What is the country of residence factor?

We apply the country of residence factor annually to your total healthcare contribution. 

You work in the Netherlands and live abroad. Your family members are treaty-entitled. 

You pay a nominal contribution health insurance law (Zvw) per member of the family. We multiply the total amount by the country of residence factor. 

You live with a Dutch pension or benefit abroad. You and your family are treaty-entitled.

You pay a nominal contribution Zvw for yourself and your family members. In addition, you pay an income-dependent contribution (percentage of your income) Zvw and Wlz. Tax credits may apply to the income-dependent contribution Wlz. Then we multiply the total amount by the country of residence factor. 

Please note: The country of residence factors, the nominal contribution Zvw and the percentages for the income-dependent contributions Zvw and Wlz are determined by the minister of VWS each year.

Nominal Zvw contribution

• per month: EUR 123.17 (this amount serves as the basis for applying the country of residence factor).

Income-dependent Zvw contribution

• employer’s contribution for benefits under the Work and Income (Capacity for Work) Act (WIA) / Invalidity Insurance Act (WAO) / Invalidity Insurance (Self-Employed Persons) Act (WAZ) or surviving dependant’s pension: 7.00%;
• deduction from old-age pension and other income: 5.75%;
• maximum assessable income: EUR 58 311.

Income-dependent Wlz contribution

• deduction from income in the first and second tax bracket: 9.65% (also if there is no liability for tax in the Netherlands);
• born in 1945 or earlier: maximum assessable income EUR 35 941;
• born in 1946 or later: maximum assessable income EUR 35 129.

Country of residence factors and nominal Zvw contributions

Country	Country of residence factor	Monthly contribution (EUR)
Belgium	0.7347	90.49
Bosnia and Herzegovina	0.0681	8.39
Bulgaria	0.0823	10.14
Cyprus	0.1434	17.66
Denmark	0.9982	122.95
Germany	0.8134	100.19
Estonia	0.2480	30.55
Finland	0.7023	86.50
France	0.8918	109.84
Greece	0.2446	30.13
Hungary	0.1493	18.39
Ireland	0.8981	110.62
Iceland	1.3453	165.70
Italy	0.5322	65.55
Cape Verde	0.0167	2.06
Croatia	0.1871	23.05
Latvia	0.1083	13.34
Liechtenstein	0.9923	122.22
Lithuania	0.2631	32.41
Luxembourg	0.7384	90.95
Northern Macedonia	0.0599	7.38
Malta	0.3987	49.11
Morocco	0.0222	2.73
Montenegro	0.0821	10.11
Norway	1.3064	160.91
Austria	0.6408	78.93
Poland	0.1601	19.72
Portugal	0.2600	32.02
Romania	0.0824	10.15
Serbia	0.0682	8.40
Slovenia	0.3344	41.19
Slovakia	0.2445	30.12
Spain	0.3855	47.48
Czech Republic	0.2341	28.83
Tunisia	0.0280	3.45
Turkey	0.0851	10.48
United Kingdom	0.6593	81.21
Sweden	0.7906	97.38
Switzerland	0.7536	92.82

Tax credits

Type	Amount of credit (EUR)
General tax credit
income not exceeding EUR 21 043	738
income between EUR 21 043 and EUR 68 508	between 738 and 0
income exceeding EUR 68 508	0
Young disabled person’s tax credit	198
Elderly person’s tax credit – You are entitled to this tax credit if you have reached state pension age (66 years and 4 months) on 31 December 2021:
aggregate income not exceeding EUR 37 970	856
aggregate income between EUR 37 970 and EUR 49 323	between 856 and 0
aggregate income exceeding EUR 49 323	0
Single elderly person’s tax credit – You are entitled to this tax credit if you receive a single person’s old-age pension.	223
General tax credit for partner with no or low income
Partner born before 1.1.1963 and below state pension age	2 837
Partner born after 31.12.1962	378
Partner of state pension age or older	1 468
Green investment tax credit	214

Nominal Zvw contribution

• per month: EUR 117.92 (this amount serves as the basis for applying the country of residence factor).

