Why do you pay Zvw contributions on top of your health insurance?
Your monthly premium to the health insurer and the income-related Health Insurance Act contribution are two different payments. The premium is part of your health insurance policy. The Zvw contribution is handled via the Tax and Customs Administration and depends on certain types of income.
With a regular job, the employer usually pays the employers healthcare insurance levy. On profits from business or income from other work, you generally pay the healthcare insurance contribution yourself via an assessment. Therefore, switching from employment to freelance can result in a new tax letter, while your health insurance remains the same.
| Payment | What for and to whom? |
|---|---|
| healthcare premium | The premium for your policy, paid to your health insurer. |
| Zvw contribution | An income-dependent contribution. As a self-employed person, you usually pay this yourself to the Tax and Customs Administration. |
| Income Tax | Tax on your taxable income, with your own calculation and assessment. |
Which payment route applies to a type of income is stated in the table of employers' levy or Zvw contribution. Pensions, benefits and a DGA salary can be treated differently from a regular job.
What is the rate of the Zvw contribution in 2026?
For entrepreneurs, the contribution amounts to 2026 4,85%. The maximum contribution income is €79.409. No extra contribution is calculated on income above that maximum. If you exclusively have contribution income that you pay for yourself via an assessment, 4.85% of the maximum amounts to about €3,851 per year.
Use the tax rate of the year to which the assessment relates. An assessment that you receive in 2026 may indeed relate to 2025. Check the official percentages and maximum amounts per year.
What amount is the contribution calculated on?
The calculation starts with the contribution income. For your business, this is basically the taxable profit: the fiscally calculated profit after the entrepreneurs' allowance and SME profit exemption to which you are entitled. Personal deductions, such as mortgage interest for your own home, do not reduce this business part of your contribution income. Therefore, do not use your turnover, received invoices or bank balance directly. For income from other work, it concerns the result after the applicable cost deduction.
Your bookkeeping forms the basis for this: revenue, business expenses and any tax adjustments must be assigned to the correct year. The amount from a provisional overview may therefore differ from the final outcome in your tax return. You can find more explanation at income tax for the self-employed.
Example: sole income from your business
Your contribution income for 2026 after the tax calculation is €36,000. You have no salary, pension, or other income and are insured in the Netherlands under the Zvw (Healthcare Insurance Act) for the entire year. The contribution is then:
€36,000 × 4.85% = €1,746.
This example deliberately starts from the already established contribution income. It does not state that €36,000 in turnover or profit before deductions yields the same result.
How does the Zvw (Health Insurance Act) work if you are also employed?
The salary on which your employer pays employers' Zvw levy already uses part of the annual maximum. You only pay for your other contribution income yourself to the extent that there is still room within that maximum. As a result, having a job alongside your business does not automatically mean that you will pay contributions again on your entire profit.
Example: salary and entrepreneurial income together above the maximum
Suppose that in 2026 you have €55,000 of wages subject to the Zvw (Health Insurance Act) on which the employer pays the employer’s health insurance contribution. In addition, you have €30,000 of contribution income from your business. There is no other relevant income and you are insured in the Netherlands for the whole year.
- Maximum in 2026: €79,409.
- Already used by your salary: €55,000.
- Remaining space: €79,409 − €55,000 = €24,409.
- Contribution regarding the business: €24,409 × 4.85% = approximately €1,184.
Is your pay on which employer's levy has been paid already at least €79,409? Then in this situation no room remains for a Zvw assessment on your entrepreneurial income. The Tax and Customs Administration describes the calculation for multiple incomes in 2026. Check your annual statement for the Health Insurance Act (Zvw) wage; do not just copy your net salary.
Why do you get a provisional health insurance act (Zvw) assessment?
A provisional assessment uses an estimate. The Tax and Customs Administration can base this on, for example, profits from business or income from other work that you declared previously. The amount therefore does not necessarily have to be appropriate if you expect lower profits, have stopped doing business or are working more as an employee.
Check the tax year, estimated income and other income details. If the estimate is out of date, you can change your provisional Health Insurance Act (Zvw) assessment via Mijn Belastingdienst. Read the explanation about the provisional healthcare insurance contribution assessment and the amendment route.
How do you file a tax return and how do you pay?
You provide your income details via the income tax return. The Zvw (Healthcare Insurance Act) contribution is calculated in the online return accordingly. If you have to pay a contribution, you will receive a separate assessment for this. The Tax Authorities explain this at pay Zvw contribution.
Keep the assessment notice with your tax documents and check whether it is a provisional or final assessment. Follow the payment details and deadlines that apply to that assessment. When budgeting your net income, also set money aside for the Zvw (Health Insurance Act); only setting aside money for income tax does not give a complete picture.
What do you check if the amount doesn't seem right?
- The year: hoort het gebruikte tarief bij de periode op de aanslag?
- Het inkomen: klopt de schatting, of gaat het al om definitieve aangiftegegevens?
- Loon, pensioen of uitkering: zijn de juiste bedragen voor de Zvw meegenomen?
- Het maximum: is rekening gehouden met inkomen waarover al werkgeversheffing of bijdrage is betaald?
- Je verzekeringssituatie: woonde of werkte je een deel van het jaar in het buitenland? Dan kan een aparte beoordeling nodig zijn.
Bij te veel ingehouden bijdrage over meerdere banen of uitkeringen kan een teruggaaf volgen. Denk je dat zo’n teruggaaf ontbreekt, gebruik dan de uitleg bij bijdrage Zvw terugkrijgen. Dat is een andere situatie dan een onjuiste winstschatting op je voorlopige aanslag.
Frequently Asked Questions
Might I have to pay Zvw if my income tax is zero?
Ja. Heffingskortingen kunnen de inkomstenbelasting verlagen, maar gelden niet op dezelfde manier voor de bijdrage Zvw. Daardoor kan een aparte Zvw-aanslag overblijven. De Belastingdienst benoemt dit verschil in de uitleg over inkomstenbelasting en Zvw. Nul inkomstenbelasting is dus geen bewijs dat ook je Zvw nul moet zijn.
Am I allowed to deduct the Zvw contribution?
Je eigen bijdrage Zvw is niet aftrekbaar in de aangifte inkomstenbelasting. De gewone zorgpremie en het eigen risico evenmin. De Belastingdienst vermeldt dit bij de gegevens voor je belastingaangifte. Haal dit niet door elkaar met zakelijke verzekeringen of zorgkosten waarvoor afzonderlijke aftrekvoorwaarden gelden.
Do I only pay Zvw if I am an entrepreneur for income tax purposes?
No. Income from other work can also lead to a Zvw assessment. The designation as a self-employed person (zzp'er) or a Chamber of Commerce registration does not determine this. The tax treatment of your income determines which details you include in the tax return.
Does this calculation also apply if I live or work outside the Netherlands?
Not automatically. The examples assume someone is covered under the Dutch Zvw for the entire year. In the case of cross-border work, another country may be competent or a correction may be necessary. In that case, check your insurance situation first before applying the Dutch percentage to your total income.
