Healthcare on Aruba: the AZV, a premium of 10.5% through wages, and no treaty with the Netherlands

Yes, on Aruba you are insured as soon as you are registered there: the General Health Insurance (AZV) is one statutory system for all residents, without an insurer to choose and without a policy. The premium is 10.5% of your premium income up to Afl. 85,000, of which your employer bears 8.9% and you 1.6% through your payslip; as a self-employed person you pay the 10.5% yourself, and the maximum is Afl. 8,925 a year. The find in the premium table: whoever reached the AOV age of 65 in 2026 pays 0% on the first Afl. 30,000 and 10.5% on the excess, where in 2025 that was still 5%. The pitfall is on the Dutch side: Aruba is not a treaty country. There is no S1, no CAK contribution and no country-of-residence package; the CAK writes literally that for Aruba you take out your own insurance. Your Dutch basic insurance ends at your deregistration, the AZV starts at your registration at Censo, and in the weeks between you are covered only by what you have taken out yourself.

How does the AZV work, and who pays what?

The AZV is governed by the National Ordinance on General Health Insurance of 1992, with implementing decrees for, among other things, medicines and dressings, aids, dental care and the limitation of specialist care; the government publishes those legal texts on one page. The premium runs through the tax office, Departamento di Impuesto, and the table is fixed per year:

Situation (2026)	Premium	Limit and maximum
Employed	10.5%: employer 8.9%, employee 1.6%	premium limit Afl. 85,000; at most Afl. 8,925, of which employee Afl. 1,360
Self-employed	10.5%	premium limit Afl. 85,000; at most Afl. 8,925
AOV-entitled (reached 65 in 2026)	0% on the first Afl. 30,000, 10.5% on the excess	at most Afl. 5,775
For comparison 2025	pensioners 5% on the first Afl. 30,000	at most Afl. 7,275

For whoever comes retired that is the sum that counts: the premium for an AOV-entitled person is lower in 2026 than in the years before, and the limit of Afl. 85,000 ensures that a higher income does not contribute without end.

What happens when I am ill and working?

Besides the AZV, which covers the care costs, Aruba has a separate sickness insurance for wages. An employee with a monthly salary of Afl. 5,850 or less falls under it and receives, when unfit for work, 80% of the daily wage from the fourth day of illness; the SVb pays nothing for the first three days, and the right lapses after two years for the same cause of illness. The premium of 2.65% of the gross daily wage is the employer's; they may not deduct it from your wage. In pregnancy 100% of the daily wage applies for at most twelve weeks. Whoever earns more than the limit arranges continued pay during illness in the employment contract.

What else do I use the AZV proof for?

For your children. At school enrolment the school board asks for an extract from Censo and "a proof of AZV insurance"; if a pupil is not AZV-insured, the parents sign a declaration releasing the school from liability, or take out an equivalent private insurance. The AZV registration of the whole family should therefore be settled before school enrolment, and that in turn hangs on the registration at Censo.

What is the pitfall?

No treaty means no safety net. Whoever moves within the EU takes their Dutch right to care along through the S1; on Aruba your cover only starts at your registration, and the window for that is short: how the thirty days after your Censo registration work is in your first weeks on Aruba. Whoever is late pays for the care between registration and enrolment themselves.

In practice: take out a bridging insurance before departure that covers the weeks until your AZV registration, stop the Dutch health insurance per the date of deregistration, and only cancel the bridging cover once the AZV registration is confirmed. Your AZV moreover runs with your permit: renewing late at DIMAS is also too late for your care.

In Vertrekklaar this is phase 4 of 5 of the journey, step 4.4: the same steps, but for your situation — in your order, tickable, and with the deadlines watched. See the whole journey to Aruba or go straight to step 4.4 in the open plan.