Dutch Health Insurance (ZVW) - Income-Based Premium

The income-based health insurance premium (ZVW) is a mandatory contribution that funds the Dutch healthcare system. Unlike the basic premium you pay to your insurer, this premium is based on your income and collected through payroll or tax assessments.

Last Updated: 2025-08-06

Key Points

  • Employees pay 6.51% of gross income up to €66,956
  • Self-employed pay 5.26% due to different risk profile
  • Healthcare allowance (zorgtoeslag) available for low-income households
  • Separate from basic premium paid to insurance companies
  • Covers essential healthcare benefits for all residents

Calculation Example

Health Insurance Premium for €55,000 Employee

Gross Annual Salary:€55,000
Employee Premium Rate:6.51%
Result:€3,581 annual premium

Premium calculation: €55,000 × 6.51% = €3,581. This is collected through payroll deduction alongside income tax.

Frequently Asked Questions

What's the difference between basic premium and income-based premium?

Basic premium is a fixed amount you pay directly to your insurance company (around €1,300-1,500/year). Income-based premium is calculated on your income and collected by the tax authority to fund the healthcare system.

Why do self-employed pay a lower rate?

Self-employed individuals have a different risk profile and fewer employment-related health benefits. The 5.26% rate reflects this adjusted risk assessment compared to the 6.51% employee rate.

How does healthcare allowance (zorgtoeslag) work?

Healthcare allowance helps low-income households pay their health insurance. Maximum allowance is €137/month for singles and €274/month for couples. Income and asset limits apply.

Is there a maximum income for this premium?

Yes, the income-based premium is calculated on income up to €66,956 (2025). Income above this threshold is not subject to the health insurance premium.