Healthcare in Poland: from the CAK's S1 to the NFZ
Poland is a treaty country. With a Dutch statutory pension you apply for an S1 form at the CAK, register it at the NFZ office of your province, and are treated as if you were insured there. The Netherlands pays, you pay the treaty contribution, and Poland charges you no premium of its own. The form in your drawer is not yet insurance.
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With a Dutch pension or benefit you fall under the Dutch scheme via the CAK in Poland, and Poland provides the care. Within the EU, healthcare is the item that turns out least surprising, provided you keep to the order. Two things do stand out with Poland:
- The registration. The surprise is not in the right but in the registration: the form alone does nothing.
- The price. Because healthcare in Poland is cheaper than in the Netherlands, the CAK uses a country-of-residence factor of 0.1940 in 2026.
That country-of-residence factor adjusts your contribution to the price level of healthcare in your country of residence. So you pay a little less than a fifth of the contribution that would apply at the Dutch factor of 1.
Retired: how does the S1 route via the CAK work?
Poland is on the list of treaty countries. If you have a Dutch pension or a benefit and no longer work in the Netherlands, you register with the CAK. The CAK assesses whether the foreign scheme applies to you and then sends you an S1 form. According to NederlandWereldwijd the processing time is at most four weeks.
You no longer pay a Dutch health premium but a treaty contribution. Your pension fund or benefits agency deducts it automatically in most cases. Poland charges you no premium of its own on top: you fall under the Dutch scheme, and Poland provides the care.
Family members with their own pension or benefit register independently. If they have no income of their own, you put their names on your application, and the Polish health fund decides whether they are co-insured.
Apply for the form well before departure and only cancel your Dutch policy once it is settled. A gap between two systems is the most expensive thing that can happen to you on this journey.
What does the treaty contribution cost in Poland?
The CAK calculates it as: (the nominal contribution + two income-related amounts) × the country-of-residence factor. The income-related amounts are the percentages you would pay in the Netherlands for the Zvw (the Health Insurance Act) and the Wlz (the Long-term Care Act).
| Item (2026) | Amount |
|---|---|
| Nominal Zvw contribution, before the country-of-residence factor | € 157.00 a month |
| Income-related Zvw contribution on AOW and other income | 4.85%, up to an income of € 79,409 |
| Income-related Wlz contribution | 9.65%, up to € 38,883 (born 1946 or later) or € 41,123 (born 1945 or earlier) |
| Country-of-residence factor Poland | 0.1940 |
| Nominal contribution after the country-of-residence factor | € 30.46 a month |
A worked example with those figures, at € 2,000 of pension a month:
- The income-related part is 14.5% of that, € 290.
- Together with the nominal € 157 that makes € 447.
- Times 0.1940 that comes to about € 87 a month.
For co-insured family members under eighteen you pay nothing. The country-of-residence factor is set anew every year; in 2025 it was 0.1649 for Poland.
The step people skip: registering with the NFZ
The S1 in your drawer is not insurance. The NFZ, the Polish national health fund, says so itself: to be treated on the basis of the S1, you first register it with the NFZ office of the province where you live. That office records the S1 and gives you a confirmation of your right to healthcare.
After that you are entitled to the full package, including planned treatment and appointments with specialists, on the same terms as a Polish insured person.
If you have a PESEL, the Polish personal identification number, any healthcare provider can check your entitlement electronically. You then show your identity document instead of the confirmation. That is why the address registration at the municipality comes before the NFZ in this journey.
The European health card is no substitute. With the EHIC you only get the care that is needed during a temporary stay in Poland, and the doctor weighs how long you are staying. Whoever lives there needs the S1 and the NFZ registration; a waiting list for a planned operation only starts running after that.
What do you get in the public system, and what do you pay extra?
You first go to a GP who has a contract with the NFZ. They refer you to a specialist or to hospital. In hospital, treatment, tests and medicines are free.
For prescription medicines outside hospital you pay, depending on the drug:
- nothing;
- 30% or 50% of the funding limit;
- a fixed amount of 3.20 złoty;
- or the full price if the drug is not on the reimbursement list.
Dental care is free only to a limited extent.
If you work in Poland: how does it work then?
Whoever goes to work in Poland does not fall under the CAK route. That is for those who have a pension or benefit from the Netherlands and no longer work in the Netherlands. You are then insured through the Polish system. As a self-employed person you register with ZUS, the Polish social insurance institution, for that within seven days; see working in Poland.
What changes on 1 November 2026?
From 1 November 2026, new applicants are expected to be admitted to the CAK health insurance only with a statutory pension or statutory benefit, such as the AOW.
Whoever leaves with an early retirement pension or bridging benefit then falls outside it and arranges their own health insurance until AOW age. Existing customers keep their rights.
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 Poland 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.
- NederlandWereldwijd — the foreign scheme and the treaty countries — nederlandwereldwijd.nl
- NederlandWereldwijd — how do I arrange my health insurance through the CAK — nederlandwereldwijd.nl
- NFZ — treatment in Poland of people insured in another EU country, with the S1 and the EHIC — nfz.gov.pl
- CAK — country-of-residence factors and the nominal contribution per country, 2026 — hetcak.nl
- CAK — how the country-of-residence factor is applied to your contribution — hetcak.nl
- CAK — emigrating on early retirement, the expected change from 1 November 2026 — hetcak.nl
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