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Family members of employees


You work in the Netherlands and you live abroad. Or your family members live abroad without you. Because of your work, you are obliged to take out health insurance in the Netherlands. This does not apply to your family members. But sometimes you can 'co-insure' them. This means they are entitled to medical care in your country of residence at the expense of the Netherlands. You then pay a healthcare contribution for your co-insured family members to the Netherlands. The CAK collects this contribution.

News

Visit the CAK at the Emigration Expo

Are you going to emigrate? Or just curious about the possibilities? Then visit the Emigration Expo in Expo Houten April 1 and 2. The CAK is also present to answer all your questions about your health insurance abroad.

A well prepared move

Study, work, entrepreneurship or enjoying a well-earned retirement. Whatever you are going to do abroad, you want to be well prepared when you cross the border. At the Emigration Expo you will find information about emigration and all that is involved, conveniently in one place. For example, will you need a visa, how do you buy a house, how will you find work and what about your health insurance?

Information stands en presentations

More than 200 exhibitors from the Netherlands and abroad can be found at the Expo. A large number of countries are present, but also organizations such as DUO (studying and internship), Municipality of The Hague (voting abroad), Netherlands Worldwide, UWV and the CAK. In addition, there are more than 100 free presentations by specialists, experts by experience and emigrants.

CAK

In certain situations, the Netherlands remains responsible for your health insurance if you move abroad. You will then have to deal with the CAK. Want to know more? Have a look:

  • Scheme for pensioners and beneficiaries
  • Scheme for family members of employees

New calculation method for country of residence factor

As of 1 January 2023, the calculation method for the country of residence factor that we apply to the healthcare contribution will change. For a number of clients, this represents a significant increase in the country of residence factor and therefore also the healthcare contribution.

What is a country of residence factor?

The health care package and its cost vary from country to country. The country of residence factor shows the difference between the country of residence of your co-insured family members and the Netherlands. That is why we always multiply your healthcare contribution by a country of residence factor. This way you do not pay too much and not too little for the care your family members receive in their country of residence.

New calculation method

The Dutch Ministry of Health, Welfare and Sport sets the country of residence factors again each year. As of January 1 2023, the Ministry uses a new calculation method with figures from A System of Health Accounts (pdf, 1.2 MB). These health care figures are more up-to-date, transparent and usable for the long term.

Read more about the new calculation method

Register

Where do I have to take out health insurance?

If you work in the Netherlands, you must take out health insurance with a Dutch health insurer. You can choose a health insurance provider yourself. Each health insurer is obliged to accept you for the basic health insurance.

Healthcare in your country of residence

Do you want to use healthcare in your country of residence? For example consulting a GP or the hospital? Then apply for a document S1/form 106 from your Dutch health insurance company. This document allows you to register with a health insurance fund in your country of residence. You will then receive the same healthcare as other insured residents in your country of residence.

Tip

Do you work in the Netherlands and in the country where you live? Please check with the Sociale Verzekeringsbank (SVB.nl) in which country you have to take out health insurance.

How do I register my family members with the CAK?

  1. Apply for a document S1/form 106 for yourself at your Dutch health insurance company.
  2. Submit the document/form to a local health insurance fund in the country where you and your family members live. Register your family members with the health insurance fund. You do not need a separate document/form for your family members.
  3. The health insurance fund determines which family members can be co-insured and will notify us. From that moment on, your family members are registered with us as being co-insured with you. You and your co-insured family members receive the same basic healthcare as the residents of your country of residence.
  4. You have to pay a healthcare contribution to the CAK for your co-insured family members of 18 years and older. You will receive a letter from us confirming this.


Does the local health insurance fund determine that your family members cannot be co-insured? Please ask in the country of residence about the possibilities for health insurance for your family members.

Please note

You will only receive a document S1/form 106 if you live in a treaty country, with the exception of Serbia, Bosnia and Herzegovina and Montenegro. Do you live in one of these 3 countries or in a non-treaty country? Please ask in your country of residence how to take out health insurance for your family members.

