Are you suffering from an inflamed throat, a runny nose, hot and cold flashes or even a fever? There is no doubt, you are sick! And unless booking a return ticket to visit your favourite doctor and getting pampered by mom (like in the good old days) is not an option, there is only one thing to do: find a doctor in Belgium. The Belgian healthcare system is a mystery to you? Do not fret. Make yourself a cup of tea, put on your comfy socks, crawl under your blanket, and check out our guide to healthcare in Belgium.
What are the costs for seeing a doctor in Belgium?
In Belgium, you have to pay to get treated by a doctor. If you want to avoid that a simple flu costs you an arm and a leg you better take out a good insurance. If you are a citizen of the European Union, Iceland, Liechtenstein, Norway or Switzerland, you can use the European Health Insurance Card (EHIC) for short stays. For a longer stay, you can use this card at first, but once you are registered as a resident, or when you start working, you will need to register with a Belgian “mutuality” or health insurance fund (a type of insurer, see next point). If you come from another country, it is appropriate to provide insurance that will cover your medical expenses. Once you start working, you can make use of the Belgian reimbursement system. Please note, there are many scenarios and many laws! To know exactly which law applies to your situation and the procedure to follow, visit the following website.
Solidarity is good for your health!
The healthcare system in Belgium is based on the principle of solidarity. To allow universal treatment, all employees and self-employed people in Belgium need to pay a portion of their salary ("social contributions") to the government, which then redistributes it to people in need through a health insurance fund, also called "mutuality". This system works as a system of solidarity between the rich and the poor, as well as healthy and sick people.
What is a health insurance fund in Belgium?
Health insurance funds are responsible for reimbursing parts of citizens’ medical expenses. Citizens therefore pay an annual portion of their salary to the state: so-called social contributions. The state then redistributes these funds to partially reimburse healthcare costs. This means that in Belgium, if you do not want to individually cover all your healthcare, it is essential that you join a health insurance fund (or another insurer). Depending on your political, religious or other beliefs, you may choose to refer to:
- Alliance Nationale des Mutualités Chrétiennes: an umbrella organisation for a network of Christian health and social insurance companies in Belgium;
- Union Nationale des Mutualités Neutres: an umbrella organisation for regional health and social insurance companies;
- Union Nationale des Mutualités Socialistes: an umbrella organisation for socialist health and social insurance companies;
- Union Nationale des Mutualités Libérales: an umbrella organisation for liberal health and social insurance companies;
- Union Nationale des Mutualités Libres: an umbrella organisation for independent health and social insurance companies;
- La Caisse Auxiliaire d’Assurance Maladie -Invalidité: this organisation is not a mutuality (health insurance fund), but also reimburses for healthcare.
- (La Caisse des soins de santé de HR RailCare: for employees and pensioners of the statutory Belgian Railway, as well as their dependents).
The list and contact details of all health insurance funds in Belgium are available on the website of INAMI. INAMI, is the National Insurance Institute of Health and Disability, a Belgian public social security institution that organises the healthcare system and controls health insurance funds and the CAAMI.
How am I reimbursed?
In Belgium, you need to pay the doctor upfront for a consultation or any medical interventions. In return, you will receive a receipt. You then need to send this receipt to your health insurance fund, which reimburses you in part for the paid amount, directly to your bank account. Sometimes people with very low incomes are entitled to only pay the non-refundable amount of the consultation. In this case, the doctor is paid by the health insurance fund directly. This principle is called "the third payer system", which also applies in some institutions such as family planning clinics or drug-related centres.
Do all physicians have standardised prices?
No, not all doctors charge the same fees. Most physicians in Belgium work within the state health insurance scheme (conventionné/geconventioneerd), which regulates the costs of doctors and other healthcare providers, while some work for the private sector, or combine both private and public work. If you go to a doctor working within the state health insurance scheme, their services are generally well covered by your health insurance fund. The services of doctors who did not join the agreement will cost you more, without additional reimbursement. Therefore it is important to find out about the charges before any medical visit!
As we have explained in the previous paragraphs, paying social contributions is an integral part of the Belgian healthcare system and will allow you to be reimbursed for your medical expenses. All your medical expenses? Unfortunately not. Indeed, only the main costs (medications, your doctor visits, physio, etc.) are reimbursed by your contributions. For other types of interventions (hospital care, home visits, etc.) you will have to take out supplementary insurance with a health insurance fund of your choice. Note that this insurance is mandatory for all health insurance funds! If, for example, your employer already supports your medical expenses, you can turn to the Auxiliary Sickness and Invalidity Insurance Fund. It also reimburses for healthcare, but does not require you to take out supplementary insurance.
Optional supplementary insurance
Sometimes healthcare can result in high costs. Do you have problems with your teeth and therefore need to frequently see a dentist? Health insurance funds do not always reimburse you for all your care. Do you want a single room during your hospitalisation? The doctor may decide himself to apply a non-refundable supplement for this service. To cover all incidental charges, health insurance funds offer optional supplementary insurances.
What about your children? Are they required to pay as well? No, not if you are enrolled in a health insurance fund. Medical expenses for all your dependents will be reimbursed until they themselves start working or reach the age of 25.