Long-term care insurance in Germany: guide for expats in the Netherlands

Long-term care in the Netherlands (Wet langdurige zorg or WLZ) is designed for individuals who require continuous supervision or round-the-clock medical attention.

Expats often confuse WLZ with standard Dutch health insurance, but it actually operates as a separate pillar of the Dutch social security system. In this guide, we will clarifies how the WLZ works, who qualifies, and how to verify your status or apply for coverage.

Key takeaways

• What is Wlz: The Dutch Long-Term Care Act (Wet langdurige zorg) covers individuals requiring permanent, intensive care or round-the-clock supervision.
• Wlz vs. Zvw: Wlz addresses heavy, ongoing care needs, whereas standard Dutch health insurance (Zvw) handles routine medical treatment and hospital care.
• Who decides: The Care Assessment Centre (CIZ) determines eligibility for Wlz care, while the Social Insurance Bank (SVB) clarifies insurance status in complex cases.
• Care at home: Receiving care at home is possible under Wlz, provided the home environment remains safe, healthy, and manageable.
• Likely costs: The Central Administration CAK calculates your mandatory personal contribution (eigen bijdrage) and provides an online calculator for estimates.
• Expat coverage: Most residents and employees automatically contribute to Wlz through payroll taxes, though cross-border workers should verify their status directly with the SVB.

What WLZ is and how it differs from Zvw and Wmo

Wlz, short for Wet langdurige zorg, is the Dutch Long-Term Care Act. You can think of it as the public long-term care insurance framework for people who need lifelong intensive care, constant supervision, or care nearby to stay safe.

One thing worth knowing is that Dutch care is split across several laws. Depending on whether you need routine medical treatment, local community support, or permanent intensive care, your care is managed by different authorities and funded through different channels:

Scheme	Main purpose	Who decides	Typical care
Wlz	Severe, permanent long-term care	CIZ for care indication	Residential care or intensive care at home
Zvw	Ordinary medical care	Health insurer and providers	GP, hospital, district nursing
Wmo	Support for independent living	Gemeente	Household help, day activities, home adaptations

WLZ vs Zvw

Zvw, the Zorgverzekeringswet or Health Insurance Act, covers normal medical care such as your huisarts (GP), hospital treatment, and many shorter-term care needs. Wlz is for much heavier needs, where someone needs permanent care, constant supervision, or care nearby because they cannot keep themselves safe.

A common question is where home nursing fits. If you need district nursing after surgery or because of a temporary condition, that is more likely to sit inside the healthcare system in the Netherlands than under Wlz.

WLZ vs Wmo

Wmo, the Wet maatschappelijke ondersteuning, is support from your gemeentefor living independently. It can include help such as household support, mobility aids, home adaptations, and local day services.

Wmo helps people keep daily life going, whereas Wlz is for much heavier, usually permanent care needs.

Who is insured under WLZ and who can receive care

Many people are insured under Wlz without ever receiving Wlz care. That separation matters because SVB and CIZ do different jobs.

SVB, the Social Insurance Bank, helps decide whether you are insured under Wlz in unclear situations. CIZ, the Care Needs Assessment Centre, decides whether you actually qualify for a CIZ Wlz indication.

Check your position rather than assume it if you:

• Live in one country and work in another
• Have been posted abroad by a Dutch employer
• Are a student, intern, or cross-border teleworker
• Are moving to or from the Netherlands with cover elsewhere

Residents, workers, and cross-border cases

In standard cases, people who live or work in the Netherlands are insured under Wlz. However, exceptions apply to cross-border workers, posted workers, students, and people moving in or out of the country, especially if another country may also claim social insurance responsibility.

Practical example: If you live in Belgium and work in Rotterdam, or your Dutch insurer says your status is unclear, ask SVB for an assessment of your Wlz insurance position.

When someone qualifies for a CIZ indication

CIZ decides whether someone needs permanent care, constant supervision, or care nearby because they cannot stay safe without it. This is different from simply having a chronic illness, a diagnosis, or ongoing treatment.

