Healthcare in Zanzibar: no CAK, so insure yourself
Tanzania is not a treaty country for the CAK. If you move to Zanzibar, your Dutch basic insurance stops and you arrange international health insurance yourself. On every entry as a visitor you also buy the mandatory travel insurance of the Zanzibar Insurance Corporation.
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If you move to Zanzibar, you arrange your health insurance yourself. Tanzania, of which Zanzibar is part, is not among the CAK treaty countries. So even with an AOW or pension you get no healthcare there at Dutch expense, and your Dutch basic insurance stops when you emigrate. What you need is international health insurance with medical evacuation. On top of that, every foreign visitor buys the mandatory travel insurance of the Zanzibar Insurance Corporation (ZIC): USD 44 per adult and USD 22 per child.
What applies?
| Topic | What the source says | Source |
|---|---|---|
| Healthcare from the Netherlands (CAK) | not possible: Tanzania is not a treaty country | CAK |
| Dutch basic insurance | stops when you no longer live in the Netherlands | Health Insurance Act, section 2 |
| Mandatory ZIC travel insurance | USD 44 per adult, USD 22 per child, cover up to 92 days | ZIC |
| Since 1 October 2026 | mandatory insurance for the mainland too; one policy per trip is enough | ZIC, 7 October 2026 |
| Local healthcare | reasonable in the big cities, limited elsewhere | NederlandWereldwijd |
| Zanzibar Health Services Fund | under the bill, a 7 % contribution for employees; other groups later | 2022 bill |
Why does your Dutch health insurance stop?
The Health Insurance Act requires basic insurance as long as you are insured under the Long-term Care Act (section 2). Anyone living outside the Netherlands is usually no longer insured under that act. If you emigrate, your basic insurance therefore stops too.
Only in a treaty country does the CAK keep your healthcare going at Dutch expense. Outside the EU, the EEA and Switzerland these are the United Kingdom, Bosnia and Herzegovina, Cape Verde, North Macedonia, Morocco, Montenegro, Serbia, Tunisia and Turkey. Tanzania is not one of them. Cancel your Dutch policy as soon as you are deregistered, and let your new insurance start on that day.
If you go for only part of the year and keep living in the Netherlands and registered there, your basic insurance continues. Treatment abroad is then reimbursed up to what it costs in the Netherlands. Transport back to the Netherlands is not included: you arrange that with travel insurance or supplementary insurance.
Which insurance do you take out instead?
International health insurance, with an insurer you choose yourself. According to NederlandWereldwijd, healthcare is reasonable in the big cities and limited elsewhere. Anyone admitted to hospital sometimes has to be transferred to another country.
Check three things with every policy:
- Medical evacuation. Is transport to a hospital in another country included?
- Return to the Netherlands. Will you be brought home if that is medically necessary?
- Cover at orange or red. Zanzibar currently has colour code yellow, but ask what happens if the travel advice changes.
What is the mandatory ZIC travel insurance?
Since 1 October 2024 every foreign visitor to Zanzibar must have travel insurance from the Zanzibar Insurance Corporation. You buy it online. It costs USD 44 per adult and USD 22 per child, and it covers a stay of up to 92 days. According to ZIC you must buy it regardless of any travel or health insurance you already have.
Since 1 October 2026 mandatory insurance also applies to the mainland. One policy per trip is enough: the place where you enter Tanzania decides where you buy it. If you arrive in Zanzibar first, that is ZIC. Keep the certificate with the QR code.
The ZIC insurance does not replace your own insurance, says NederlandWereldwijd. The notices speak of "foreign visitors". Whether you buy it again on every return with a residence permit, and up to what age a child counts as a child, we could not verify. Ask ZIC or the immigration service in Zanzibar.
Is a mandatory Zanzibari health insurance coming?
Perhaps. In November 2022 there was a bill for a Zanzibar Health Services Fund. According to that text the scheme would also apply to "foreigners living in Zanzibar where their residence exceeding six months". It starts with employees, with a contribution of 7 %: 3.5 % from the employer and 3.5 % from the employee. Other groups follow only once the minister announces it. Every foreigner coming to Zanzibar would also need health insurance that is valid in Zanzibar.
We could not read the adopted act itself. So we do not know whether that group of foreigners stayed in, or whether the minister has already designated it. If you work in Zanzibar, ask your employer how it stands.
Which health risks does the travel advice mention?
NederlandWereldwijd mentions malaria, dengue and cholera. The risk is highest in the rainy season, from March to May: cover your skin and use insect repellent. Proof of yellow fever vaccination is only required if you travel from a country where yellow fever occurs, or changed planes there. If you come straight from the Netherlands, it does not apply.
And if you come back?
If you come back and live in the Netherlands again, you are once more required to be insured. Take out basic insurance from the day you are back, and only cancel your international policy after that.
In Vertrekklaar this is phase 3 of 5 of the journey: the same steps, but for your situation — in your order, tickable, and with the deadlines watched. See the whole journey to Zanzibar or look inside the open plan first.
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 healthcare from the Netherlands (Tanzania is not among them) — hetcak.nl
- Health Insurance Act, section 2 — who must be insured — wetten.overheid.nl
- NederlandWereldwijd — travel advice for Tanzania, healthcare, the mandatory local travel insurance and health (changed 9 October 2026) — nederlandwereldwijd.nl
- Zanzibar Insurance Corporation — the mandatory inbound travel insurance, USD 44 per adult and USD 22 per child — zic.co.tz
- Zanzibar Insurance Corporation — notice of 7 October 2026 on the insurance for Zanzibar and the mainland — zic.co.tz
- Tanzanian embassy in Tokyo — the mandatory travel insurance for Zanzibar since 1 October 2024, cover up to 92 days — jp.tzembassy.go.tz
- Zanzibar House of Representatives — Zanzibar Health Services Fund bill (2022), s. 2 and s. 45 — zanzibarassembly.go.tz
- Rijksoverheid — health insurance abroad for a stay of less than a year — rijksoverheid.nl
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