Healthcare in Uruguay: no CAK, but FONASA for those who work and ASSE for those who do not
The social security treaty with Uruguay covers your AOW, but not your healthcare: Uruguay is not on the CAK's list. Anyone working in Uruguay falls under FONASA, the national health fund run through the BPS, and pays 3 to 8 % of their wage. Anyone not working chooses the public provider ASSE or a private mutualista.
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Uruguay and the Netherlands have a social security treaty, but it does not cover your health insurance. Uruguay is not on the CAK's list of treaty countries. So there is no S1 form and no Dutch cover at the Netherlands' expense. In Uruguay itself your healthcare depends on one question: do you work there or not? Those who work fall under FONASA, the national health fund collected by the BPS. Those who do not work join the public provider ASSE or a private mutualista.
| What | For whom | What it costs |
|---|---|---|
| Dutch basic insurance | ends on emigration | |
| CAK and S1 | only in a treaty country; Uruguay is not one for healthcare | not possible |
| FONASA, single | employees and the self-employed | 3 % of the wage up to 2.5 BPC, 4.5 % above |
| FONASA, with partner and children | same, with family members without their own entitlement | 5 % up to 2.5 BPC, 8 % above |
| FONASA, employer | 5 % of the wage, sometimes with a supplement | |
| ASSE, free | those below the income limits | no premium, no co-payments |
| ASSE, cuota | those above the limits, or without residence yet | a monthly fee |
| Carné de salud at ASSE | required for your residence application | free for ASSE members, otherwise 0.4 UR |
The BPC, the base de prestaciones y contribuciones, is currently 6,864 pesos a month according to the BPS. 2.5 BPC is therefore 17,160 pesos.
What happens to your Dutch insurance?
Your basic insurance belongs to living in the Netherlands and ends when you emigrate; how to arrange that without a gap is covered in cancelling your health insurance. According to the Belastingdienst, anyone with no Dutch income after emigration is no longer insured for the national insurance schemes, and then also has no right to the Long-term Care Act.
In Spain or Portugal you arrange your healthcare with a Dutch pension through the CAK. That is only possible in a treaty country, writes NederlandWereldwijd. The treaty with Uruguay does mention health insurance, but only for the question of which country insures you if you work there. It contains no arrangement for healthcare at Dutch expense.
How does FONASA work?
Anyone in paid employment is registered with the BPS by the employer and pays a contribution that depends on the wage and the family. Your care then runs through a provider: a mutualista, a private healthcare institution, or ASSE. If you have never been affiliated before, the BPS assigns you to ASSE. Within 180 days you may switch in certain cases. Cover applies from the day of affiliation.
Your partner without their own entitlement and your children up to 18 can be co-insured; that is why the contribution is then higher. Sole proprietors and people providing services independently also fall under FONASA. More on working is in working in Uruguay.
And if you do not work?
Then you do not fall under FONASA, and you arrange it yourself. ASSE has three forms:
- Free, for those below the income limits. You then also pay no co-payments for consultations or medicines. You prove the income of your whole household, with the latest statement.
- Through FONASA, if you are insured through work.
- For a monthly fee, the cuota ASSE, if you are above the limits. A foreigner without residence can also become a member this way.
For affiliation you bring your identity document, proof of your income and your residence certificate or proof that your application is under way. The limits and the monthly fee are not on ASSE's page; ask for them at the counter.
The other route is a mutualista, as a private member. Prices and conditions differ per institution. Ask in writing beforehand about a waiting period for certain care and about exclusions for conditions you already have.
Do not let a gap open between the end of your Dutch insurance and the start of your cover in Uruguay. Your Dutch policy ends on the day you emigrate, and in Uruguay you are only insured once you are affiliated with ASSE or a mutualista. Arrange travel or international health insurance for those first weeks.
What is the carné de salud?
The carné de salud is a medical check you need for your residence permit, and which is also required in Uruguay to work. You get it from a provider recognised by the Ministry of Public Health. At ASSE it is free for members; non-members pay 0.4 UR. Bring a valid proof of your tetanus vaccination, and recent blood test results if you have them.
For the residence application you also hand in proof that you follow the Uruguayan vaccination schedule. See the residence routes.
What does it cost you in total?
That depends on your income and your choice. Work out your budget with AOW, pension and tax: your AOW goes with you to Uruguay in full, but you pay for your healthcare yourself. Bring your medicines for the first months; how that works at the border is covered in medicines across the border. Where healthcare falls in the order of visa and departure is shown in the route to Uruguay.
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 Uruguay 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 (Uruguay is not among them) — hetcak.nl
- NederlandWereldwijd — health insurance through the CAK, only in a treaty country — nederlandwereldwijd.nl
- Belastingdienst — after emigration no more Wlz and Anw — belastingdienst.nl
- Social security treaty Netherlands–Uruguay, article 2 — health insurance only falls under the rules on applicable legislation — wetten.overheid.nl
- BPS — the FONASA contributions per household situation — bps.gub.uy
- BPS — who is insured through FONASA and how affiliation with a provider works — bps.gub.uy
- ASSE — affiliation free of charge, through FONASA or for a monthly fee — gub.uy
- ASSE — the carné de salud, free for those affiliated with ASSE — gub.uy
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