You have a pension or benefit from the Netherlands and you are moving abroad. Or maybe you already live there and you will soon receive a Dutch pension. This might affect your health insurance. When you live in or move to a treaty country you are probably entitled to medical care at the expense of the Netherlands. You then need to register with the CAK.
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.
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.
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.
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.
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).
You live in or move to a treaty country. And you receive a statutory pension or benefit from the Netherlands. Register with the CAK.
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?
Have you received a document S1/form 121 from us? This document allows you to register with the health insurance fund in your new country of residence. The leaflet accompanying document S1/form 121 shows which healthcare insurance fund (or institution) in your country you need to go to. If you have registered, we will be informed. The healthcare insurer in your country of residence will hand you your health insurance card.
For some countries, we arrange your registration directly with the health insurance fund there. You don't have to do anything yourself. You will receive a letter from us.
It is useful to request information from the health insurance fund in your new country of residence first. They can tell you if you need any additional documents or information.
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.
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.
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.
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 necessary 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.
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).
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.
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.
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.
The information is for pensioners and beneficiaries only. For information on the healthcare contribution for family members of employees, please check this page.
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 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.
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.
Are you entitled to tax credits? We can only deduct it from the Wlz part of your healthcare contribution. However, your Wlz part can never be lower than 0. For example, if your tax credit is EUR 800 and your Wlz contribution is EUR 700, we set your Wlz contribution to EUR 0.
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.