The healthcare act contribution: the bill that surprises freelancers
Written by Ilias Aarrass3 min read · Published on · Last reviewed on 
In short
Besides income tax you pay a 2026 income-related healthcare contribution of 4.85 per cent on profit, up to € 79,409 of contribution income, so around € 3,850 at most.
- It arrives as a separate assessment alongside your income tax assessment; a provisional assessment lets you pay in instalments.
- The basis is your profit after the entrepreneur deductions and the SME profit exemption, not your turnover.
- The contribution is deductible nowhere: not as a business cost and not as a personal deduction.
- In 2025 the rate was still 5.26 per cent, with a lower maximum contribution income of € 75,864.
You've filed your return, you've set money aside for income tax, and then a second assessment lands: the income-related contribution under the Health Insurance Act. For many starting freelancers that's an unpleasant surprise, because it's a substantial amount on top of the tax. This article explains what this contribution is, roughly what it costs and how to anticipate it.
What is the healthcare act contribution?
Everyone in the Netherlands pays for healthcare twice. The first is the premium you transfer to your health insurer yourself, the nominal premium. The second is an income-related contribution. For employees the employer pays that contribution, which is why you never see it as an employee. As an entrepreneur you have no employer, so you pay that contribution yourself on your profit. It isn't income tax but a separate contribution under the Health Insurance Act, collected through its own assessment.
How much do you pay?
For entrepreneurs it is 4.85% in 2026 of your profit after the entrepreneur's deductions; in 2025 it was still 5.26%. There is a ceiling: contribution income counts up to 79,409 euros, so the contribution is never more than some 3,850 euros a year. The percentage and that maximum are set anew each year, so use the current figures for your year. On a profit of 40,000 euros you are looking at roughly 1,650 euros, and that comes on top of your income tax.
One more thing to know: for entrepreneurs this contribution is not deductible from your profit. So you can't claim it as a cost, however businesslike the assessment feels.
When do you get the assessment?
The contribution is determined on the basis of your income tax return and arrives as a separate assessment, usually shortly after or together with your income tax assessment. If you have a provisional income tax assessment, you can also receive a provisional assessment for the healthcare contribution and pay it in instalments. If your profit changes significantly, adjust both provisional assessments; they don't move in step automatically.
How much should you set aside?
Many freelancers set aside a percentage of every invoice for tax, but only reckon with income tax. Add the healthcare contribution and you often end up a few percentage points higher than you thought. If you work with a fixed reservation percentage, it's wise to set that percentage together with your bookkeeper based on your expected profit, rather than using a rule of thumb from the internet.
What's sensible to do?
Assume that two assessments will follow your return and plan accordingly. If you can't pay an assessment in one go, request a payment arrangement in good time rather than waiting for collection measures. We include the healthcare contribution as standard in the calculation we make with your annual figures, so you know what's still coming.
A worked example and how to reserve for it
The Zvw assessment arrives separately from your income tax, often around the same time. Those who do not reserve for it are surprised by it every single year.
Worked example: € 55,000 profit in 2026
- Profit after entrepreneur deductions (contribution income)
- around € 47,000
- Zvw contribution: 4.85%
- around € 2,280
- To reserve per month
- around € 190
Result: Count this into your fixed reservation alongside income tax and VAT; see [how much to set aside](kb:hoeveel-opzij-zetten-belasting)
Frequently asked questions
How much is the Zvw contribution for freelancers in 2026?
4.85 per cent of your contribution income, capped at 79,409 euros of income. The contribution therefore never exceeds roughly 3,850 euros. In 2025 the rate was 5.26.
What is the contribution calculated on?
On your profit after the entrepreneur deductions and the SME exemption, the contribution income. Wages from a job on the side do not count twice: your employer already paid an employer levy on those.
Is the Zvw contribution deductible?
No, nowhere. Not as a business cost and not as a personal deduction. That makes it different from, say, your disability insurance premium, which is deductible.
When do I receive the Zvw assessment?
As a separate assessment based on your income tax return, usually shortly after or together with your income tax assessment. With a provisional assessment you can also pay it spread over the year.
Do I pay Zvw in a loss year?
No. Without positive contribution income there is no contribution. If you have wages besides your loss, those were already covered through your employer.
Sources
- Healthcare contribution rates 2026Belastingdienst · belastingdienst.nl
Sources checked on
This article provides general information based on the rules known for 2026 and does not replace personal tax advice. For your specific situation, we're happy to take a look with you.
