Written by
John Spencer
John Spencer is the founder of Compare Expat Plans, where he focuses on helping people compare health plans for life abroad. He emphasizes clear information, neutral analysis, and practical decision support.
Netherlands DAFT Visa Insurance Requirements
The Dutch American Friendship Treaty (DAFT) allows US citizens to establish a business in the Netherlands with a relatively low investment threshold (€4,500). As a Dutch resident, you're normally required to have Dutch basic health insurance (basisverzekering). However, DAFT visa holders can apply for an exemption if they have equivalent international coverage.
Key Insurance Requirements
- • Dutch health insurance (basisverzekering) is mandatory for residents
- • International insurance requires exemption from SVB/CAK
- • Exemption requires "equivalent coverage" to Dutch basic package
- • Coverage must include hospitalization, GP care, and prescriptions
- • Pre-existing conditions must be covered (for Dutch insurance)
- • Decision: Dutch insurance OR international with exemption
The Netherlands has a unique system: everyone must have basic insurance (basisverzekering) at a regulated price (around €120-140/month). This covers essential care. For more coverage, you add supplementary insurance (aanvullende verzekering). Insurers cannot reject you for basic insurance regardless of health status.
For DAFT visa holders, the choice comes down to: Do you want to fully integrate into the Dutch system, or maintain international coverage for flexibility (especially if you travel to the US frequently)?
Quick Comparison: Insurance Options for DAFT Visa
DAFT visa holders have three paths: premium international insurance with exemption, standard international with exemption, or Dutch basic insurance. Here's how they compare:
| Feature | Cigna Global | Allianz Care | Dutch Insurance |
|---|---|---|---|
| DAFT Visa Acceptance | ✓ Accepted with exemption | ✓ Accepted with exemption | ✓ Required by default |
| Dutch Hospital Network | Good (direct billing) | Good (direct billing) | Excellent (all hospitals) |
| US Coverage | ✓ Optional add-on | ✓ Optional add-on | ✗ Not covered |
| Pre-existing Conditions | Moratorium option | Moratorium option | ✓ Full coverage required |
| Eigen Risico (Deductible) | Customizable | Customizable | €385 mandatory |
| Mental Health | Full coverage | Full coverage | Covered (with referral) |
| Annual Maximum | €1M - Unlimited | €1M - Unlimited | Unlimited (basic care) |
| Best For | US visits, global needs | Flexible coverage | Full Dutch integration |
Cigna Global
Cigna Global is a strong choice for DAFT visa holders who travel frequently or maintain ties to the US. Their plans can include US coverage—essential if you're visiting family or have business interests stateside.
Strengths
- • US coverage available (critical for Americans)
- • Good network in Dutch cities
- • Modular plans for customization
- • Comprehensive mental health coverage
- • Can qualify for Dutch exemption
- • 24/7 English-speaking support
Considerations
- • US inclusion adds significant cost
- • Must apply for Dutch exemption
- • Network smaller than Dutch insurers
- • Age-based pricing increases over time
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International coverage with US access for American expats.
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Allianz Care
Allianz Care provides flexible international coverage with strong European networks. Their plans can qualify for the Dutch exemption while offering more flexibility than local insurance.
Strengths
- • Good Dutch hospital network
- • Flexible plan options and deductibles
- • Strong European coverage
- • Wellness and preventive benefits
- • Brand recognition in Netherlands
- • Can qualify for Dutch exemption
Considerations
- • US coverage varies by plan
- • Must apply for exemption
- • Claims processing can be slower
- • Age-based pricing
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Flexible international coverage for Dutch residents.
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Dutch Basic Insurance (Basisverzekering)
Dutch basic health insurance is the standard path for residents. Multiple insurers offer it (Zilveren Kruis, CZ, VGZ, etc.) at regulated prices around €120-140/month. No one can be rejected, and pre-existing conditions must be covered.
Strengths
- • Flat pricing regardless of age/health
- • All pre-existing conditions covered
- • Access to entire Dutch healthcare network
- • No exemption paperwork needed
- • Maternity fully included
- • Seamless integration with Dutch system
Considerations
- • No US coverage at all
- • €385 mandatory deductible (eigen risico)
- • Limited coverage outside Netherlands
- • Dental, vision need supplementary
- • Referral required for specialists
How to get Dutch insurance: Compare at Independer.nl or Zorgwijzer.nl (in Dutch). Popular insurers include Zilveren Kruis, CZ, OHRA, and VGZ. Most offer English online portals. Sign up within 4 months of registration in the Netherlands.
Coverage Comparison
Here's how coverage compares across key categories for DAFT visa holders:
| Coverage Type | Cigna Global | Allianz Care | Dutch Insurance |
|---|---|---|---|
| Inpatient Hospital | 100% covered | 100% covered | 100% (contracted) |
| Outpatient Care | 100% covered | 100% covered | 100% (with referral) |
| Emergency Evacuation | Unlimited | Unlimited | Limited |
| Prescription Drugs | 100% covered | 100% covered | Formulary based |
| Dental | Optional | Optional | Optional add-on |
| Vision | Optional | Optional | Optional add-on |
| Maternity | Optional add-on | Optional add-on | ✓ Included (midwife) |
| Fysio (Physiotherapy) | Varies by plan | Varies by plan | Limited sessions |
Dutch basic insurance covers essential care comprehensively but requires referrals for specialists. International plans offer more direct access but may have network limitations in the Netherlands.
