Wmo and Wlz explained · elderly care in the Netherlands

If your mother or father needs care in the Netherlands, you will soon hear three abbreviations: Zvw, Wmo and Wlz. They are three separate laws, each with its own gatekeeper, application route and bill. This page explains the Wmo and Wlz and how they fit with health insurance, so you know where to start and what your parent will pay.

In short: the Zvw (Zorgverzekeringswet, Health Insurance Act) pays for medical care such as the GP and nursing at home. The Wmo (Wet maatschappelijke ondersteuning 2015, Social Support Act) makes your municipality responsible for help that lets people keep living at home. The Wlz (Wet langdurige zorg, Long-term Care Act) covers people who permanently need someone close by day and night.

The three systems at a glance

	Zvw	Wmo	Wlz
Typical help	GP, hospital, district nursing (wijkverpleging): wound care, help washing and dressing	Cleaning help, guidance (begeleiding), day activities, short respite stays, home adaptations such as an adapted shower	Permanent 24-hour care or supervision, at home or in a care institution
Who decides	The district nurse sets the hours	The municipality (gemeente)	The CIZ assesses, the regional care office (zorgkantoor) arranges the care
How to apply	Contact a district nurse directly, no GP referral needed	Report the need to the Wmo desk or social team of the municipality where your parent is registered	Application form to the CIZ, signed by your parent or with their signed authorisation
Time limits	No formal application, the nurse assesses	Assessment within 6 weeks of reporting, decision within 2 weeks of the application	Decision within 6 weeks of a complete application
What your parent pays	No deductible for GP care or district nursing	At most €21.80 a month in 2026, collected by the CAK	Income-related contribution via the CAK, at home €30.40 to €1,115.80 a month in 2026

The Zvw, care that usually does not last

The Social Insurance Bank (SVB) puts the difference between the Wlz and the Zvw simply: the Wlz covers long-term care, the Zvw covers care that usually does not last long. Your parent's basic health insurance pays for the GP and for district nursing. The compulsory deductible is €385 in 2026, but GP care and district nursing do not count towards it.

Your parent does not need a referral for district nursing. The district nurse decides how many hours are needed, and the law sets no maximum. According to the National Health Care Institute, an insurer has no legal basis for expecting relatives to fill hours with unpaid care.

The Wmo, help from your municipality

Under the Wmo, the municipality first looks at what your parent can manage alone or with help from people around them. It may ask adult children whether they are willing to help, but you are not obliged to. Only then does it provide tailored support, such as cleaning, a stairlift or an adapted shower, guidance, day activities or a short stay elsewhere to give the carer a break.

The route has fixed steps. You report the need, and your parent may hand in a personal plan within seven days. The municipality must complete its assessment, usually a conversation at home often called the keukentafelgesprek (kitchen table conversation), within six weeks. After the formal application it decides within two weeks.

The own contribution is a flat rate of at most €21.80 a month in 2026, no matter how many Wmo services your parent uses. For a married couple it is one contribution for both. A couple pays nothing if at least one partner is under the state pension age, which is 67 in 2026.

The Wlz and the CIZ assessment

The Wlz is for people who, because of an illness or disability, will permanently need either constant supervision or care nearby 24 hours a day. "Nearby" means a carer does not have to be in the room all the time, but must be able to be there quickly. The CIZ (Centre for Care Assessment) decides whether your parent qualifies. Applying costs nothing, and the decision comes within six weeks of a complete application.

Wlz care does not automatically mean a nursing home. Your parent can receive it at home as a full package, a modular package or a personal budget (pgb). The own contribution depends on income and assets from two years earlier. At home it is always the lower contribution: for a modular package or pgb between €30.40 and €933.60 a month in 2026. In an institution, your parent usually moves to the higher contribution of up to €3,061.80 a month after four months, unless a partner still lives at home.

Which door to knock on

Medical care at home, such as wound care, medication or help washing because of an illness: contact a district nurse (Zvw).
Practical help to keep living independently, such as cleaning, a home adaptation, day activities or respite for you: the municipality (Wmo).
Someone must be available day and night for the rest of your parent's life, for example with dementia and serious risk of self-neglect: the CIZ (Wlz).
Only a risk of falling: on its own this does not count as serious harm for the Wlz, so start with the municipality and the district nurse.
Not sure: ask the municipality for a client support worker (cliëntondersteuner) before anything else.

A worked example in euros

Take Margaret, 81, widowed, who lives in the Netherlands. After a stroke she needs help showering every morning, weekly cleaning and an adapted bathroom.

Showering help comes from a district nurse. It is paid from her basic insurance and does not touch her €385 deductible.
Cleaning and the bathroom adaptation come through the Wmo. Two services, one contribution: 12 × €21.80 = €261.60 for twelve months.
If her husband were still alive and 65, one partner would be under the state pension age and the Wmo contribution would be €0.
If her needs later become permanent and round the clock and she chooses a modular Wlz package at home, she pays at least 12 × €30.40 = €364.80 and at most 12 × €933.60 = €11,203.20 a year, depending on her income and assets. She then stops paying the Wmo contribution.

The lesson: moving from the Wmo to the Wlz is not only a change of desk. It can mean a much higher monthly bill, even when nothing changes about where your parent lives.

Pitfalls international families run into

Your parent may not be insured for the Wlz at all

The Wlz covers residents and people who work in the Netherlands. According to the SVB, being registered at a Dutch address does not automatically make someone a resident for the Wlz, and a person coming to the Netherlands for the first time, or returning after more than three years abroad, is not insured automatically. That applies even with Dutch or EU nationality.

There is a second catch. A parent who lives in the Netherlands but receives a long-term pension from another EU or EEA country or Switzerland is usually not insured for the Wlz. Without Wlz insurance your parent cannot take out Dutch basic health insurance either; sometimes a treaty policy (verdragspolis) is possible instead. If in doubt, request a Wlz investigation from the SVB before you plan care around it.

A Wlz indication is hard to undo

Regelhulp, the government's care guide, warns that a Wlz indication is lifelong. Your parent cannot go back to municipality or insurer care unless their situation improves so much that they no longer qualify. Your parent must sign the application or a written authorisation. As an adult child you cannot sign on their behalf unless a court has appointed you or a lasting power of attorney (levenstestament) names you.

You cannot interpret at the CIZ visit

If your parent does not speak Dutch well, the CIZ arranges an independent interpreter. Family members and friends are not allowed to interpret. Mention it on the application form.

Free help with all of this exists

Every municipality must make client support available, and the Wmo states that no contribution is charged for it. The municipality must point your parent and you to it before the assessment, and the CIZ must do the same for a Wlz application.

If your parent lives in a garden home next to you

A garden home (mantelzorgwoning) does not change the care system. Your parent gets care through the same three laws. What changes is the municipality: Wmo support can only be requested where your parent is registered, so once they are registered at your address, your municipality handles it. Expect questions at the kitchen table conversation about what you already do, and be clear about what you can keep up.

The informal care relationship also matters for the home itself. According to the government's information point IPLO, a garden home can in many cases be built without a permit, within the rules of the municipal plan. Read who a garden home is intended for, run the permit check for your address or look at our garden home models.

Sources

This page gives general information about the Dutch care system as it applies in 2026. It is not personal care, legal or financial advice. Rules and amounts change, and your parent's situation may differ. Check with the municipality, the CIZ, the CAK or the SVB before you make decisions.

Wmo and Wlz explained, how elderly care works in the Netherlands