zem.nl

ZEM Policy basic healthcare insurance 2025


The ZEM Policy is a combination policy

Under this combination policy, you are 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. However, in the case of oral care and paramedical care, the policy will fully reimburse care from any provider (both contracted and non-contracted).

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

Contracted care

  • 100% reimbursement

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

Non-contracted care

  • 75% reimbursement (100% for oral and paramedical care)

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

  • You first pay the invoice yourself, and then submit it to ZEM for reimbursement

There are two exceptions where reimbursement of care from a non-contracted provider is lower than 75%:

  • Mental healthcare, 70% max.

  • District nursing, 70% max.

View the rate list for non-contracted care

Find a contracted care provider

View all reimbursements in the Reimbursement Overview

Excess and AV-ZEM supplementary insurance

If you receive care covered by the basic insurance policy, you must pay your excess towards the costs of the care. The amount of the compulsory excess is set by the government. In 2025, your excess is €385.

The AV-ZEM policy also covers the compulsory excess of €385. This means that you will not have to pay any invoices for your excess. In other words, no uncertainty, no hidden costs. This supplementary insurance is only available under group insurance via an employment agency that is affiliated with ZEM.

More information about your excess

Read more