As an international professional moving to the Netherlands, you’ll quickly encounter the 30% ruling. This tax benefit can have significant implications for your health insurance situation. Many expats make the mistake of assuming they are automatically exempt from Dutch health insurance, but the reality is more complex. In this article, we explain exactly how the 30% ruling works in combination with your health insurance obligation status, what costs you can expect, and how to make the best choice for your situation as an international employee in the Netherlands.
What Exactly Is the 30% Ruling?
The 30% ruling, also known as the expat scheme, is a tax benefit that the Dutch government has introduced to attract highly skilled foreign specialists. Under this regulation, up to 30% of your gross salary is exempt from Dutch income tax.
To qualify for the 30% ruling, you must meet several conditions:
- You were recruited from abroad by a Dutch employer
- You have specific expertise that is scarce in the Dutch labor market
- You lived at least 16 months of the past 24 months more than 150 kilometers from the Dutch border
- Your salary meets the minimum threshold of €46,660 per year (2025), or €35,468 if you are under 30 and have a master’s degree
From 2025, there is a maximum salary of €246,000 to which the ruling can be applied. The ruling has a maximum duration of five years and is administered by the Tax Authority.
Health Insurance Obligation or Exemption Under the 30% Ruling?
A common misconception is that you are automatically exempt from Dutch health insurance if you use the 30% ruling. However, this is not correct. Whether you are required to take out Dutch health insurance depends on your place of residence and work status, not on your 30% ruling status.
You are required to take out Dutch health insurance if you:
- Are resident in the Netherlands (registered with the GBA/BRP)
- Work in the Netherlands and pay wage tax
- Have no coverage through another EU member state
Exceptions exist for:
- Employees who work temporarily in the Netherlands (less than four months)
- Persons covered by health insurance from another EU country through the A1 declaration
- Diplomats and certain international organization staff members
As a 30% ruling user, you can choose supplementary international insurance alongside your Dutch basic insurance, but you usually cannot replace the basic insurance with an international policy.
Costs and Benefits of Dutch Health Insurance
The costs of Dutch health insurance consist of various components that you as an expat must understand:
| Cost Component | Amount (2025) | Explanation |
|---|---|---|
| Basic Premium | €130-€150 per month | Varies per insurer |
| Deductible | €385 per year | Mandatory minimum amount |
| Healthcare Allowance | Up to €111 per month | Income-dependent contribution |
For international employees, Dutch health insurance offers several advantages:
- Comprehensive coverage: All medically necessary care is covered
- No waiting periods or pre-existing condition clauses
- Direct access to Dutch healthcare providers
- Possible healthcare allowance if your income falls below certain limits
International expat insurance often costs €200-€500 per month, but offers more flexibility in healthcare provider choice and worldwide coverage. The choice depends on your personal situation and healthcare needs.
Common Mistakes with Health Insurance and 30% Ruling
Many international employees make costly mistakes with their health insurance choice. Here are the most common pitfalls:
Wrong Assumption About Exemption
The biggest mistake is assuming that the 30% ruling automatically provides exemption from health insurance obligation. This often results in fines from the Dutch government and problems with healthcare providers.
Late Registration
Those who do not register for health insurance within four months of arriving in the Netherlands receive a fine of €47 per month. This fine increases to a maximum of €2,316 per year.
Wrong Insurance Choice
Some expats choose the cheapest insurance without looking at the coverage. This can lead to high unexpected costs, especially for dental care or physiotherapy.
Double Insurance
International employees sometimes keep their foreign insurance alongside a Dutch policy, resulting in unnecessary double costs.
Forgetting to Apply for Healthcare Allowance
Many expats don’t know they are entitled to healthcare allowance, missing out on hundreds of euros annually.
Step-by-Step Plan: Choosing the Right Health Insurance
As a user of the 30% ruling, you can make the best health insurance choice with these concrete steps:
Step 1: Determine Your Insurance Obligation
- Check if you are registered with the municipality
- Verify if you pay wage tax in the Netherlands
- Check if you are covered through another EU member state
Step 2: Compare Dutch Insurers
- Use comparison sites like Zorgwijzer.nl
- Pay attention to premium, deductible options, and supplementary insurance
- Check if your preferred healthcare providers are contracted
Step 3: Determine Your Additional Needs
- Dental care (not in basic package)
- Physiotherapy beyond standard coverage
- Alternative medicine
- Care abroad
Step 4: Register on Time
- Take out insurance within four months of arrival
- Insurance takes effect on the first day of the month after registration
- Keep all documentation for your records
Step 5: Apply for Healthcare Allowance
- Check through the Tax Authority if you are entitled to healthcare allowance
- Submit your application via MijnToeslagen
- Update your information when your income changes
For complex situations where you need to weigh 30% ruling, international aspects, and compliance considerations, professional guidance can be valuable. We help international employees and their employers navigate through this complex legislation, ensuring you make the right choices without costly mistakes.
By following these steps, you ensure that as an international professional, you benefit optimally from both the 30% ruling and the right health insurance for your situation in the Netherlands. If you need personalized advice for your specific situation, please contact our specialists.
