Pensioners who emigrate to or live in a treaty country

If you are receiving a Dutch pension and are living abroad, you can no longer have health insurance in the Netherlands. However, if you live in a treaty country you are probably entitled to medical care at the cost of the Netherlands. In that case please contact the CAK.

If you no longer live or work in the Netherlands, you can no longer have Dutch health insurance. Before you move you need to take the following steps:

  • Check whether you are receiving a Dutch statutory pension or benefit. You can verify this on our Pension and benefits page.
  • Check whether you are moving to a treaty country.
  • Ideally, inform your health insurer of your moving date 2 months before you leave. The organisation that pays your pension or benefit should also be informed as soon as possible that you are emigrating. You have to wait until shortly before your departure to notify the municipality from which you are moving. This can be done from 5 days before you relocate.

Read more about health insurance and moving abroad

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

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? In that case you are entitled to medical care in your new country of residence. That is why you need to register with us.

Read more on moving abroad and your health insurance

Complete the S1/121 application form (7.12.2020, PDF, 758 kB) and send it to us. If you are entitled to medical care in your country of residence, 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.

You will only receive an S1/E121 if:

  • You are receiving a Dutch statutory pension or benefit.
  • You live in a treaty country.

That depends on their situation:

  • Are they receiving a pension or benefit themselves? If so, they also have to apply for the S1/E121 using the S1/121 application form (7.12.2020, PDF, 758 kB).
  • Are they not receiving a pension or benefit themselves? In that case enter their names on your application form. These family members are not automatically entitled to medical care in your country of residence. However, it may be possible to include them under your policy. This will be determined by the health insurance fund in your country of residence.
  • 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.

In most countries you register with the health insurance fund in your place or country of residence. The leaflet accompanying the S1/E121 tells you which body you need to contact. It is a good idea to obtain some information from that body first. They can tell you whether you need any additional documents. There may also be certain arrangements to make before you can register with a health insurance fund. In Sweden, for example, you must already be in possession of a tax number, so you need to apply for that in advance.

Once you have registered with the health insurance fund, we will receive confirmation of this.

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.

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.

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.

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

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.

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.

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.

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. In such a case, only the income that they earn themselves is counted.

You will receive an annual statement from us in which you will see the final amount of your healthcare contribution. We will send out this annual statement after the end of each calendar year. You will usually receive it in the second half of the following year.

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.

What are you searching for?

Tip: enter one or two words.

De website van het CAK maakt gebruik van cookies.


Wij kunnen u dan zo goed mogelijk helpen. Het accepteren van cookies zorgt ervoor dat deze website goed werkt en dat wij onze website steeds kunnen verbeteren.
Uiteraard zorgen wij goed voor uw privacy.