Pensioners who emigrate to or live in a treaty country

If you no longer live or work in the Netherlands, you can no longer have Dutch health insurance.

There are 3 possibilities:

1. Are you moving to a country that is not a treaty country? Arrange health insurance for yourself and any family members who are moving with you in your new country of residence. In this case you do not need to have any contact with the CAK.
2. Are you moving to a treaty country, but are not (or not yet) receiving a statutory pension or benefit? Arrange health insurance for yourself and any family members who are moving with you in your new country of residence. At this stage you do not need to have any contact with the CAK.
3. Are you receiving a statutory pension and are you moving to a treaty country? Then you have to Apply for a document S1/form 121. If you are entitled, we will send you the document S1/form 121. With the S1/121 you can register with a health insurance company in your country of residence. Only after registration can you use medical care in your country of residence.

Read more about health insurance and moving abroad

If you emigrate, your Dutch health insurance expires. Are you still receiving a statutory pension or benefit from the Netherlands and are you moving to or do you live in a treaty country? Then you must insure yourself for medical expenses through the CAK. You are legally obliged to do so. You do not have the choice to arrange your own health insurance. Your country of residence covers the care costs with the Netherlands. You pay a healthcare contribution (similar to a health insurance premium) to us.

More information

Read more on moving abroad and your health insurance
Read more on the obligated healthcare contribution in article 69 of the Zorgverzekeringswet (Dutch only)

You pay a healthcare contribution to the CAK. This contribution comprises:

1. The fixed contribution under the Healthcare Insurance Act (Zvw). This contribution is determined annually by the Minister for Health, Welfare and Sport.
2. Income-dependent contributions. The percentages for these correspond to what you would have to pay on your income in the Netherlands. You pay these contributions on the income you receive from the Netherlands and any income from another country.

Read more about the cost of your contribution

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 countries
• EEA countries
• treaty countries outside the EU/EEA

We refer to these countries as ‘treaty countries’.

Read on for an overview of the treaty countries

You have to Apply for a document S1/form 121. If you meet the conditions, we will register you as a treaty-entitled person. We will then send you the S1/E121, which you can use to register with a local health insurance fund.

At Apply for a document S1/form 121 you will find more information on what conditions you have to meet and what you can expect.

Did you receive a document S1/form 121 from us? Then take this document to the health insurance fund in your country of residence.

Register at the health insurance fund

You first apply to the health insurance fund in your new place of residence or country of residence. In some countries, this may also be another body. The leaflet accompanying the document S1/form 121 shows which health insurance fund (or body) is in your country. 

If you have registered with the health insurance fund, we will be notified of this. 

Exception: 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.

Read more about getting medical care abroad

Do you live in a treaty country? If so, you are entitled to medical care in accordance with the laws of that country if you have an S1/E121. You can find out which treatments and medicines will be refunded from the health insurance fund you register with. Any costs you incur in your country of residence must be claimed from your health insurance fund in that country. You cannot claim those costs from us.

A healthcare benefit is a contribution towards the costs of your health care insurance. Whether you receive a healthcare benefit depends on your and your partner’s income. You apply for a healthcare benefit to the Tax and Customs Administration in the Netherlands. They will also take the country of residence factor into account. If you live in a country with a low country of residence factor, you will probably not be entitled to a healthcare benefit.

See the Tax and Customs Administration website (Belastingdienst.nl) for the conditions and more information.

NB: Co-insured children aged 18 and above can apply for a healthcare benefit independently.

The EHIC entitles you to necessary medical care in EU/EEA countries and Switzerland. You cannot use the EHIC in your country of residence.

Do you live in an EU/EEA country or Switzerland? Apply for an EHIC

Read more about medical care in another EU country

If you do not live in an EU/EEA country or Switzerland, you are not entitled to an EHIC. To cover any medical costs incurred while you are staying in these countries, it makes sense to take out extra insurance or travel insurance.

Do you live in an EU/EEA country or Switzerland? If so, you are entitled to medical care in the Netherlands. This concerns care that forms part of the Dutch basic package. You can show the care provider the EHIC that you received from us. Do you not yet have an EHIC? Apply for an EHIC online.

Do you want more information?

You can find out more at I want to go to the Netherlands for medical treatment

Or visit the website of the Zilveren Kruis to see what care is refunded and what steps you need to take. 

When am I not entitled to care in the Netherlands?

Do you not live in an EU/EEA country or Switzerland? 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 need to pay a healthcare contribution to us? If so, we will ask the Employee Insurance Agency (UWV) whether you are receiving an income from a Dutch employer or organisation. UWV keeps a central record of everyone with an income. An income can take the form of a salary, pension or benefit.

Once we know who you are receiving an income from, we will ask your pension fund (or benefits agency) to deduct the contribution from your income. Your pension fund (or benefits agency) will then transfer your healthcare contribution to us.

One of your Dutch pension funds or benefits agencies will deduct the fixed contribution every month for you and any family members aged 18 and above who are included under your policy.

All your pension funds or benefits agencies will also deduct the income-dependent contributions from your pension or benefit.

The final annual statement shows your final healthcare contribution. We can make a final annual statement as soon as we get your world income from the Dutch Tax Administration. You will receive the annual statement for the previous year before 30 September each year. Haven't we received any information from the tax authorities yet? Then you'll get a provisional annual statement instead of a final one.

You will receive an annual statement from us. We will send this out after the end of the calendar year. This annual statement will include a summary of the contribution due from you and of the amounts you have paid.

• Have you overpaid? If so, you will receive a refund.
• Have you underpaid? In that case you will have to make an additional payment.

We also apply tax credits in the annual statement.

For more information please see Financial information for treaty-entitled persons.

That depends on their situation:

• Are they receiving a pension or benefit themselves? If so, they also have to Apply for a document S1/form 121.
• Are they not receiving a pension, benefit or income themselves? It may be possible to include them under your policy. The health insurance fund in your country of residence will decide and let us know. If you are living in the EU/EEA, Switzerland or United Kingdom you can register your family members on your S1/121 application form. Are you living in another treaty country? Then you will have 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/E106 to register with a health insurance fund in your country of residence. They can apply for this from their Dutch health insurer.

Do you want to go to work or start your own business (for example a B&B) in your country of residence or the Netherlands?Then you must report this to us, even if you also receive a pension or benefit. We will look into the consequences for your treaty-entitlement and health insurance. Read more about the consequences for your social insurance at the SVB website.

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