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Leading health insurance companies based on revenue in Netherlands 2019

Which Dutch health insurance companies are the biggest? In 2019, Zilveren Kruis topped the ranking for gross premiums written due to medical expense insurances in the Netherlands, with a revenue of around ten billion euros. Dutch insurance companies, however, are often part of a larger concern. The five companies Achmea Zorgverzekeringen (in first place), De Friesland Zorgverzekeraar N.V. (sixth), FBTO Zorgverzekering N.V. (14th) and Interpolis Zorgverzekeringen (16th), for example, are all part of the concern Zilveren Kruis. This health insurance concern had a market share of 30 percent in the Netherlands in 2019.

Both the state and the private market are behind basic health insurance in the Netherlands

It is mandatory for Dutch residents or employees to have a basic health insurance. The Dutch government decides yearly on the contents of this basic package which is then offered by the health insurance companies. This package is the same for all companies and the companies are obliged to accept anyone who meets its requirements, regardless of age or medical history. Dutch citizens can then switch between health insurers at the end of every year (for example, if they believe they can get the same package elsewhere at a cheaper price). The idea behind this system is two-fold. First, the government hopes that free market competition curbs increasing health costs (as companies strive to make healthcare as affordable as possible in order to attract more customers). Second, the system is meant to show Dutch citizens how expensive healthcare is. The topic of healthcare expenses is so important to the Dutch that one particular element of the basic health insurance, the so-called mandatory excess or verplicht eigen risico, is widely considered to influence voting behavior during national elections.

On concerns, companies, brands and products

In 2019, the Netherlands had 11 health insurance concerns and roughly 40 companies. The companies use brands with which they can offer between one to four types of health insurance products, or policies (in Dutch: polissen) for the basic insurance. These all offer the same basic healthcare (as required by the government) but with varying price ranges. Supplementary (or aanvullende) health insurances are also available, but the contents of these can be decided by the health insurance companies themselves. This ranking includes several of these supplementary insurances.

Leading health insurance companies in the Netherlands in 2019, by revenue in gross written premiums

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Release date

November 2020



Survey time period


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Statistics on "Health insurance in the Netherlands"

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