A joint study by the Dutch Healthcare Authority (NZa) and the Netherlands Authority for Consumers and Markets (ACM) into the health-insurance market has revealed that the number of health-insurance plans that hardly differ from each other (or not at all) is still so large that it impedes consumers in their choice for a plan. Many consumers find it difficult to understand the differences and to select the health-insurance plan that best meets their needs. In 2023, 61 percent of consumers could have saved an average of 103 euros per year. They had taken out standard health-insurance plans for which alternatives existed that were the same (or almost the same) in terms of reimbursement, network coverage, and some key service elements, yet were more economical. ACM and NZa have put forward recommendations to policymakers, the Dutch legislature, and health insurers for making it easier to choose health-insurance plans.
More-economical alternatives for the standard health insurance are available


The study also shows that consumers are sometimes required to take out more-expensive standard health-insurance plans if they wish to take out more-extensive additional insurance plans, even though more-economical standard health-insurance plans would also meet those consumers’ needs. As a result, individuals that need these types of health-care plans pay more for their standard health-insurance plans than do others. Such restrictions of consumers’ choices put pressure on the principle of solidarity underpinning the Dutch health-care system. ACM and NZa find this an undesirable situation.


Consumers find health-insurance plans complicated products, especially with regard to reimbursements for out-of-network providers (health-care providers with which health insurers have no contract). In the study, ACM and NZa put forward recommendations for improving the choice process of consumers. Whether or not consumers switch is ultimately their own decision, but they should not experience any unnecessary impediments. The most important recommendations are reducing the number of identical (or nearly identical) insurance policies per health insurer as well as mandating health insurers that, with each standard health-insurance plan, consumers have access to all additional health-insurance plans of that particular health insurer.
What does ACM do in the health-care sector?


By carrying out market studies, among other activities, ACM helps realize its mission of ensuring that markets work well for all people and businesses, now and in the future, and also in the health-care sector. Our oversight helps ensure health care that is of high quality, affordable, and accessible. In the Dutch health-care system, the choices of patients and insured are central. Since consumers have a choice, health-care providers and health insurers wish to differentiate themselves from each other: in terms of price, quality, and services. As a result of this system, health-care quality remains high, and insurance premiums remain affordable.


The study “Policy differences and consumer choices on the health-care market” (in Dutch: Polisverschillen en consumentenkeuzes in de zorgverzekeringsmarkt) used data from ACM’s annual consumer survey into the health-care market, among other sources. That survey revealed that, during the recent switching period (at the end of each calendar year), insured paid more attention to the freedom of choice of health-care provider. To help consumers make their choices on the health-insurance market, ACM has updated the information on the website of its consumer information portal ACM ConsuWijzer.

Challenges in Choosing Health Insurance Plans Persist in the Netherlands

The study reveals that many health insurance plans in the Netherlands are too similar, making it hard for consumers to choose the best option. Consumers may end up paying more for standard plans to access additional coverage, impacting the principle of solidarity in the healthcare system. Recommendations include reducing identical insurance policies and ensuring access to all additional plans. The study aims to improve consumer choice and simplify the decision-making process. The Dutch Healthcare Authority and the Netherlands Authority for Consumers and Markets are working to address these issues and enhance the transparency and accessibility of health insurance information for consumers.