What is a country of residence factor?

How do we apply the country of residence factor?

We apply the country of residence factor annually to the total healthcare contribution you have to pay for your family members. The healthcare contribution consists of a nominal contribution Zvw per family member. Then we multiply the total amount by the country of residence factor.

Contributions Zvw and country of residence factors 2023

Nominal Zvw contribution

• per month: EUR 138,08

Contributions Zvw and country of residence factors 2022

• per month: EUR 126,83 (this amount serves as the basis for applying the country of residence factor)

Contributions Zvw and country of residence factors 2021

Nominal contribution for the Zvw

• per month: € 123,17 (this amount serves as the basis for applying the country of residence factor).

Contributions Zvw and country of residence factors 2020

Nominal contribution for the Zvw

• per month: € 117,92 (this amount serves as the basis for applying the country of residence factor).

Contributions Zvw and country of residence factors 2019

Nominal contribution for the Zvw

• per month: € 115,42 (this amount serves as the basis for applying the country of residence factor).

* 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.

Explanation of country of residence factors for 2019

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 treaty contribution is adjusted using a country of residence factor, as in each country the costs of medical care are different. Is the statutory healthcare 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 healthcare 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. Should we use the WHO figures to recalculate the country of residence factor? This could then 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 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 decrease.

* For Liechtenstein we used the Eurostat figures

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

Since the end of 2014, certain healthcare costs in the Netherlands are no londer part of the statutory health insurance. As of 2015 these costs have been paid under the Social Support Act (Wmo). This means that the average healthcare costs used to calculate the country of residence factor have decreased 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 in those countries for 2015 were not yet known. 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.

Contributions Zvw and country of residence factors 2018

Nominal contribution for the Zvw

• per month: € 109,33 (this amount serves as the basis for applying the country of residence factor).

* The country of residence factor for Germany for 2017, 2018 and 2019 was adjusted downwards with effect from 25 October 2019. For 2018 it was adjusted to 0.8595 and the monthly contribution is € 93.97.
** From 12 February 2019: North Macedonia

Contributions Zvw and country of residence factors 2017

Nominal contribution for the Zvw

• per month: € 107,50 (this amount serves as the basis for applying the country of residence factor).

* The country of residence factor for Germany for 2017, 2018 and 2019 was adjusted downwards with effect from 25 October 2019. For 2017 it was adjusted to 0.7532 and the monthly contribution is € 80.97.

** From 12 February 2019: North Macedonia.

Adjustment to country of residence factor for Germany for 2017, 2018 en 2019

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 has the country of residence factor for Germany been adjusted?

We use the country of residence factor to adjust your healthcare contribution according to the level of healthcare in your country of residence. Each year the Minister for Health, Welfare and Sport determines the country of residence factor for the treaty countries. For the calculation of this we depend on data from the respective country of residence.

When calculating the country of residence factor for Germany, we took healthcare costs into account which are not part of the calculation afterwards. For the years 2017, 2018 and 2019, the residence factor set for Germany has therefore been too high.

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)

How do I calculate the new monthly contribution?

You calculate the new monthly contribution as follows:

Multiply the new country of residence factorby the nominal Zvw contributionfor the same year. The result is the new monthly contribution.

Example 2019: 0.7827 x 115.42 = 90.34

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 paid too much healthcare contribution or the level of the healthcare contribution deducted was too high, you will receive a refund from us.

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.