Health insurance company DSW is putting up its monthly premium by €11.50, taking the price of basic coverage to €149 a year.

The rise is the biggest ever by the insurer, which is traditionally the first to go public with its fees, ahead of the six-week transfer window that starts in mid November. 

DSW said on Tuesday it is concerned about the growing number of people who avoid healthcare because they can’t afford top-up fees or are in debt. “We think the increase in fees has to stop because we have reached the limit of what people can afford to pay,” said director Aad de Groot. 

This year DSW has not used its reserves to keep the premium increase low. “We’ve gone as far as we can,” De Groot said. “This is a premium that reflects actual costs.”

Insurance companies must publish their new rates by November 12 at the latest. The government said last week it expected premiums to rise by €12 a month

The government determines the make up of the basic policy and the own risk payment, which is currently frozen at €385. Insurance companies are free to set their own prices and to determine the cost and composition of top up policies, covering items like dental services and extra physiotherapy.

Income-dependent healthcare benefits (zorgtoeslag) will reach a maximum of €127 per month for a single person or €243 for a family. 

Four companies Achmea (Zilveren Kruis), VGZ, CZ and Menzis control 90% of the market.