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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.

For most countries, not much changes. For some countries such as Lithuania, Norway and Iceland, the country of residence factor is falling considerably. Some due to the mitigating measures. But for a number of countries such as Belgium, Cyprus, Denmark, Germany, Finland, Croatia, Liechtenstein, Luxembourg, Austria, the United Kingdom, Sweden and Switzerland, this represents a significant increase in the country of residence factor.

Mitigating measures

In order to mitigate the effects of the introduction of the new calculation method, the Ministry adopted two measures for 2023.

  • A three-year average: the country of residence factor for 2023 is an average of the factors in 2021, 2022 and 2023.
  • A maximum of 1: several countries end up with a country of residence factor above 1, which are all rounded down.

What does this mean to you?

In the table at the bottom of this page you can find out the consequences for your country of residence factor. Also keep in mind that the nominal (fixed) Zvw contribution will rise more than average in 2023 (from EUR 126.83 to EUR 138.08 per month). This nominal contribution forms the basis for calculating your healthcare contribution. An example calculation can be found at the bottom of this page.

What will you pay from 1 January?

The amount you pay depends on the country of residence and the number of co-insured family members. You will receive an invoice from us at the end of December or early January for the healthcare contribution in 2023. The invoice contains the exact amounts per month.

More information

  • More information about the adaptation of the Dutch Healthcare Act (Zvw) and an explanation of the new calculation method is published in the Staatscourant van 4 november 2022 (pdf, 607 kB) (Dutch only). Please note: the country of residence factors for Malta, Morocco, Montenegro and North Macedonia mentioned in the Staatscourant have been adjusted later. See table below.

Country of residence factors 2022 and 2023

Country Factor 2022 Factor 2023
Country of residence factors 2022 and 2023
Belgium 0.7369 0.7484
Bosnia and Herzegovina 0.0715 0.0741
Bulgaria 0.0893 0.0937
Cyprus 0.1504 0.2155
Denmark 0.9836 1.0000
Germany 0.8138 0.8814
Estonia 0.2684 0.2647
Finland 0.6716 0.7069
France 0.8816 0.8614
Greece 0.2271 0.2269
Hungary 0.1521 0.1564
Ireland 0.9185 0.9267
Iceland 1.3388 1.0000
Italy 0.5233 0.5086
Cape Verde 0.0177 0.0210
Croatia 0.1945 0.2840
Latvia 0.1231 0.1334
Liechtenstein 0.9172 1.0000
Lithuania 0.2830 0.2539
Luxemburg 0.7491 0.7671
North Macedonia 0.0567 0.0584
Malta 0.3956 0.3957
Morocco 0.0253 0.0226
Montenegro 0.0821 0.0887
Norway 1.3213 1.0000
Austria 0.6732 0.7243
Poland 0.1829 0.1643
Portugal 0.2727 0.2790
Romania 0.1113 0.1085
Serbia 0.0810 0.0795
Slovenia 0.3645 0.3510
Slovakia 0.2471 0.2393
Spain 0.4019 0.4051
Czech Republic 0.2917 0.3003
Tunisia 0.0258 0.0281
Turkey 0.0643 0.0708
United Kingdom 0.6308 0.7043
Sweden 0.7751 0.8700
Switzerland 0.7145 0.9711

Example calcation of a healthcare contribution

In this example the fixed contribution is EUR 138.08, the country of residence factor 0.2500 and the number of co-insured family members aged 18 and above 3.
Example calcation of a healthcare contribution
Fixed contribution Zvw:EUR 138,08 x number of months (12) x number of persons (3) € 4 970.88
Country of residence factor 0.2500 x

The healthcare contribution per year

€

1 242.72


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