Healthcare in Poland: from the CAK's S1 to the NFZ
Poland is a treaty country. With a Dutch statutory pension you apply for an S1 form at the CAK, register it at the NFZ office of your province, and are treated as if you were insured there. The Netherlands pays, you pay the treaty contribution, and Poland charges you no premium of its own. The form in your drawer is not yet insurance.
Within the EU healthcare is the item that turns out least surprising, provided you keep to the order. With Poland the surprise isn't in the entitlement but in the registration: the form alone does nothing.
Retired: the S1 route through the CAK
Poland is on the list of treaty countries. If you have a Dutch statutory pension or benefit, you register with the CAK. You receive an S1 form, and with that you're entitled to care in Poland at the expense of the Netherlands.
For that you no longer pay a Dutch healthcare premium but a treaty contribution, which in most cases is withheld automatically from your pension. The amount depends on your income and on your country of residence. Poland charges you no health premium of its own on top: you don't fall under the Polish insurance but under the Dutch, and Poland only provides the care.
Apply for the form well before your departure — count on six weeks — and only cancel your Dutch policy once it's settled. A gap between two systems is the most expensive thing that can happen to you on this journey.
The step people skip: registering with the NFZ
The S1 in your drawer is no insurance. You have to register it at the NFZ office of your province, with your PESEL and your address registration. You then receive a confirmation giving entitlement to the full package of care in Poland, and you're treated as if you were insured with the NFZ.
Only then are you known in the Polish system, and only then can you choose a GP. Without a PESEL the NFZ cannot enrol you — which is why the address registration at the municipality always comes first.
If you work in Poland: the route via the employer
Whoever takes up employment falls under the Polish system via the employer and the NFZ, with the Polish premium. Your Dutch insurance ends on the day your Polish one begins, and the CAK doesn't come into it. Whoever is self-employed insures via their own registration with the ZUS, the Polish social insurance institution.
What the public system is, and what it isn't
Your entitlement is an entitlement to the public system: the same care as for Polish insured people, with the same waiting times. For a specialist that can be months. Many Dutch people in Poland therefore combine the NFZ with a private subscription at one of the big private chains in the cities — that is a choice, not an obligation, and the amounts are manageable by Dutch standards.
Outside the big cities Polish is the language of the consulting room. Find a GP in your first weeks, before you need one, and ask about English when choosing if you don't have Polish yet.
The deadline for early retirement
From 1 November 2026, as expected, only new applicants with AOW or a disability benefit will be admitted to the healthcare route for pensioners. Whoever leaves on early retirement without AOW then falls outside it and depends on a private policy or, when working, on the Polish system via the employer.
Whoever is already a client keeps their rights. Whoever is on the edge has an interest in being registered before that date.
What this rests on
The facts in this article come from these official pages. Rules change — when in doubt the source is leading, not this article.
- NederlandWereldwijd — the scheme for living abroad and the treaty countries — nederlandwereldwijd.nl
- NederlandWereldwijd — how do I arrange my health insurance through the CAK — nederlandwereldwijd.nl
- NFZ — registration of the forms E106, E109, E121 and the S1 documents — nfz-bialystok.pl
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