More information

Read more on I work in the Netherlands and live abroad​

Learn what else you need to think about besides health insurance at Netherlandsworldwide.nl

I don't live with my family members abroad. How can my family members receive medical care in their country of residence?

​Do your family members live in a treaty country? Then follow the next steps:

  1. Apply for a document S1 or 109 for your family members. You can download the application forms below.

Please note

  • Are your family members living in the EU, EEA, Switzerland of the United Kingdom? Then you will need a document S1: Application for a document S1 family member (pdf, 516 kB) (01-06-2022).
  • Are your family members living in Bosnia and Herzegovina, Cape Verde, Morocco, Montenegro, North Macedonia, Serbia, Tunisia or Turkey? Then you will need a document 109: Application for a document 109 family member (pdf, 530 kB) (29-06-2022).
  1. Fill in the application form (one for each family member) and send it to: CAK, Regeling Buitenland, Antwoordnummer 91041, 2509 Den Haag.
  2. When approved you will receive the S1 or 109. With this document you can register your family member(s) with the local health insurance fund in their country of residence.

What happens next?

The local health insurance fund checks if your family member(s) can be co-insured and will notify us. You will receive a letter from us stating which family members are co-insured. Your co-insured family members will receive a health insurance card from the local health insurance fund or a proof of registration. With that they will receive the same healthcare as other residents of their country of residence.

More information

Read more on I live in the Netherlands, my family members abroad

Tip

Do your family members not live in a treaty country? If so, take out health insurance for them in their country of residence.

Why do I have to pay a healthcare contribution for my family members?

If your family members live abroad, in certain situations you need ‘co-insure’ them for healthcare through the CAK. You are obliged to do so if they live in a treaty country and have no income themselves. Their country of residence settles the healthcare costs with the Netherlands. You pay a healthcare contribution (a kind of premium) for your family members to us.

  • Read more on co-insuring your family members on I work in the Netherlands and live abroad or I live in the Netherlands, my family members abroad
  • Read more on the mandatory healthcare contribution in Article 69 of the Healthcare Insurance Act (Zorgverzekeringswet - only in Dutch) (wetten.nl)

Entitlement to healthcare

Healthcare in your country of residence

Your family members are entitled to medical care according to the laws in your country of residence. You can ask the health insurance fund where you register, which treatments and medicines are covered. Costs incurred by your family members in your country of residence can only be claimed from the health insurance fund in their country of residence. You cannot claim those costs from us.

If you are incurring healthcare costs for yourself in your country of residence, you can claim them from your health insurance fund in the country of residence. You can also claim those costs from your Dutch health insurance company. Your Dutch health insurance also covers costs abroad. More information about this you'll find in the terms of your healthcare policy.

More information?

Read more on I work in the Netherlands and live abroad

Healthcare in other countries

Choose your situation

Your family members live in a country of the EU, of the EEA, in the United Kingdom or in Switzerland

They are entitled to medically necessary care in other EU/EEA countries, Switzerland and the United Kingdom. For example, if they're on holiday there. They do need an EHIC (European Health Insurance Card). You can apply for an EHIC for your family members online. The EHIC is not valid in their country of residence. There they'll have to use the local health insurance card. To cover healthcare costs during holidays in countries outside the EU/EEA, Switzerland or the United Kingdom, you need to take out extra insurance or travel insurance.

Your family members live in another treaty country

Do your family members not live in an EU/EEA country, Switzerland or the United Kingdom? Then they are not entitled to an EHIC. And also not to reimbursement of necessary medical care or medical treatment in other countries. To cover medical expenses when staying in other countries, you need to take out extra insurance or travel insurance.

Going to another country for medical treatment

Do your family members want to go to another country for medical treatment? Then they first need permission from the healthcare insurance fund in their country of residence. Do you only want to buy them medicines there? Even then, you must first ask for permission. Do you not have that permission (yet) and will your family members be treated? Or do you buy those medicines without permission? Then there is a risk of having to pay the costs yourself.

More information?

