? Isso seria incrivelmente valioso para ajudar na tomada de decisão. Obrigado!