Healthcare on Curaçao: the bvz, the premium through your tax and the gap before you register

Yes, on Curaçao you are insured as soon as you live there: every resident falls under the basic health insurance (bvz), without a policy and without an insurer, with a premium the Tax Administration collects. That premium is 13.6% of your annual income, and 6.5% for those no longer insured for the AOV; below ANG 12,000 a year you pay nothing, above ANG 150,000 nothing more on the excess. The find in the law is in the word resident: you only are one "by virtue of registration under a valid residence title in the population register". Between your deregistration in the Netherlands and your registration at Kranshi you are therefore insured nowhere, and you close that gap yourself. The pitfall for pensioners: there is no S1, no CAK route and no treaty. Curaçao is not on the list of treaty countries, and the CAK says it plainly: take out your own insurance, also for Aruba, Curaçao and the BES islands.

Who is insured, and from when?

The law is short: insured is whoever is a resident, or whoever, without being a resident, works in employment on Curaçao and pays wage tax there. And a resident is "whoever, by virtue of registration under a valid residence title, is included in the population register and is actually settled in Curaçao". Two things must therefore be right: the declaration by operation of law as residence title, and the registration at Kranshi. Whoever holds a permit for temporary residence is precisely not insured; that does not apply to the Dutch citizen with a declaration by operation of law.

Your Dutch basic insurance ends on the day of your deregistration. The weeks after that, until Kranshi has registered you, you are insured in neither system: that is the bridging gap you close before departure with a temporary insurance.

What does the bvz cover, and how do you get to a doctor?

The entitlements are in the law: medical care and primary psychological care, specialist and hospital care, paramedical care, dental care, pharmaceutical care, aids and appliances, obstetric and maternity care, transport, medical referrals abroad for care not provided on the island, and home care. A co-payment or an excess can be set by national decree; the nature and conditions of each entitlement are in those implementing decrees, not in the law itself.

You can only claim your entitlements with a proof of registration from the implementing organisation (the SVB Curaçao), valid for at most three years. With it you register in the name of one GP, one dentist and one pharmacy; only there can you go, and you can change that choice only after a year, except when moving house or after a serious breach of trust. So choose your GP in your own neighbourhood, not the first one with room.

Item	What applies
Premium	13.6% of annual income; 6.5% if you no longer owe AOV premium
No premium	with an annual income of ANG 12,000 or less
Reduction (sliding scale)	from 3.8% to 0.6% with an annual income between ANG 12,000 and 18,000
Ceiling	no premium on the part above ANG 150,000
Collection	through the employer (employer's and employee's share) or through the income tax assessment
Proof of registration	valid for at most 3 years; needed at every care provider
GP, dentist, pharmacy	fixed registration; change only after 1 year

What do you pay, and how is it collected?

The premium is calculated on your total gross annual income, without deduction of personal expenses. In employment your employer withholds an employee's and an employer's share; too much or too little withheld employee premium is settled with your income tax assessment. Whoever is not in employment pays the premium with the income tax assessment. Whoever has the penshonado scheme remains liable for the bvz premium; and whoever no longer pays AOV premium drops to 6.5%.

What is the pitfall?

There is no S1 and no CAK. In the EU your Dutch right to care travels with you through the treaty; on Curaçao your care only starts at your registration, and until that day you are covered only by what you have taken out yourself. Whoever leaves the declaration by operation of law until after arrival stretches that gap to months, because Kranshi only registers you with a residence title still valid for at least four months.

In practice: arrange the temporary cover before departure, submit the declaration from the Netherlands, go to Kranshi within five days, then collect your proof of registration and choose your GP. From that moment the bridging insurance can be cancelled. What the bvz does not reimburse you can insure additionally if you wish; whether that is needed you see from the implementing decrees and from the first bill.

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 Curaçao or go straight to step 1.2 in the open plan.