Income-dependent Zvw contribution

• employer’s contribution for benefits under the Work and Income (Capacity for Work) Act (WIA) / Invalidity Insurance Act (WAO) / Invalidity Insurance (Self-Employed Persons) Act (WAZ) or surviving dependant’s pension: 6.70%;
• deduction from old-age pension and other income: 5.45%;
• maximum assessable income: EUR 57 232.

Income-dependent Wlz contribution

• deduction from income in the first and second tax bracket: 9.65% (also if there is no liability for tax in the Netherlands);
• born in 1945 or earlier: maximum assessable income EUR 35 375;
• born in 1946 or later: maximum assessable income EUR 34 712.

Country of residence factors and nominal Zvw contributions

Country	Country of residence factor	Monthly contribution (EUR)
Belgium	0.7303	86.12
Bosnia and Herzegovina	0.0695	8.20
Bulgaria	0.0780	9.20
Cyprus	0.1410	16.63
Denmark	1.0095	119.04
Germany	08041	94.82
Estonia	0.2408	28.40
Finland	0.7340	86.55
France	0.9066	106.91
Greece	0.2589	30.53
Hungaria	0.1445	17.04
Ireland	0.8972	105.80
Iceland	1.1637	137.22
Italy	0.5504	64.90
Cape Verde	0.0176	2.08
Croatia	0.1836	21.65
Latvia	0.1020	12.03
Liechtenstein	1.0584	124.81
Lithuania	0.2553	30.10
Luxembourg	0.7107	83.81
Northern Macedonia	0.0598	7.05
Malta	0.3783	44.61
Morocco	0.0229	2.70
Montenegro	0.0821	9.68
Noorway	1.3678	161.29
Austria	0.6730	79.36
Poland	0.1709	20.15
Portugal	0.2736	32.26
Romania	0.0877	10.34
Serbia	0.0718	8.47
Slovenia	0.3520	41.51
Slovakia	0.2584	30.47
Spain	0.4065	47.93
Czech Republic	0.2464	29.06
Tunisia	0.0289	3.41
Turkey	0.0902	10.64
United Kingdom	0.7004	82.59
Sweden	0.8339	98.33
Switzerland	0.7933	93.55

Tax credits

Type	Amount of credit (EUR)
General tax credit
income not exceeding EUR 20 711	701
income between EUR 20 711 and EUR 68 507	between 701 and 0
income exceeding EUR 68 507	0
Young disabled person’s tax credit	194
Elderly person’s tax credit – You are entitled to this tax credit if you have reached state pension age (66 years and 4 months) on 31 December 2020:
aggregate income not exceeding EUR 37 372	805
aggregate income between EUR 37 372 and EUR 48 185	between 805 and 0
aggregate income exceeding EUR 48 185	0
Single elderly person’s tax credit – You are entitled to this tax credit if you receive a single person’s old-age pension.	217
General tax credit for partner with no or low income
Partner born before 1.1.1963 and below state pension age	2 711
Partner born after 31.12.1962	542
Partner of state pension age or older	1 413
Green investment tax credit	207

Nominal Zvw contribution

• per month: EUR 115.42 (this amount serves as the basis for applying the country of residence factor).

Income-dependent Zvw contribution

• employer’s contribution for benefits under the Work and Income (Capacity for Work) Act (WIA) / Invalidity Insurance Act (WAO) / Invalidity Insurance (Self-Employed Persons) Act (WAZ) or surviving dependant’s pension: 6.95%;
• deduction from old-age pension and other income: 5.70%;
• maximum assessable income: EUR 55 927.

Income-dependent Wlz contribution

• deduction from income in the first and second tax bracket: 9.65% (also if there is no liability for tax in the Netherlands);
• born in 1945 or earlier: maximum assessable income EUR 34 817;
• born in 1946 or later: maximum assessable income EUR 34 300.

