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With a third of domestic health insurance gross direct premiums written in Europe, the Netherlands has by far the highest share of total premiums. In the Netherlands, private health insurance is mandatory. Insurance companies in the Netherlands must offer a universal healthcare package at a fixed price for all ages and status of health. In 2019, health benefit gross premiums on the insurance market in the Netherlands amounted to almost 47 billion euros.

Germany, which has the oldest social health care system in the world runs a statutory health insurance plan. Those employed pay 50 percent of their insurance directly from their wages, with the company picking up the rest of the bill. Those who are self employed must pay for the complete cover. In 2020, the market share of the German health insurance market was 23.1 percent.

Health insurance: market share of gross direct premiums written on the domestic market in 2020, by country

Characteristic	Market share
Netherlands	39.1%
Germany	23.1%
France	14.1%
Switzerland	6%
Spain	5.3%
United Kingdom	3%
Belgium	1.6%
Italy	1.4%
Austria	1.1%
Sweden	1.1%
Finland	0.6%
Norway	0.6%
Turkey	0.5%
Portugal	0.5%
Greece	0.5%
Denmark	0.4%
Slovenia	0.4%
Czechia	0.2%
Luxembourg	0.2%
Cyprus	0.1%
Latvia	0.1%
Poland	0.1%

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Release date

August 2022

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Region

Europe

Survey time period

2020

Supplementary notes

Domestic market.
Iceland, Hungary, Malta, Estonia, Lithuania, Ireland, Croatia, Bulgaria, Romania, and Slovakia total premiums written amounting to less than 0.1 percent of the market share and were therefore not included.

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