Verdragspolis registration

Use this form to register for the Verdragspolis. The Verdragspolis covers medical care both in the Netherlands and in the country in which you are insured (through your health insurance in that country).



If so, ask the Sociale verzekeringsbank (SVB) for a 'Wlz assessment'. This can be done via the website of the SVB (www.svb.nl), or via telephone number +31 (0)20 656 48 48.


Your package

The 'Jongeren' and 'Gezinnen' additional insurance packages already include dental insurance. If you have either of these packages, you will not need to take out separate dental insurance.
Take advantage of a discount on the premium and more extensive reimbursements. If you have received a group insurance number from your employer or member organisation, please enter it here. Please note: the discount is given only on the premium for an additional insurance package, because you do not have to pay a premium for the 'Verdragspolis'.

Your foreign health insurer


Your details


Enter the details of the person receiving income from work or retirement benefits from abroad.


You find your customer number in My CZ or the CZ app.
If you are not an EU/EEA national, we need a copy of the front and back of your residence permit.
We will cancel your current health insurance for you from the date you are registered in the Verdragspolis. We do this because we are obliged to provide your current health insurer with information that is necessary for the implementation of the health insurance and the Dutch Healthcare Insurance Act. This also applies to registered family members.
We are sometimes able to help you faster if we call you.
Only for addresses outside of the Netherlands.

Partner


You cannot add the partner and children to the existing Verdragspolis. They must be insured through a compulsory Dutch basic insurance policy. Would you like more information about CZ’s basic insurance policies? Contact us on 088 555 77 77.


Your partner’s package


The 'Jongeren' and 'Gezinnen' additional insurance packages already include dental insurance. If you have either of these packages, you will not need to take out separate dental insurance.

Your partner’s details


You find your customer number in My CZ or the CZ app.
If your partner is not an EU/EEA national, we need a copy of the front and back of his/her residence permit.
If so, we will cancel the current health insurance from the date your partner is registered in the Verdragspolis.

Children


If you have child(ren) with own income from the Netherlands, you cannot add them to the exisiting Verdragspolis. In that case, you will insure the child through a compulsory Dutch basic insurance.


You find your customer number in My CZ or the CZ app.
If your child is not an EU/EEA national, we need a copy of the front and back of his/her residence permit.
If so, we will cancel the current health insurance from the date your child is registered in the Verdragspolis.
You find your customer number in My CZ or the CZ app.
If your child is not an EU/EEA national, we need a copy of the front and back of his/her residence permit.
If so, we will cancel the current health insurance from the date your child is registered in the Verdragspolis.
You find your customer number in My CZ or the CZ app.
If your child is not an EU/EEA national, we need a copy of the front and back of his/her residence permit.
If so, we will cancel the current health insurance from the date your child is registered in the Verdragspolis.
You find your customer number in My CZ or the CZ app.
If your child is not an EU/EEA national, we need a copy of the front and back of his/her residence permit.
If so, we will cancel the current health insurance from the date your child is registered in the Verdragspolis.
You find your customer number in My CZ or the CZ app.
If your child is not an EU/EEA national, we need a copy of the front and back of his/her residence permit.
If so, we will cancel the current health insurance from the date your child is registered in the Verdragspolis.

Payment method for the mandatory deductible or additional insurance premiums


Because you already pay premium to your foreign health insurer, you do not have to pay premium for the Verdragspolis.


Only enter a BIC if your bank account is not a Dutch bank account.
If so: Please also send us a copy of your valid passport. Via email to verdragspolis@cz.nl or via post to CZ, Postbus 90152, 5000 LD Tilburg.

Signature


Before you sign, we would like to point out the following: 1. We can only process your registration for the ‘Verdragspolis’ once we have received your E106/S1/E121 form issued by your foreign health insurer 2. We will check your details against the External Reference Register (‘Extern Verwijzingsregister’). An entry in this fraud register may affect your additional insurance package.


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Do you have a question about the Verdragspolis?

Call +31 46 459 59 86. You can reach us Monday to Friday 08.30 am to 5.30 pm. You will only pay the usual call rates.