Country of residence factors and nominal Zvw contributions

Country	Country of residence factor	Monthly contribution (EUR)
Belgium	0.7392	85.32
Bosnia and Herzegovina	0.0672	7.76
Bulgaria	0.0735	8.48
Cyprus	0.1363	15.73
Denmark	0.9951	114.85
Germany *	0.8701	100.43
Estonia	0.2262	26.11
Finland	0.7161	82.65
France	0.8316	95.98
Greece	0.2490	28.74
Hungaria	0.1381	15.94
Ireland	0.8667	100.03
Iceland	0.9802	113.13
Italy	0.5470	63.13
Cape Verde	0.0177	2.04
Croatia	0.1674	19.32
Latvia	0.0672	7.76
Liechtenstein	0.9720	112.19
Lithunia	0.2399	27.69
Luxembourg	0.7358	84.93
Macedonia	0.0565	6.52
Malta	0.3574	41.25
Morocco	0.0193	2.23
Montenegro	0.0821	9.48
Noorway	1.3729	158.46
Austria	0.6632	76.55
Poland	0.1691	19.52
Portugal	0.2616	30.19
Romania	0.0814	9.40
Serbia	0.0714	8.24
Slovenia	0.3377	38.98
Slovakia	0.2405	27.76
Spain	0.4001	46.18
Czech Republic	0.2412	27.84
Tunisia	0.0292	3.37
Turkey	0.0874	10.09
United Kingdom	0.7741	89.35
Sweden	0.8213	94.79
Switzerland	0.8000	92.34

* The country of residence factor for Germany for 2017, 2018 and 2019 was adjusted downwards with effect from 25 October 2019. For 2019 it was adjusted to 0.7827 and the monthly contribution is EUR 90.34.

Tax credits

Type	Amount of credit (EUR)
General tax credit
income not exceeding EUR  20 384	653
income between EUR  20 384 and EUR 68 507	between 653 and 0
income exceeding EUR 68 507	0
Young disabled person’s tax credit	195
Elderly person’s tax credit – You are entitled to this tax credit if you have reached state pension age (66 years and 4 months) on 31 December 2019:
aggregate income not exceeding EUR 36 783	822
aggregate income between EUR 36 783 and EUR 47 423	between 822 and 0
aggregate income exceeding EUR 47 423	0
Single elderly person’s tax credit – You are entitled to this tax credit if you receive a single person’s old-age pension.	221
General tax credit for partner with no or low income
Partner born before 1.1.1963 and below state pension age	2 477
Partner born after 31.12.1962	661
Partner of state pension age or older	1 268
Green investment tax credit	212

The country of residence factors for 2019 were calculated in a different way. Below you can read about why this change was made and how the calculation is performed.

What is the country of residence factor?

A healthcare contribution is adjusted using a country of residence factor, as the costs of medical care differ from one country to another. Is the statutory care in your country of residence cheaper per person than it is in the Netherlands? If so, your treaty contribution will be lower. If the statutory care in your country of residence is more expensive, your treaty contribution will be higher.

How is the country of residence factor calculated?

We divide the average healthcare costs per person in your country of residence by the average healthcare costs per person in the Netherlands. We always use the healthcare costs from the same year. If we take the healthcare costs in your country of residence in 2014 as a basis for the calculation, we will also use the healthcare costs in the Netherlands in 2014. If these costs are exactly the same, the country of residence factor is 1. The treaty contribution is multiplied by the country of residence factor. Are the costs in your country of residence 10% lower than in the Netherlands, for example? In that case the country of residence factor is 0.9 and your treaty contribution is therefore 10% lower.

Why have you changed the calculation for 2019?

To calculate the country of residence factor, we rely on information from your country of residence about healthcare costs. However, for more and more countries it is becoming difficult to obtain the correct information. For 2019 we therefore used a different source: the World Health Organization (WHO).

What is different in the calculation for 2019?

The WHO figures* are calculated in a slightly different way compared with those we received from your country of residence in previous years. If we used the WHO figures to recalculate the country of residence factor, this could result in a significant increase in this factor, which is not desirable. For that reason we are only using the WHO figures to adjust (i.e. index) the country of residence factor. If, according to the WHO, the healthcare costs in your country of residence are rising by more than those in the Netherlands, the country of residence factor will increase. Conversely, if healthcare costs in the Netherlands are rising more quickly than those in your country of residence, the country of residence factor will fall.

