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.
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.
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.
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.
Apply for a document S1/form 106 for yourself at your Dutch health insurance company.
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.
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.
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.
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.
Is your co-insured family member getting married or starting a job? Then he or she usually has an own right to health insurance. Notify this change to the health insurer in the country of residence as soon as possible. You will then no longer have to pay a healthcare contribution for this family member. We can only implement this once we have received confirmation from the health insurer in the country of residence.
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.
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.
Your family members live in a country of the EU, of the EEA, in the United Kingdom or in Switzerland
Your family members are entitled to medically necessary care in other EU/EEA countries, Switzerland and the United Kingdom. For example, when they are there on vacation. They do need an EHIC (European health insurance card) for this. They can apply for an EHIC online. The EHIC is not valid in their country of residence. There they can simply use the local health insurance card. Are they going on holiday to countries outside the EU/EEA, Switzerland or the United Kingdom? Then 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 therefore also not entitled to the reimbursement of necessary medical care or medical treatment in other countries. To cover medical costs when staying in other countries, you should take out additional insurance or travel insurance.
For yourself, apply for an EHIC at your Dutch health insurer. You can also ask them if you need permission for treatment abroad.
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.
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.
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.
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.
The costs of healthcare abroad are often different than they are in the Netherlands. What healthcare is insured and what not, also differs. In some cases that means that healthcare is more expensive in your country of residence, but generally the healthcare is cheaper. We refer to the ratio between the costs in the two countries as the country of residence factor.
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.
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.
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.