Since 2008, it is compulsory from the age of 18 to pay a total mandatory excess before the basic health insurance reimburses medical costs. In this way, everybody contributes to certain types of healthcare such as maternity care. Excess can be increased with either 100, 200, 300, 400 or 500 euros. In return for taking on the extra risk of potentially paying more medical costs, the premium will decrease. The higher the voluntary excess, the less premium will have to be paid.
In 2005, total health expenditure as share of GDP in the Netherlands was approximately 12 percent. Subsequently, this increased to approximately 14 percent in 2015.