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ZEM Policy basic health insurance 2026


The premium of the basic health insurance ZEM Policy is €159.25 per month.

The basic health insurance ZEM Policy is a combination policy

Under this combination policy, your employee is entitled to 100% reimbursement for care from contracted care providers. We have contracts with all GPs and hospitals in the Netherlands. Reimbursement for care from non-contracted providers is limited.

Contracted care

  • 100% reimbursement

  • Agreements on the quality of the care provided, prices and availability

Non-contracted care

  • 75% reimbursement

  • No agreements on the quality of the care provided, prices and availability

  • The insured party first pays the invoice, and then submits it to ZEM for reimbursement

There are three exceptions:

  • Physiotherapy, remedial therapy, occupational therapy, speech therapy and oral care: 100%, if the price is compatible with the market rate

  • Specialist medical care: 90%

  • Mental healthcare and district nursing: 70%

View the rate list of non-contracted care

Find a contracted care provider

View all reimbursements in the Reimbursement Overview

Excess and AV-ZEM supplementary insurance

If your employee receives care covered by the basic healthcare insurance policy, they must pay their excess towards the costs of the care. The amount of the compulsory excess is set by the government. In 2026, the excess is €385.

The AV-ZEM policy also covers the compulsory excess of €385. This means that your employee will not have to pay any invoices for their excess. In other words, no uncertainty, no hidden costs. This supplementary insurance is only available for employees who participate in group insurance via employment agencies that have a contract with ZEM.

More information excess

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