Healthcare in Czechia: from the CAK's S1 to the health insurer
Czechia is a treaty country. With a Dutch statutory pension you apply for an S1 form at the CAK, hand it in at a Czech health insurer of your choice, and are supplementarily insured there at the expense of the Netherlands — with the right to full care. The certificate is valid at most five years at a time, and the form in your drawer is not yet insurance.
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If you live in Czechia, you choose a Czech health insurer yourself. Czechia has no national health fund like Poland, but a system of health insurers side by side.
And the bill comes out lower than in the Netherlands. For Czechia the CAK uses a country-of-residence factor of 0.4257 in 2026. That is the figure with which the CAK adjusts your contribution to the cost level of healthcare in your country of residence. So you pay a little less than half of the contribution that would apply at the Dutch factor of 1.
Retired: how does the S1 route via the CAK work?
Czechia is on the list of treaty countries. Do you have a Dutch pension or a benefit and no longer work in the Netherlands? Then you register with the CAK.
The CAK assesses whether the foreign scheme applies to you and then sends you an S1 form: the European proof that the Netherlands pays for your care. 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. Czechia charges you no premium of its own: the Czech insurer bills the care to the Netherlands.
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 Czechia?
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) |
| Country-of-residence factor Czechia | 0.4257 |
| Nominal contribution after the country-of-residence factor | € 66.83 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 0.4257 that comes to about € 190 a month.
The factor is set anew every year. In 2025 it was 0.4078 for Czechia.
How do you register with a Czech insurer?
With your S1 you go to a Czech health insurer; which one, you choose yourself. The insurer does three things:
- it records the form;
- it sends the foreign institution a confirmation;
- it registers you as výpomocně pojištěný, supplementarily insured.
You receive a registration certificate or an insurance card. It is valid as long as your S1 is, at most five years at a time; after that a new document follows. With it you are entitled to full healthcare in Czechia.
The form in your drawer is not insurance. Only after registration are you known in the Czech system, and only then can you choose a GP who has a contract with your insurer. So choose the insurer partly on the doctors in your area.
If you have family members without income of their own, they must be registered in the same country as you. The Czech insurer requests a separate document for them from the Dutch institution, and you supply the marriage or birth certificate. After that they also get their own registration certificate.
And when you are in the Netherlands?
Then you are entitled to full care there too. The Czech insurer says so itself: a pensioner with an S1 is entitled to full care in the country that pays the pension with the European health card issued by the foreign insurer. So request that card from the CAK.
For a number of other EU countries that doesn't apply, but the Netherlands is not on that list.
What do you pay yourself in the Czech system?
Your right is a right to the same care as Czech insured persons, with the same co-payments. For prescription medicines there is an annual cap on the co-payments that count:
- 5,000 crowns for adults;
- 1,000 crowns for children and for those over 65;
- 500 crowns for those over 70.
Above that cap you no longer pay counting co-payments at the pharmacy. Extra payments for a more expensive drug than the cheapest variant don't count and you always pay them.
Do you work in Czechia?
Then your healthcare doesn't run through the CAK. That route is for those who have a pension or benefit from the Netherlands and no longer work in the Netherlands. You are then insured in Czechia.
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 Czechia 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
- ČPZP — the pensioner with a pension from another EU country — cpzp.cz
- 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
- VZP — the annual cap on co-payments for medicines — vzp.cz
- CAK — emigrating on early retirement, the expected change from 1 November 2026 — hetcak.nl
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