The health care system in Belgium is a mixture of public and private provision. In both sectors, patients will be expected to pay fees which are funded through a combination of Belgian social security and health insurance funds. In most cases, the patient will pay the cost upfront and will be refunded a proportion later, with the charges being paid for things such as dental and medical fees, hospital treatment, prescriptions and maternity costs. Using the money from their health insurance fund, known as a mutuelle in French, or ziekenfonds in Dutch, patients have the freedom to choose where they are treated and by whom. Many people opt to top up their mandatory health insurance fund with private insurance, thus covering the full cost of any treatment.
Whether you’re an employee or a self-employed worker, you must register with a health insurance fund and start making regular contributions. The amount contributed will be 7.35% of your gross salary. 3.55% of this will be deducted from your wage, another 3.8% paid by your employer. If you’re self-employed you’ll make the full 7.35% payment via social security contributions. This will cover you and any dependents, and there are several health insurance funds to choose from, so you can compare quotes and select the one which you find most suits your needs.
European Health Insurance Card
If you hold a valid European Health Insurance Card (EHIC), you can use this to access medical services until you take up permanent employment or become a permanent resident. At this point, you have to register with a health insurance fund.
The percentage of the fees you pay which will be reimbursed afterward will vary depending upon the treatment and your individual circumstances. A general example is that the majority of people will be able to claim as much as 75% of the cost of a minor treatment or doctor’s appointment. If you have to stay in a hospital, then you have to pay a fixed fee for the accommodation while the actual medical fees will be covered directly by your insurer. You should always check the cover provided in detail with your health insurance fund to decide whether you want to take out additional private insurance. Self-employed people, for example, are often only covered for major health issues and so might want to take out additional private insurance.
It should be noted that many people won’t qualify for reimbursements until they’ve been paying into a health insurance fund for six months. There may be an exception to this rule if you can demonstrate that you’ve paid sufficient contributions to the social security system in your home country, or have been covered by the health care provisions of another EU country.
When you complete your residency registration at your local town hall you’ll be supplied with an electronic ID card, known as an eID. This is your official identification card, and all Belgian residents over the age of 15 must carry it at all times. You need to show this card when registering for social security and health insurance, and it will allow doctors and other medical practitioners to verify your insurance status. If you’re an employee, then registering for social security may be handled by your employer and if not, you can register at your nearest social security office.
Choosing a Health Insurance Company
Having registered with the social security office you are able to join the health insurance fund of your choosing. Most of the funds in Belgium are linked to a specific religious or political grouping, such as liberal, socialist or Christian, and as most offer more or less the same service an employer may automatically register you with any one of them. If you wish to register with a fund which touches upon your own political, social or religious leanings, then you should let your employer know as soon as possible. You may also wish to register with a fund which offers particular benefits such as an English language service.
It should be noted that registering with a health insurance company usually means you’ll have to present a copy of your passport or ID card.
The following is a list of some of the largest health insurance funds in Belgium:
- Mutuelle Chretienne
- Mutuality Socialiste
In most cases, you’ll be expected to pay for your treatment at the time of receiving it and then make a claim to your health insurance fund. This generally means filling in a claim form and submitting it alongside a receipt for the payment. Certain insurance funds may have set up agreements with specific clinics, offering a full reimbursement, or allowing for the reimbursement to be deducted as you make the initial payment. Arrangements such as this make it all the more important to choose your health insurance fund very carefully.
If you have to stay in hospital you’ll be charged a fixed daily fee which varies depending upon circumstances. Individuals such as the retired, disabled or unemployed will be charged less. When you leave hospital you’ll be asked to pay your own share of the charges with the insurance company being charged directly for the outstanding amount.
Prescription fees are charged in a similar manner to hospital charges. You’ll be asked to pay as much as 80% at the counter – the amount, as with hospital fees, will depend upon your circumstances – and the remainder of the charge will be claimed from your health insurance company.
Standard dental care in Belgium works along similar lines – treatment is paid for and then a partial reimbursement can be claimed. In order for this to happen, the dentist you use has to be on a state-approved list, and your insurer will be able to supply such a list for you. Where more advanced dental work is concerned – such as bridges and crowns – your dentist will offer you quotes on the various options which your insurance fund will then have to approve. It should be noted that, in order to maintain insurance coverage for dental work, you have to have a check-up at least once a year.
Private Health Insurance
Since health insurance funds generally only cover up to 75% of any fees, many people choose to top up their cover with private health insurance. Some employees also offer top-up private cover of this kind as a benefit of working for them. Since you will be asked to pay at least 25% of all medical fees, private insurance is definitely worth considering when you move to live in Belgium, particularly if you have an existing condition which means you’re likely to require on-going treatment.
The cost of insurance of this kind can vary widely, so make sure you do your research and find the deal which is best suited to your circumstances. Some companies offer special ‘family deals’ which cut the cost of covering any dependent children. Unlike state health insurance, a personal private insurance plan won’t cover any children you have.
Hospitals in Belgium generally come under the category of being private or public hospitals, as well as university hospitals and polyclinics, the latter being clinics at which specialists offer minor treatments for conditions which don’t require an overnight stay. As a patient, you’re free to choose your own specialist and hospital, but you should check that the choices you make are covered by your insurance fund if you want to claim a reimbursement.
If you need emergency treatment you can walk into an ‘emergency outpatients’ department without an appointment or referral, although you may be charged a small fee for doing so.
The fees charged for a stay in hospital (see above) should drop off dramatically after the first day, though it should be remembered that you will be expected to provide your own soap and a towel. Upon arriving in a hospital you will be asked to show your iED and pay a guarantee. If you’re sharing a room you’ll pay a set fee for the room, and the costs of any treatment should be reimbursed virtually in full. If you opt for a single room the cost of the room will be higher and the doctor may choose to set their own fees. Ask for a breakdown of any extra charges when you first arrive at the hospital.
A Belgian pharmacy will be called a pharmacy or apotheek, and will have a neon green cross advertising its’ whereabouts. Most pharmacies are open Monday to Friday and on Saturday mornings, with an emergency service available on Saturday afternoons, all day Sunday and for out of hours service on a rotating basis. To find out where your nearest 24-hour pharmacy is you can enter your postcode at https://www.pharmacie.be/, or call 0903 99 000.
You can call the Europe wide emergency number 112 (114 for hearing assisted services) free of charge from any phone. When you call this number you will be asked for the nature of the emergency in question, your address and the number of people threatened with harm.
Other emergency numbers:
Medical service – 100
Emergency doctor – 1307