* For Liechtenstein the Eurostat figures were used

Country of residence factor for 2017 as a basis for the 2019 factor

Since the end of 2014, certain healthcare costs in the Netherlands have no longer fallen under statutory social health insurance. As of 2015 these costs have been paid under the Social Support Act (Wmo). That means that the average healthcare costs used to calculate the country of residence factor have fallen in the Netherlands. Consequently, the country of residence factor for certain countries rose significantly in 2018. For those countries we are calculating the 2019 country of residence factor on the basis of the factor for 2017.

Country of residence factor for 2018 as a basis for the 2019 factor

For all other countries healthcare costs for 2014 or earlier were still being used to calculate the country of residence factor for 2018. This is because the healthcare costs for 2015 were not yet known in the case of those countries. For those countries we are calculating the 2019 country of residence factor on the basis of the factor for 2018.

Same starting point for all countries

We are therefore performing the calculation for all countries using average healthcare costs that pre-date the change made in 2015. In this way we are keeping the new calculation as fair as possible for everyone.

From 2017 to 2019 the country of residence factor set for Germany was too high. Are you a treaty-entitled person and did you live in Germany during that period? If so, the amount of the healthcare contribution that was deducted or that you paid was too high.

Why is the country of residence factor for Germany being adjusted?

We use the country of residence factor to adjust your healthcare contribution according to the level of healthcare in your country of residence. The Minister for Health, Welfare and Sport determines the country of residence factor annually for the treaty countries. To calculate it, we rely on data from the country of residence concerned.

When the country of residence factor was calculated for Germany healthcare costs were taken into account that, in retrospect, should have been omitted from the calculation. Consequently, the country of residence factor set for Germany was too high for 2017, 2018 and 2019.

Treaty-entitled persons who lived in Germany during that period therefore overpaid their healthcare contribution or the level of the healthcare contribution deducted was too high. The country of residence factor has now been recalculated and adjusted downwards.

To which period does the adjustment apply?

The adjustment of the country of residence factor for Germany applies only to the years 2017 to 2019. In previous years the country of residence factor had been calculated correctly.

What are the new country of residence factors for Germany for 2017, 2018 and 2019?

Country of residence factor for Germany and nominal contributions under the Healthcare Insurance Act (Zvw)

Year	Old country of residence factor	Old monthly contribution (EUR)	New country of residence factor	Nominal Zvw contribution (EUR)	New monthly contribution (EUR)
2017	0.8372	90.00	0.7532	107.50	80.97
2018	0.9559	104.51	0.8595	109.33	93.97
2019	0.8701	100.43	0.7827	115.42	90.34

How do I calculate the new monthly contribution?

You calculate the new monthly contribution as follows:

Multiply the new country of residence factor by the nominal Zvw contribution for the same year. The result is the new monthly contribution.

Example for 2019: 0.7827 x 115.42 = 90.34

Do you want more information?

Want to find out more about the country of residence factor? Take a look at the page What is the country of residence factor?

I am a treaty-entitled person and lived in Germany in 2017, 2018 and/or 2019. What do I need to do?

You do not need to take any action. At the end of 2019 you received a letter from us containing more information.

If it becomes clear that you overpaid your healthcare contribution or the level of the healthcare contribution deducted was too high, you will receive a refund from us. Find out when and how you will be notified:

• Have you received a provisional annual statement for 2017 and/or 2018? If so, you will receive a final annual statement indicating the adjustments and the correct amounts for those years. We expect to be able to send this once we have received details of your income from the Tax and Customs Administration.
• Have you received a final annual statement for 2017 and/or 2018? If so, you will receive a revised statement indicating the adjustments and the correct amounts for those years. We expect to be able to send this in the first 3 months of 2020.
• For 2019 you will receive a provisional annual statement by 30 September 2020 indicating the adjustments and the correct amounts for that year.

I am a treaty-entitled person, but do not live in Germany. Does this adjustment also affect the country of residence factor in my treaty country?

The adjustment of the country of residence factor for Germany does not affect the country of residence factor in other treaty countries. That means that the country of residence factor for 2017 to 2019 will remain the same for all other treaty countries.