Health insurance on a low income: Are you eligible for support?

Health insurance can take a sizeable bite out of a tight budget. People on low incomes in the Netherlands may qualify for help through a municipal health insurance policy, but where they live can determine whether that support is available and how much they pay. 

What is a municipal health insurance policy?

These policies, known as gemeentepolissen, are intended to make broader healthcare cover more affordable. Yet research by the Institute for Public Economics (IPE) shows substantial differences between municipalities, leaving residents with different levels of support for the same insurance.

A gemeentepolis (municipal health insurance policy) combines basic health insurance with supplementary cover for people on low incomes. Participating municipalities arrange the packages with an insurer and usually contribute towards the monthly premium.

The supplementary insurance can cover costs such as dental treatment, physiotherapy and glasses or contact lenses. Some packages also cover the eigen risico (compulsory excess), reducing the risk of an unexpected bill when someone needs care. The precise cover and reimbursement limits depend on the package.

This is separate from the zorgtoeslag (national healthcare allowance), which helps eligible residents pay their health insurance premiums. A municipal policy provides insurance cover, with any municipal contribution reducing what the resident pays. The two forms of support can be used together.

Same insurance, different postcode, different price

Residents in different municipalities can pay substantially different monthly premiums for the same insurance cover, depending on how much their municipality contributes. IPE found that residents with the same VGZ/Univé supplementary package, including cover for the compulsory excess, pay 23,75 euros per month in Zaanstad and 84,15 euros in Waalre after municipal contributions. These amounts exclude the basic health insurance premium.

That is a difference of 60,40 euros a month, or 724,80 euros a year, for the same supplementary cover. The insurer’s package is the same; the amount each municipality contributes changes what residents pay.

Access also depends on local rules. According to the IPE report, 86 percent of municipalities offering a policy set the maximum qualifying income at 120 to 130 percent of the social assistance benefit rate applicable to the applicant’s age and household situation. Some municipalities also limit the total value of savings and other assets an applicant can have and still qualify.

In 2026, 34 municipalities offer no municipal policy at all, compared with four in 2017. That does not necessarily mean residents have no other local support available, but they cannot access this particular scheme through their municipality.

What happens when people cannot afford care?

A dental appointment or physiotherapy session can become a difficult financial decision when someone has little money to spare. In an episode titled “Schulden of Kiespijn" (Debt or Toothache?)”, investigative journalism programme Pointer examines how people on low incomes face a choice between postponing healthcare and taking on debt to pay for it.”

IPE estimates that 160.000 people miss out on municipal health insurance because their municipality either offers no policy or contributes too little to make it affordable. The institute argues that accessible cover can help prevent people from avoiding treatment and protect them against debt.

There is disagreement over how to address these gaps. IPE recommends replacing municipal policies with national arrangements: an exemption from out-of-pocket payments for basic healthcare for people on low incomes, alongside a contribution towards supplementary insurance. 

VGZ favours retaining the municipal system. According to NOS, the insurer has contacted the 34 municipalities without a policy to discuss introducing or reinstating one. IPE recommends replacing municipal policies with national support, while VGZ wants more municipalities to offer a policy. Neither proposal changes the support currently available to residents.

How to check what support you can get

You can check whether you qualify for a municipal health insurance policy on Gezondverzeker. Search for your municipality, select a package and open “Kom ik in aanmerking?” (“Am I eligible?”) to see the local requirements. If you are unsure, contact your municipality for help. 

Check the eligibility rules carefully, including the income threshold for your household and any asset limit. Look at how much the municipality contributes and the monthly premium you would pay after that contribution.

The details of the cover matter just as much as the price. Check dental reimbursement limits, the number of physiotherapy sessions included and whether the compulsory excess is covered. Compare the total premium and likely out-of-pocket costs with other insurance options to see which package suits your needs.

If your municipality does not offer a policy, ask what other help with healthcare costs may be available and which conditions apply. Check your eligibility for the national healthcare allowance separately, too. Access to zorgtoeslag does not depend on your municipality offering a policy.