Mandatory Acceptance of Basic Health Insurance for Rotterdam Residents
In Rotterdam, the **mandatory acceptance rule** requires health insurers to enroll all residents in the **compulsory basic health insurance**, regardless of health status, age, or risk profile. This principle of solidarity in healthcare ensures vulnerable residents—including expats and newcomers registered with the Municipality of Rotterdam—never remain uninsured. It is a cornerstone of the **Dutch Health Insurance Act (Zorgverzekeringswet, Zvw)** and applies to everyone living or working in the port city.
What Does Mandatory Acceptance Mean?
The **mandatory acceptance rule for basic insurance** legally obliges insurers to approve every application for basic coverage. Unlike private insurance, where risk factors determine eligibility, insurers in Rotterdam **cannot refuse** anyone for basic protection. This means residents—even with pre-existing conditions—can always secure a policy covering GP visits, hospital stays, and prescription medications under the reimbursement system.
This system guarantees **equal access to care** for all port city dwellers. Without it, insurers might only accept healthy applicants, driving up premiums and excluding groups like seniors in Rotterdam-Zuid. The rule applies **only to basic insurance**; additional coverage often requires stricter conditions, such as a health check.
Legal Foundation
The mandatory acceptance rule is codified in the **Dutch Health Insurance Act (Zvw)**, specifically in **Article 11 Zvw**. This stipulates that insurers must honor applications without discrimination based on health, age, gender, or other factors. Exceptions are rare—for example, in cases of double insurance or incomplete applications lacking identification.
**Article 12 Zvw** ensures premiums are uniform across insurers, regardless of individual risk. The **Dutch Authority for Consumers and Markets (ACM)** enforces compliance and can impose penalties. In 2023, the ACM addressed complaints from Rotterdam, clarifying that insurers **cannot ask health-related questions** for basic applications. Residents can seek free advice on these rules through the **Rotterdam Legal Advice Desk (Juridisch Loket Rotterdam)**.
The Zvw aligns with the broader Dutch social security framework and connects to the **Market Conduct Act for Health Insurance**. For more on switching insurers, see our guide on changing health insurers in Rotterdam.
Practical Examples from Rotterdam
For instance, a 65-year-old Rotterdam resident with type 2 diabetes seeking a more affordable policy **must be accepted** by the new insurer for basic coverage—**without surcharges or exclusions** for their condition. They pay the standard premium, just like other residents.
Or consider a young person with cystic fibrosis moving from Feijenoord to another Rotterdam neighborhood. Thanks to the rule, they **cannot be rejected** despite high care needs. Insurers typically respond within 30 days, often with retroactive coverage.
Even newcomers—such as a Ukrainian refugee registering with the Municipality of Rotterdam—are covered under the same rule. They can arrange basic insurance **without medical screening**, provided they have a **BSN (citizen service number)**.
Rights and Obligations
Your Rights as a Rotterdam Resident
- Guaranteed enrollment: Every insurer must accept your basic application.
- Uniform premium: No increases due to health status.
- Full basic coverage: Includes care for pre-existing conditions.
- Right to complain: If rejected, you can escalate to the **Social Insurance Appeals Board (SKGZ)** or **Rotterdam District Court**; the **Juridisch Loket Rotterdam** assists with preparation.
Your Obligations
- Arrange basic insurance **within four months** of registering with the Municipality of Rotterdam, or face a fine from the **Tax Authority (Belastingdienst)**.
- Pay premiums **on time**; arrears trigger sanctions under the Zvw.
- Provide **accurate information**; misrepresentation can lead to policy cancellation.
- Hold **only one basic policy**; dual coverage is prohibited.
Summary of rights vs. obligations:
| Aspect | Rights | Obligations |
|---|---|---|
| Acceptance | Always admitted | Submit correct application |
| Premium | Equal cost | Pay promptly |
| Coverage | Full basic package | No overlap |
Frequently Asked Questions for Rotterdam Residents
Can an insurer refuse me basic health insurance?
No. **Article 11 Zvw** prohibits refusal based on personal grounds. Only administrative issues—such as missing documents—may apply. In doubt, consult the **Juridisch Loket Rotterdam**.
Does this apply to supplemental insurance?
No. Additional policies may require medical underwriting and exclude risks. The rule applies **only to basic insurance**.
What happens when switching insurers?
You can switch freely; the new insurer **must accept** you. Your old policy ends on the new coverage’s start date, with no gaps.