For example, advanced dementia or a severe lifelong disability that leaves someone unable to wash, dress, eat, or respond safely in emergencies is more likely to meet the threshold on the CIZ English page.

What WLZ covers and where care can happen

Once your eligibility for WLZ care is approved, the next question is what daily support will look like. WLZ can fund care in a residential facility or, in some cases, directly in your own home.

It may include:

• Residential care in a nursing home or similar institution
• Nursing and personal care
• Supervision and support with daily living
• Some treatment linked to the long-term condition

Care at home, residential care, and the zorgkantoor

Wlz care does not automatically mean moving into a care home. Some people can stay at home if that remains safe, healthy, and practical, and if the care plan is workable in daily life.

After a positive decision, the zorgkantoor, your regional care administration office, helps discuss the arrangement. Use the official Government.nl Wlz overview to confirm the home-care route and what happens after approval.

Contracted care versus a personal budget

Contracted care means care is arranged through providers that work within the Dutch system in your region. A pgb, or personal budget, gives you more say in choosing and organising care, but it usually brings more paperwork and responsibility.

Neither route is universally better. The right fit depends on how much control you need, how much admin you can manage, and who will help coordinate care.

What WLZ costs and how to check your own contribution

Costs are a major concern for families entering the long-term care system, especially given how differently WLZ operates from basic health insurance. The overall cost structure boils down to two components: the public premiums you pay into the social security net, and the out-of-pocket personal contribution (eigen bijdrage) calculated for your ongoing care.

Cost element	What it covers	Who handles it	Where to verify
Wlz premium	Contribution to the public long-term care system	Tax and social insurance system	Government.nl coverage FAQ
Eigen bijdrage	Personal contribution for Wlz care received	CAK	CAK calculator
Insurance position	Whether you should be in the Dutch system at all	SVB	SVB assessment page

Premiums, CAK payments, and how to verify costs

CAK calculates the eigen bijdrage Wlz based on personal circumstances. Use the official CAK calculator instead of forum advice or old examples, because personal contributions vary and can change.

One thing worth knowing is that the Wlz premium and the care contribution are not the same thing. You may be insured under the system and still need CAK to calculate a separate contribution if care is actually arranged.

Paying Dutch care costs from abroad

If you or a relative needs to send money to the Netherlands to help with care-related bills, first confirm who is legally paying what and whether the charge comes from CAK, a care provider, or another part of the system. That avoids sending money to the wrong place or duplicating a payment.

Readers managing euros from another country may find an international transfer service or multi-currency account such as Wise useful for paying care-related costs from abroad.

How to apply for WLZ in the Netherlands

If you want to know how to apply for Wlz, first work out whether your question is about insurance position, care eligibility, or both. SVB does not grant Wlz care, and CIZ does not decide whether you should be insured under the scheme.

Documents, assessments, and common expat mistakes

Most applications need personal details, proof of identity, and supporting medical information. If you have recently arrived, sorting your Burgerservicenummer (BSN) early can save time because it is often needed for Dutch administration.

Common mistakes include asking SVB for care approval, assuming every chronic condition qualifies, or relying on outdated forum examples instead of current official tools.

Sources

Expatica’s experts are all about providing the most up to date and accurate information. All guides are fact checked, and whenever we use external sources (like government websites or research papers) we’ll make a note of them here so you can check them out too.

1. Long-term care act (Wlz) – plain-language overview of Wlz and care eligibility, Government.nl
2. Am I covered by the long-term care act (Wlz)? – guide for checking insurance basics and working abroad scenarios, Government.nl
3. The Wlz scheme – details on Wlz insurance positions for residents and cross-border workers, SVB
4. Assessment of your Wlz insurance position – official path to confirm your specific Wlz insurance status, SVB
5. CIZ English – information on care indications, eligibility, and applying from abroad, CIZ
6. Eigen bijdrage calculator – tool for estimating personal contributions toward Wlz care, CAK
7. Dutch support for navigating care and long-term assistance, Regelhulp.nl