
S1 form for health insurance cover where you live
An S1 form is proof of your Dutch health insurance. You can use it to apply for health insurance cover in your home country.

Proof of Dutch health insurance
With the S1 form, you can prove to healthcare insurers in your country of residence that you have Dutch health insurance. As such, you are entitled to medical care in your country of residence. If you are insured with HollandZorg, you can ask HollandZorg for the S1 form.
Apply for the S1 form from HollandZorg
If you have taken out HollandZorg Public Healthcare Insurance, you can apply for a S1 form by filling out our contact form (button below). Was your HollandZorg health insurance policy organised through your employer? In that case, you will receive the S1 form automatically. The form will be made available in your MyHollandZorg mailbox. We will send you an email as soon as the form is ready to download.
What's important to know:
- When you register in a municipality in Netherlands (Dutch primary registration people (BRP)), the S1 form automatically becomes invalid.
- You will have to submit the fully completed S1 form as soon as possible but within 6 months, usually in person, to the health insurance company in your home country.
- The S1 form is valid from registration date to the date of deregistration of your health insurance.
Register with a healthcare insurer in your country of residence with a S1 form
Once you have received the S1 form from HollandZorg, you use it to register with a healthcare insurer in your country of residence. Do you have a (legal) partner or children? The healthcare insurer in your country of residence decides which family members will be co-insured.
Which healthcare is available with the S1 form?
With the S1 form, you are entitled to the statutorily insured medical care in your country of residence. You are also entitled to all care covered by the HollandZorg Public Healthcare Insurance. The reimbursements of this healthcare are according to Dutch criteria. Costs you incur in your country of residence will not always be reimbursed in full. This depends on the healthcare and your country of residence. Read the HollandZorg insurance conditions (PDF) for more information.