Cancelling as you're going to live or work abroad

You'll lose your right to the health insurance

Use the form below to cancel your insurance. Are you abroad for study purposes without paid work, then you are still entitled to the Dutch healthcare insurance.

For whom do you want to cancel the insurance?

Please note: Children and adults must each be added separately. You can cancel the insurance for up to 7 people.

Insured person 1

 
 
Find it on your insurance card or policy document
 
 

Insured person 2

 
 
 
 

Insured person 3

 
 
 
 

Insured person 4

 
 
 
 

Insured person 5

 
 
 
 

Insured person 6

 
 
 
 

Insured person 7

 
 
 

Preferred cancellation date

 

Informing us of your cancellation within 2 months, then we will cancel your insurance per the indicated date.
Informing us of your cancellation after 2 months, then we will cancel your insurance per receipt date of your cancellation request.

(New) Address abroad or in the Netherlands

 
Read in our privacy statement (in Dutch only), how we handle your personal details carefully.