Pricing Comparison
Dutch insurance has flat pricing; international insurance varies by age. This creates an interesting decision point:
| Age Group | Cigna Global | Allianz Care | Dutch Insurance |
|---|---|---|---|
| 25-30 | €180-280/month | €170-260/month | €120-140/month |
| 30-35 | €220-340/month | €210-320/month | €120-140/month |
| 40-45 | €320-480/month | €300-450/month | €120-140/month |
| 50-55 | €450-650/month | €420-600/month | €120-140/month |
For younger Americans, Dutch insurance is more expensive than basic international coverage. For older Americans, Dutch insurance becomes very competitive. The real differentiator is US coverage—if you need it, international is your only option.
Network Access
Network access varies significantly depending on your choice:
| Region/City | Cigna Global | Allianz Care | Dutch Insurance |
|---|---|---|---|
| Amsterdam | Strong - 10+ hospitals | Strong - 10+ hospitals | Excellent - all hospitals |
| Rotterdam | Good - 6+ hospitals | Good - 6+ hospitals | Excellent - all hospitals |
| The Hague | Good - 5+ facilities | Good - 5+ facilities | Excellent - all hospitals |
| Other Cities | Limited - reimbursement | Limited - reimbursement | Full network access |
| United States | Strong (with US option) | Strong (with US option) | Not covered |
| Rest of World | Worldwide coverage | Worldwide coverage | Emergency only |
If you're staying primarily in the Netherlands, Dutch insurance provides the best network access. If you travel to the US regularly, international insurance is essential.
Real-World Scenarios
Scenario 1: Young Entrepreneur, No US Ties
28-year-old starting a tech company in Amsterdam, no plans to return to the US regularly.
Recommendation: Dutch Basic Insurance
Best network, flat pricing, no exemption hassle. Add supplementary for dental/vision. At this age, Dutch pricing is slightly higher but full integration is valuable.
Scenario 2: Consultant with US Clients
35-year-old consultant who visits US clients 4-6 times per year, 2-3 weeks each trip.
Recommendation: Cigna Global with US coverage
US coverage is essential for this travel pattern. The extra cost is justified by meaningful US network access. Apply for Dutch exemption.
Scenario 3: Older Entrepreneur with Pre-existing Conditions
52-year-old with managed hypertension, establishing business in Rotterdam, occasional US trips.
Recommendation: Dutch Basic Insurance + Travel Insurance
Dutch insurance covers all conditions at flat rate. Much cheaper than age-adjusted international premiums. Buy separate travel insurance for US trips.
Scenario 4: Family Moving to Netherlands
Couple in their 40s with two children, planning 5+ years in the Netherlands.
Recommendation: Dutch Basic Insurance for all
Family coverage is much more affordable in Dutch system. Excellent pediatric care. Full maternity coverage if planning more children. Kids get zorgtoeslag (subsidy).
Scenario 5: Digital Nomad Testing DAFT
30-year-old using DAFT for residency but traveling 6+ months/year across Europe and US.
Recommendation: Cigna Global with US coverage
Global coverage essential for this lifestyle. Dutch insurance provides almost no coverage outside Netherlands. Apply for exemption.
Our Verdict
For DAFT visa holders planning to stay primarily in the Netherlands, Dutch basic insurance offers the best value and network access. For those who travel to the US regularly or maintain a global lifestyle, Cigna Global with US coverage provides necessary flexibility despite higher costs.
Choose Dutch Insurance If...
- • Staying mainly in Netherlands
- • Have pre-existing conditions
- • Want full local network
- • Planning family/maternity
Choose Cigna If...
- • Regular US travel needed
- • Want worldwide coverage
- • Prefer premium service
- • Young and healthy
Choose Allianz If...
- • Europe-focused travel
- • Want flexible deductibles
- • Don't need US coverage
- • Like brand recognition
Frequently Asked Questions
How do I apply for the Dutch insurance exemption?
Apply through SVB (Sociale Verzekeringsbank) or CAK. You'll need to prove your international insurance provides "equivalent coverage" to Dutch basic insurance. This includes GP care, hospital care, prescriptions, maternity, and mental health. Processing takes several weeks.
What is the €385 eigen risico?
The eigen risico is a mandatory annual deductible for Dutch basic insurance. You pay the first €385 of care costs (except GP visits, which are free). After that, insurance covers 100%. You can opt for a higher deductible (up to €885) for lower premiums.
Can I switch between Dutch and international insurance?
Yes, but timing matters. Dutch insurance typically switches annually (by January). To move from international to Dutch, cancel your international plan and enroll in Dutch insurance. Going the other direction requires applying for exemption first.
What happens if I get sick in the US with Dutch insurance?
Dutch basic insurance covers only emergency care abroad, with significant limitations. You'd pay US rates (extremely high) and seek partial reimbursement at Dutch rates. For any meaningful US time, you need separate US coverage or international insurance.
Do I qualify for zorgtoeslag (healthcare subsidy)?
Possibly. Zorgtoeslag is a monthly subsidy (up to ~€150/month) for those with lower incomes. As a DAFT entrepreneur with variable income, you may qualify in some years. Check Belastingdienst (tax office) for current thresholds.
What's the minimum investment for DAFT?
Currently €4,500 in your Dutch business bank account. This is notably lower than most entrepreneur visa programs. You also need a viable business plan and the usual documentation (insurance, housing, etc.).
Disclaimer: Insurance requirements and DAFT visa rules change. Verify current requirements with IND (Dutch immigration) and confirm insurance details with providers before purchasing. This comparison is for informational purposes and does not constitute legal or insurance advice.
