What is a country of residence factor?

How do we apply the country of residence factor?

You pay a nominal contribution Zvw for yourself and your family members of 18 years and older. In addition, you pay an income-dependent contribution (percentage of your income) Zvw and Wlz. Tax credits may apply to the income-dependent contribution Wlz. Then we multiply the total amount by the country of residence factor.

The country of residence factors, the nominal contribution Zvw and the percentages for the income-dependent contributions Zvw and Wlz are re-determined each year.

The information on this page is for retirees and benefit recipients.  The treaty contribution is structured differently for co-insured family members of employees.

Contributions Zvw, Wlz and country of residence factors 2023

Nominal Zvw contribution

• per month: EUR 138.08

Income-dependent Zvw contribution

• employer’s contribution for benefits under the Work and Income (Capacity for Work) Act (WIA) / Invalidity Insurance Act (WAO) / Invalidity Insurance (Self-Employed Persons) Act (WAZ) or surviving dependant’s pension: 6.68%;
• deduction from old-age pension and other income: 5.43%;
• maximum assessable income: EUR 66 956.

Income-dependent Wlz contribution

• deduction from income in the first and second tax bracket: 9.65% (also if there is no liability for tax in the Netherlands);
• born in 1945 or earlier: maximum assessable income EUR 38 703;
• born in 1946 or later: maximum assessable income EUR 37 149.

Contributions Zvw, Wlz and country of residence factors 2022

Nominal Zvw contribution

• per month: EUR 126.83

Income-dependent Zvw contribution

• employer’s contribution for benefits under the Work and Income (Capacity for Work) Act (WIA) / Invalidity Insurance Act (WAO) / Invalidity Insurance (Self-Employed Persons) Act (WAZ) or surviving dependant’s pension: 6.75%;
• deduction from old-age pension and other income: 5.50%;
• maximum assessable income: EUR 59 706.

Income-dependent Wlz contribution

• deduction from income in the first and second tax bracket: 9.65% (also if there is no liability for tax in the Netherlands);
• born in 1945 or earlier: maximum assessable income EUR 36 409;
• born in 1946 or later: maximum assessable income EUR 35 472.

Country of residence factors and nominal Zvw contributions

Contributions Zvw, Wlz and country of residence factors 2021

Nominal Zvw contribution

• per month: EUR 123.17

Income-dependent Zvw contribution

• employer’s contribution for benefits under the Work and Income (Capacity for Work) Act (WIA) / Invalidity Insurance Act (WAO) / Invalidity Insurance (Self-Employed Persons) Act (WAZ) or surviving dependant’s pension: 7.00%;
• deduction from old-age pension and other income: 5.75%;
• maximum assessable income: EUR 58 311.

Income-dependent Wlz contribution

• deduction from income in the first and second tax bracket: 9.65% (also if there is no liability for tax in the Netherlands);
• born in 1945 or earlier: maximum assessable income EUR 35 941;
• born in 1946 or later: maximum assessable income EUR 35 129.

Country of residence factors and nominal Zvw contributions

Contributions Zvw, Wlz and country of residence factors 2020

Nominal Zvw contribution

• per month: EUR 117.92

Income-dependent Zvw contribution

• employer’s contribution for benefits under the Work and Income (Capacity for Work) Act (WIA) / Invalidity Insurance Act (WAO) / Invalidity Insurance (Self-Employed Persons) Act (WAZ) or surviving dependant’s pension: 6.70%;
• deduction from old-age pension and other income: 5.45%;
• maximum assessable income: EUR 57 232.

Income-dependent Wlz contribution

• deduction from income in the first and second tax bracket: 9.65% (also if there is no liability for tax in the Netherlands);
• born in 1945 or earlier: maximum assessable income EUR 35 375;
• born in 1946 or later: maximum assessable income EUR 34 712.

Country of residence factors and nominal Zvw contributions

Contributions Zvw, Wlz and country of residence factors 2019

Nominal Zvw contribution

• per month: EUR 115.42

Income-dependent Zvw contribution

• employer’s contribution for benefits under the Work and Income (Capacity for Work) Act (WIA) / Invalidity Insurance Act (WAO) / Invalidity Insurance (Self-Employed Persons) Act (WAZ) or surviving dependant’s pension: 6.95%;
• deduction from old-age pension and other income: 5.70%;
• maximum assessable income: EUR 55 927.

Income-dependent Wlz contribution

• deduction from income in the first and second tax bracket: 9.65% (also if there is no liability for tax in the Netherlands);
• born in 1945 or earlier: maximum assessable income EUR 34 817;
• born in 1946 or later: maximum assessable income EUR 34 300.

Country of residence factors and nominal Zvw contributions

* 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 healthcare contribution is adjusted using a country of residence factor, as the costs of medical care differ from one country to another. Is the statutory healthcare in your country of residence cheaper per person than it is in the Netherlands? If so, your healthcare contribution will be lower. If the statutory healthcare in your country of residence is more expensive, your healthcare 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 healthcare 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 healthcare 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. If we used the WHO figures to recalculate the country of residence factor, this could 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 by 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 fall.

* For Liechtenstein the Eurostat figures were used

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

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

Adjustment to country of residence factor for Germany for 2017, 2018 and 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 is the country of residence factor for Germany being adjusted?

We use the country of residence factor to adjust your healthcare contribution according to the level of healthcare in your country of residence. The Minister for Health, Welfare and Sport determines the country of residence factor annually for the treaty countries. To calculate it, we rely on data from the country of residence concerned.

When the country of residence factor was calculated for Germany healthcare costs were taken into account that, in retrospect, should have been omitted from the calculation. Consequently, the country of residence factor set for Germany was too high for 2017, 2018 and 2019.

Treaty-entitled persons who lived in Germany during that period paid too much healthcare contribution. 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 for 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 overpaid your healthcare contribution or the level of the healthcare contribution deducted was too high, you will receive a refund from us. Find out when and how you will be notified:

• Have you received a provisional annual statement for 2017 and/or 2018? If so, you will receive a final annual statement indicating the adjustments and the correct amounts for those years. We expect to be able to send this once we have received details of your income from the Tax and Customs Administration.
• Have you received a final annual statement for 2017 and/or 2018? If so, you will receive a revised statement indicating the adjustments and the correct amounts for those years. We expect to be able to send this in the first 3 months of 2020.
• For 2019 you will receive a provisional annual statement by 30 September 2020 indicating the adjustments and the correct amounts for that year.

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.