Healthcare in Chile: FONASA or an ISAPRE, and what the treaty does for pensioners
Chile has two systems: the public FONASA and the private ISAPREs. Members pay 7% of their taxable income, up to a ceiling. Chile is not among the CAK treaty countries, so your Dutch insurance does not continue through the CAK. But the social security treaty gives anyone receiving a Dutch pension the right to join the Chilean system like a Chilean pensioner.
4 min read
Written and checked by Auke on , against the sources at the bottom. Is something no longer right? Report it below and I'll fix it.
In Chile you choose between two systems: FONASA, the public health fund, and an ISAPRE, a private health insurer. You are in one of the two, not both. According to the Superintendencia de Salud, members pay 7% of their taxable wage or pension, with a ceiling. For Dutch citizens one thing is worth knowing in advance: Chile is not on the CAK's list. So you cannot continue your Dutch health insurance through the CAK, not even if you receive the AOW.
| FONASA | ISAPRE | |
|---|---|---|
| What | public fund | private insurer |
| Contribution | 7% of taxable income | statutory 7%; the ISAPRE charges the price of your plan |
| Ceiling | income up to 90 UF a month, so at most 6.3 UF contribution | same for the statutory 7% |
| Payment | by the 10th of the following month | same |
| Conditions | open to employees, the self-employed and pensioners, among others | health declaration when signing up |
| Combining | not with an ISAPRE | not with FONASA |
The UF is the Chilean unit of account that moves with inflation. The ceiling of 90 UF applies to wages and pensions from February 2026.
Why does the CAK arrange nothing here?
The CAK arranges health insurance for people who live in a treaty country with a Dutch pension or benefit. Those are the countries of the EU and the EEA, Switzerland, the United Kingdom and eight other countries, from Bosnia-Herzegovina to Turkey. Chile is not one of them. How to wind up your Dutch insurance on departure without a gap in cover is in cancelling your health insurance without a gap.
What does the treaty with Chile do?
The Netherlands and Chile do have a social security treaty. Article 16 of it matters for pensioners: anyone receiving a pension under Dutch legislation and living in Chile has the right to join the Chilean health system under the same conditions as a Chilean pensioner. So your insurance does not transfer; you get access to the Chilean system.
ChileAtiende also names that group at FONASA: Chileans and foreigners covered by international treaties for pensioners. They first obtain a document from the Superintendencia de Pensiones and report with it to a FONASA office. The migration law, in article 15, also states that foreigners with a residence permit have access to healthcare under the same conditions as Chileans.
According to article 9 of the administrative agreement, a Chilean body converts your pension into pesos; that is the basis for the 7%.
There is time between the end of your Dutch insurance and joining FONASA or an ISAPRE: joining FONASA online takes your RUN and your cédula, and you only have those weeks after arrival. Arrange travel insurance or an international policy for that first period.
What should you watch for with an ISAPRE?
When signing up you fill in a declaración de salud, a health declaration. The Superintendencia de Salud advises declaring everything: for an existing illness you do not declare, the ISAPRE can refuse cover. Also:
- the ISAPRE may review the base price of your plan every year, in the month you signed the contract, but not on the basis of your health;
- care abroad is not reimbursed, unless your plan has international cover;
- for the contract you hand in your cédula and your latest pay or pension slip.
What does FONASA offer?
With the Copago Cero scheme, according to ChileAtiende, you get in the public health system among other things the guaranteed treatments (AUGE/GES), emergency care with admission, medicines, prostheses, dental care and mental health care without a personal contribution. You sign up online with your RUN and the serial number of your cédula, or with your ClaveÚnica; the answer comes by email within three days. See registration and numbers.
How your AOW and pension are taxed in Chile is in AOW, pension and tax. Which permit you need is in the residence routes.
In Vertrekklaar this is phase 1 of 5 of the journey, step 1.2: the same steps, but for your situation — in your order, tickable, and with the deadlines watched. See the whole journey to Chile or go straight to step 1.2 in the open plan.
What this rests on
The facts in this article come from these official pages. Rules change. When in doubt, go by the source, not this article.
- CAK — the treaty countries for health insurance (Chile is not among them) — hetcak.nl
- NederlandWereldwijd — when you arrange your health insurance through the CAK — nederlandwereldwijd.nl
- Netherlands–Chile social security treaty, article 16 on healthcare for pensioners, and the administrative agreement, article 9 (wetten.overheid.nl) — wetten.overheid.nl
- Superintendencia de Salud — the statutory contribution of 7% and the ceiling of 90 UF — superdesalud.gob.cl
- ChileAtiende — joining FONASA, also for pensioners and through international treaties — chileatiende.gob.cl
- Superintendencia de Salud — frequently asked questions about ISAPREs, with the health declaration and cover abroad — superdesalud.gob.cl
- Ley 21.325, article 15: access to healthcare for foreigners, as for Chileans (BCN) — bcn.cl
Read on
- ArgentinaOrientation4 min
Healthcare in Argentina: no CAK, and since 2025 no longer free in the national hospital
The Netherlands and Argentina have a treaty on taking benefits abroad, but not on healthcare: no CAK and no S1. Since Decreto 366/2025 a foreigner without permanent residence only gets emergency care free of charge in a national state hospital. For everything else you need an obra social, a prepaga or your own policy.
Updated 15 October 2026
- ArubaRegistration on Aruba4 min
Healthcare on Aruba: the AZV, a premium of 10.5% through wages, and no treaty with the Netherlands
Whoever is registered on Aruba falls under the General Health Insurance (AZV): one system, no insurer to choose, and a premium of 10.5% up to an income of Afl. 85,000, of which your employer bears 8.9% and you 1.6%. Pensioners pay nothing since 2026 on the first Afl. 30,000. There is no S1 and no CAK: Aruba is not a treaty country, so you close the gap until your registration yourself.
Updated 26 September 2026
- BonaireArrival5 min
Healthcare on Bonaire: one hospital, and the flights are in the package
On Bonaire you are insured as a resident by operation of law — no premium, no excess. What the island cannot do, the insurance arranges with medical referrals abroad to Curaçao, Colombia or the Netherlands, including tickets and accommodation. The flip side: a dental package that is almost empty from the age of eighteen, physiotherapy of which the first twenty sessions are at your own expense, and a transition gap you have to insure yourself.
Updated 26 September 2026