The mutualiteit, the remgeld and the S1: how healthcare works for Dutch residents of Belgium

The most important healthcare question for a Dutch resident of Belgium is not "which health fund" but "which country" — and the answer depends on where you work, not where you live. Three scenarios, and then the Belgian system itself.

First: which country insures you?

If you keep working in the Netherlands, you simply remain insured in the Netherlands — you keep your health insurer and your healthcare allowance. With an S1 form from your insurer you also register with a Belgian mutualiteit (health fund) and are entitled to care in both countries; your family members without their own income come along via the CAK, for a treaty contribution per family member. If you go to work in Belgium, the Dutch insurance stops and you choose a health fund. And if you are retired, you become a treaty beneficiary via the CAK: an S1 opens the Belgian health fund, the Netherlands bears the costs, and you pay the CAK a contribution multiplied by the country-of-residence factor — for Belgium 0.8165 in 2026, so roughly four fifths of the Dutch premium burden, with the right to care in both countries retained.

If you leave before your AOW age, watch the date. The CAK route is expected to remain open from 1 November 2026 only to new registrants with a statutory benefit — AOW (the Dutch state pension), Anw, WAO, WIA or Wajong. Whoever brings only an early-retirement pension, an RVU payment or an occupational pension taken early then falls outside it and arranges membership of a health fund at their own expense until AOW age. Whoever is already a CAK client keeps their rights. What exactly changes, and what you can do now.

The health fund and the remgeld

In Belgium you choose a mutualiteit (CM, Helan, Solidaris and others — or the premium-free Hulpkas, without extras; the statutory reimbursement is the same everywhere). At the doctor you pay yourself first and are left with a personal share: the remgeld (co-payment). Against that stand dampers that you have to switch on actively. The most important is the global medical file: have your regular GP open it — it costs you nothing and the remgeld per consultation drops to a few euros. For expensive years there is the maximum bill (a ceiling on your total remgeld), and the dentist has its own logic: whoever skips a year gets less reimbursed the following year — so going every year from day one literally pays.

The insurances that belong with life in Belgium

Two things that no law requires but almost every Belgian has. Hospitalisation insurance covers the room and fee supplements that can mount up considerably on a hospital stay in a single room — via the health fund it is cheapest, via the employer often free; ask about it in your terms of employment. And the family insurance (private liability) is the standard there for a few tens of euros a year. If you live in the Flemish Region, there is one obligation that newcomers often miss: the Flemish care premium (€ 100 a year from age 26, via a care fund, join within six months) — a separate bill alongside your health fund, with a fine for whoever leaves it lying.

In Vertrekklaar this is phase 5 of 5 of the journey: the same steps, but applied to your situation — in your order, tickable, and with the deadlines monitored. See the whole journey to Belgium.