Read more on I want to go abroad for medical treatment

Tip

With your EHIC you are also entitled to medical care in other EU countries. For yourself, apply for an EHIC at your Dutch health insurance company. You also need to ask them if you need permission for treatment abroad.

Healthcare in the Netherlands

Do your family members live in an EU/EEA country, Switzerland or the United Kingdom? They are then entitled to medical care in the Netherlands. This is healthcare that is included in the Dutch basic health insurance package. They can show their European Health Insurance Card (EHIC) to the doctor or hospital. Do they not have an EHIC yet? If so, they can apply for an EHIC online.

Please note

Do your family members live in North Macedonia? They may be entitled to medical care in the Netherlands, but but not to an EHIC. Do your family members in the Netherlands need medical care? Contact Zilveren Kruis, Groep Buitenlands Recht. Telephone number: + 31 33 445 6870.

More information

Read more on I want to go to the Netherlands for medical treatment

Or visit the website of Zilveren Kruis to see which healthcare is refunded and which steps you need to take (only in Dutch).

Financial information

Annual statement employees with co-insured family

Each year in December you will receive an invoice for the healthcare contribution for your family members for the upcoming year. In February or March (at least before 1 April) you will receive an annual statement for the past year. This will state whether you have paid too much, too little or exactly the right amount.

Read more on the annual statement

Other financial information

Do you have other questions about financial matters, like how much healthcare contribution you will have to pay?

See the most frequently asked financial questions

Frequently asked questions

What is a treaty country?

The Netherlands has made agreements with a number of countries on medical care in case of emigration. These countries are called ‘treaty countries’.

These are:

  • EU/EEA countries plus Switzerland and the United Kingdom
  • a few countries outside the EU/EEA

Read more on treaty countries

What is a healthcare contribution?

The healthcare contribution can be compared to the health insurance premium. You pay this contribution if your family members are entitled to medical care in their country of residence at the expense of the Netherlands. Your country of residence will settle the costs of their medical care with the Netherlands. The CAK collects, on behalf of the Netherlands, the healthcare contribution, which is sometimes referred to as the Zvw-contribution or foreign contribution.

Read more on the healthcare contribution

What is a country of residence factor?

The costs of healthcare abroad are often lower than they are in the Netherlands. One country may have a more extensive statutory healthcare package than another. In some cases that means that healthcare is more expensive in that country, but generally the healthcare in your country of residence is cheaper. We refer to the ratio between the costs in the two countries as the country of residence factor.

We use the country of residence factor to adjust the healthcare contribution according to the size and costs of healthcare in your country of residence (country of residence package). The Minister for Health, Welfare and Sport determines the country of residence factor annually for the treaty countries. If healthcare in your country of residence becomes more expensive, the country of residence factor also increases. You then have to pay a higher healthcare contribution for your family members.

Read more on country of residence factors

What is a country of residence package?

A country of residence package is a package of healthcare facilities and services your family members are entitled to in their country of residence. By healthcare services, we mean, for example, costs of the general practicioner, medicines and hospitalisations. Each country has a different country of residence package.

Healthcare services

The coverage of the country of residence package is the same as the statutory healthcare package in that country. In the Netherlands, for example, this is the basic health insurance. Your family members are therefore entitled to reimbursement of the same healthcare as other residents of that country. They also have the same duties: if your country of residence has an own risk or contribution, the same applies to them.

How do I report the death of a co-insured family member?

Has your relative passed away? We are sorry for your loss. We understand that there is a lot to deal with and that you might have questions. That is why we have made an overview with information for relatives. You can read here what you need to arrange, where you need to go and what you can expect from us. Do you prefer personal contact or do you have any additional questions? Please contact us at + 31 88 711 5551. Or send us an e-mail via the online contact form.

Read more on how to report a death

Self service

  • Payment arrangment for the healthcare contribution
  • To lodge an objection
  • Contact
  • Applying for an EHIC
  • Change address or personal details (pdf, 535 kB)
  • Change or notify bank details (pdf, 499 kB)

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