Pensioners and beneficiaries

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 your country of residence 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 you get in your 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 for country of residence factor

​If you emigrate, your Dutch health insurance will end. Do you still have a statutory pension or a benefit from the Netherlands? And are you moving to or living in a treaty country? You will then have to take out health insurance via the CAK. You're legally obliged to do that. So you don't have the choice to arrange a health insurance yourself. Your country of residence settles the healthcare costs with the Netherlands. You pay a healthcare contribution (a kind of premium) to us.

• Read more on your healthcare insurance and how to register on Moving abroad and your health insurance
• Read more on the mandatory healthcare contribution in Article 69 of the Healthcare Insurance Act (Zorgverzekeringswet - wetten.nl, only in Dutch)

Please check the following first:

• Check whether you receive a statutory pension or benefit from the Netherlands. When you also receive a pension from your country of residence or still work there, you don't have to register with the CAK (because of prevailing rights). Are you not sure if that applies to you? Please contact us.
• Check whether you live or going to live in a treaty country.

There are 3 possibilities:

1. You live in or move to a country that is not a treaty country. Take out health insurance for yourself and moving family members in the country where you are going to live. You have nothing to do with the CAK.
2. You live in or move to a treaty country, but you do not receive a statutory pension or benefit from the Netherlands (yet). Take out health insurance for yourself and moving family members in the country where you are going to live. You have nothing to do with the CAK (yet).
3. You live in or move to a treaty country. And you receive a statutory pension or benefit from the Netherlands. Register with the CAK.

Do you live in a treaty country? And are you receiving a statutory pension or statutory benefitfrom the Netherlands? If so, you need to apply for a document S1/form 121 from us. With the S1/121 you register with a healthcare fund in your country of residence. Only after registration you can use medical care in your country of residence.

This depends on their situation:

• Are they receiving a statutory Dutch pension or benefit themselves? If so, they also have to apply for a document S1/form 121.
• Are they not receiving a Dutch pension, benefit or other income themselves? It may be possible to co-insure them. The health insurance fund in your country of residence will decide about this and will notify us. Are you living in the EU/EEA, Switzerland or United Kingdom? Then you can register your family members on your S1/121 application form. Are you living in another treaty country? In that case you will need to register your family members with the health insurance fund in your country of residence yourself.
• Do your family members still work in the Netherlands? If so, compulsory health insurance continues to apply and they must retain their Dutch health insurance. They will need an S1/106 to register with a health insurance fund in your country of residence. They can apply for this document from their Dutch health insurer.

You 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 will be reimbursed. You can claim costs incurred in your country of residence from the health insurance fund in your country of residence. You cannot claim those costs from us.

How do I arrange healthcare in my country of residence?

Co-insuring family members

Did you indicate on the 'Application for a document S1/form 121' that you want to co-insure family members? If so, you will receive a separate document S1/form 121 for each family member. You need to hand it over to the health insurance fund in your new country of residence. The health insurance fund assesses whether you can co-insure your family members. This depends on the rules in your new country of residence. The health insurance fund lets us know which family members you can co-insure.

Healthcare contribution

For yourself and for your co-insured family members you pay a healthcare contribution to us through your pension or benefit. Your country of residence will settle the costs of medical care for you and your co-insured family members with the Netherlands.

More information?

Read more on your health insurance on I am moving abroad

I live in an EU/EEA country, Switzerland or the United Kingdom

Do you need medically necessary care while staying in another EU/EEA country, Switzerland or the United Kingdom? If so, use your European Health Insurance Card (EHIC). You can apply for an EHIC online with us.

Please note that private care and repatriation costs are not covered by the EHIC. You cannot use the EHIC in your country of residence, use the local health insurance card there.

Are you going on holiday to a country outside the EU/EEA, Switzerland or the United Kingdom? The EHIC is not valid there. We advise you to take out additional insurance or travel insurance.

Planned medical treatment in another country

Are you traveling to another country specifically for medical treatment? Then read the information on the page I want to go abroad for medical treatment.

I live in another treaty country

If you do not live in an EU/EEA country, Switzerland or the United Kingdom, you are not entitled to an EHIC. To cover medical expenses when staying in other countries, it is useful to take out additional insurance or travel insurance.

Do you live in an EU/EEA country, Switzerland or the United Kingdom? Then you are entitled to medical care in the Netherlands. This includes not only medically neccesary care but all care included in the Dutch basic health insurance package. You can show the healthcare provider the EHIC you have received from us. Don't you have an EHIC yet? Then apply for an EHIC online.

When am I not entitled to healthcare in the Netherlands?

Do you live in a country that is not a EU/EEA country, Switzerland or the United Kingdom? In that case you are not entitled to an EHIC. That means you cannot use an EHIC to receive medical care in the Netherlands. You will need to take out extra insurance or travel insurance to cover medical costs incurred during your stay in the Netherlands.

Wlz care

Do you want to return to the Netherlands (permanently) because you need Wlz care (for example, admission to a nursing home)? The CIZ assesses whether you are eligible for Wlz care. Also take into account a waiting time. More information can be found on the website of the Zorginstituut (Dutch only).

More information?

• Read more on I want to go to the Netherlands for medical treatment
• Visit Retirees and beneficiaries at Zilveren Kruis to see what kind of healthcare is refunded and what steps you need to take to get a refund.

Every month we have a healthcare contribution deducted to your pension(s) or benefit. Each year you will receive an annual account for the previous year before 30 September. In this you'll read whether you have paid too much, too little or exactly enough.

Read the FAQs about the annual statement

Would you like to know more about the healthcare contribution? Or about the healthcare benefit?

Read the FAQs about financial matters

You can find here an overview of statutory pensions and benefits in the Netherlands. If you receive one of these pensions or benefits and live in a treaty country, register with the CAK as a treaty-entitled person.

See which pensions and benefits qualify

The Netherlands has various treaties with other countries. However, we only have agreements with the following countries relating to medical care in the event of emigration:

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

We refer to these countries as ‘treaty countries’.

See all treaty countries

You pay a healthcare contribution for the right to medical care in your country of residence. Your country of residence settles your healthcare costs with the Netherlands. This has been agreed with a number of countries. Therefore, you do not pay a health premium to the local health insurance company for basic care in your country of residence. Instead, you pay a healthcare contribution to the Netherlands.

Read more on the healthcare contribution

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 your healthcare contribution according to the size and costs of healthcare package 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.

Read more on the country of residence factor

A country of residence package is a package of healthcare facilities and services you and your co-insured family members are entitled to in your 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. You are therefore entitled to reimbursement of the same healthcare as other residents of that country. You also have the same duties: if your country of residence has an own risk or contribution, the same applies to you.

We can apply a number of tax credits to the Wlz part of your healthcare contribution, but only if we have the required information. Sometimes you have to apply for the tax credit yourself.

Read more on tax credits

Visit Netherlandsworldwide.nl and see what you need to consider, in addition to health insurance, when you are going to live, work or travel abroad.

Has your relative passed away? We are sorry for your loss. Did your deceased relative pay a healthcare contribution for himself and/or family members? Then the health insurance fund in the country of residence or the SVB/UWV will report this to to us. We will then stop collecting the healthcare contribution from the date of death.

Read more how to report the death of a treaty-entitled person