On 1 January 2006, the Health Care Insurance Act (Zorgverzekeringswet) entered into force. This new act has put an end to the difference in premiums paid under the Compulsory Health Insurance Act (Ziekenfondswet) and private insurance schemes. Anyone who is insured under the Exceptional Medical Expenses Act (Algemene Wet Bijzondere Ziektekosten, AWBZ), with the exception of military personnel in active service and conscientious objectors for the purposes of the AWBZ, will be obliged to take out basic insurance with a care insurer. For the basic insurance you will have to pay a premium to the insurer. This is known as the nominal premium. Depending on your income and family situation, you may be eligible for an allowance in respect of this premium: the health care allowance.

In addition to the nominal premium, every person obliged to take out insurance has to pay an income-related contribution. The Tax and Customs Administration has been designated as the administration agency imposing and collecting the income-related contribution.

If you do not live in the Netherlands

The Health Care Insurance Act will also apply if you do not live in the Netherlands, but are insured under the AWBZ in the Netherlands. If this is the case, you are obliged to take out basic insurance, for which you have to pay the nominal premium and the income-related contribution. In addition, you may be entitled to a health care allowance. If any members of your family are insured under the AWBZ, they, too, will be obliged to take out insurance under the Health Care Insurance Act. This only concerns persons who are covered by the Dutch social security system by virtue of the Compulsory Insurance (Additional Categories of Persons) Decree (Besluit uitbreiding en beperking verzekeringsplicht), such as the families of members of the Dutch Diplomatic Service abroad or the families of other seconded Dutch civil servants.

If you are not compulsorily insured under the AWBZ in the Netherlands, an international social security regulation may be applicable. The Netherlands has agreed international social security regulations with the EU Member States, Bosnia-Herzegovina, Cape Verde, Croatia, Iceland, Liechtenstein, Macedonia, Morocco, Norway, Serbia-Montenegro, Switzerland, Tunisia and Turkey. In that case, you will be entitled to medical care in your country of residence, which country may pass on the costs of this care to the Netherlands. The Netherlands may subsequently ask you for a contribution. This also applies to any members of your family who are not compulsorily insured under the AWBZ. If an international social security regulation applies to you, you and your family members (if any) should report to the Health Care Insurance Board (College voor Zorgverzekeringen, CvZ). The CvZ will take care of registration and impose and collect the contribution.

The income-related contribution: on what income is it calculated?

The income-related contribution is calculated on the so-called ‘contribution income’ (hereafter: income). This income is the total amount you receive in:

  • Taxable wages
    This will be the case if you are employed or receive social security benefits, pension benefits or annuity benefits from which payroll tax is withheld.
  • Taxable profits from business activities
    This will be the case if you run a business.
  • Taxable revenue from other activities
    This will be the case if you work as a freelancer, for example.
  • Taxable periodic benefits in money and kind
    This will be the case if you receive taxable periodic benefits in money and kind – such as alimony from your ex-partner or annuity benefits – from which no payroll tax is withheld.

Other income is not included in the contribution income. This means, for instance, that income from capital such as interest and dividends, and annuity benefits falling within Box 3 for income tax purposes, will be disregarded in determining the contribution income.

The income-related contribution: how much do you pay?

The income-related contribution is a percentage of your income. The contribution is calculated on income up to € 31,231. You will pay 7.2 per cent, up to a maximum of € 2,248 per annum. Your employer or benefits office will reimburse you for this contribution.

If you have to pay your contribution yourself, because your benefits office does not reimburse you for the contribution or because you are not employed, you will pay 5.1 per cent, up to a maximum of € 1,592 per annum.

If you live abroad and are insured under the exceptional medical expenses insurance scheme (AWBZ), you will pay the same percentage as a person living and working in the Netherlands. Furthermore, the situations in which you are or are not entitled to a reimbursement from your employer will be the same.

Where can you find more information?

Further information (in Dutch) on the health care allowance can be found on: www.toeslagen.nl .
Further information on the Health Care Insurance Act can be found on the following websites:

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