Health insurance in Belgium
If you're living in Belgium, here's a complete guide to applying for Belgian health insurance, which is mandatory for all residents in Belgium.
If you are living in Belgium you will find one of the best health systems in Europe, with social security contributions helping to fund the state healthcare. Residents in Belgium are required to sign up to state-sponsored insurance schemes, which allow them to claim partial reimbursements of their medical costs. To cover the personal share of medical costs, however, Belgian residents can sign up for supplementary private insurance.
Who is covered by Belgian healthcare?
Employees and self-employed
Upon commencing employment in Belgium, all foreign nationals must join the state insurance scheme or present evidence of private health insurance (the same applies to the self-employed).
EU, EEA and Swiss nationals residing in Belgium are required to make social security contributions once they start working in Belgium, which entitles them to the same healthcare rights as Belgian citizens. Belgium also has agreements with more than 20 countries outside Europe, including Canada, Australia, USA and Japan, which enables the same healthcare access as Belgian citizens. Visit www.coming2belgium.be for information in several languages.
Spouses and children
Employees eligible for Belgian insurance cover automatically receive cover for children up to the age of 18 and dependent spouses (providing they don't have their own cover).
EU students are covered by the state health insurance system in their home country throughout their period of study. Non-EU students should check whether their country has an agreement in place with Belgium. Those who don't qualify for cover must purchase their own insurance.
Expat pensioners may be entitled to state health care covered by their country of origin. It is important that you clarify what your entitlements are prior to moving to Belgium, as you will be required to provide evidence of health cover when registering for residency.
EU/EEA and Swiss citizens planning a short-term visit to the country may use their European Health Insurance Card (EHIC) to receive emergency treatment either free of charge or at a reduced cost. Other visitors can check the requirements with the consulate or embassy in their home country.
How to apply for Belgian health insurance
Upon completion of your residency registration at your local town hall, you will be issued with a Belgian eID-card (electronic ID), which replaced the previous Carte SIS (Social Identity Card) in January 2014. Your eID is an official identification card, which all Belgian residents aged over 15 must carry at all times. It serves a variety of purposes and will enable doctors and hospitals to digitally verify your insurance status.
Health insurance in Belgium is partly funded through social security contributions, and workers in Belgium will need to first register with the social security office before joining a Belgian insurance scheme.
The various insurance schemes, known as a mutuelle, are state sponsored and are mandatory for any residents wishing to receive Belgian health cover. After joining, patients will typically be reimbursed between 50 and 75 percent of their medical costs by their insurance scheme.
Applying to Belgian social security
Registration for social security may be handled by your employer, otherwise you can register at your nearest social security office. Read more about how to sign up for Belgian social security. The Belgian government also provides a detailed guide on everything you wanted to know about Belgian social security.
Both employers and employees are responsible for making social security payments, with employers funding the majority of the fee. In 2014, employees paid 13.07 percent of their annual salary to social security, while employers were required to pay an additional 25 percent towards the fund. Employee contributions are automatically deducted from your earnings.
Contributions must also be made by anyone registered as self-employed, albeit at a lower percentage than the combined requirement of employers and employees. As a result, however, the self-employed enjoy fewer rights – hence why some opt to make extra contributions in order to receive additional cover. Read more in our guide to social security in Belgium.
Registration with a health insurance scheme
Once you are registered with the social security office you are free to join any mutuelle you choose. Each mutuelle is usually linked to a political or religious group within Belgium, such as Christian, socialist and liberal groups. All the mutuelle providers offer more or less the same services, hence why employers often enrol you in one automatically. You should clarify this with your employer as soon as possible, as you may wish to choose your own mutuelle, particularly if you wish to register with one that is affiliated to your particular religious or political views, or if you find a mutuelle that offers certain useful services, such as English-language services.
Registering for a mutuelle usually requires you to present a copy of your passport or ID card.
Each mutuelle will cover most medical treatments, such as specialists, hospitals, prescriptions, pregnancy and childbirth. Once you're registered you must wait six months before being entitled to any reimbursements of medical costs. The six-month waiting period can be waived, however, providing you have been covered by a state health care plan in another EU country for the past six months.
For more details on specific insurance packages, visit the websites of some of the largest mutuelle providers in Belgium:
Healthcare cover and medical bills
The payment of medical services usually sees the patient pay for each individual consultation or treatment upon presentation of their eID card, before submitting a claim to the relevant insurance company in order to reclaim part of the cost. In most instances, up to 75 percent of the cost can be claimed back through a mutuelle, with the patient responsible for covering the rest. Claims are usually made by submitting a receipt alongside a claims form to your insurance company.
Some mutuelles may have agreements in place with certain clinics which entitle you to a full reimbursement or even the reimbursement amount deducted at the point of payment, however, this varies from one insurer to the next.
Payments for hospital treatment follow a slightly different system. Hospital patients are normally charged a fixed daily fee, which varies according to personal circumstances, for example, the unemployed, retired or disabled will pay less. At the end of your hospital visit you will only pay your personal share, with the hospital charging your insurance company (mutuelle) directly for the outstanding amount.
You are also entitled to reimbursement on all medical prescriptions, whereby you pay up to 80 percent of the price at the counter, depending on your personal circumstances. The remaining percentage is charged directly to the mutuelle, much in the same way you would pay for hospital treatment. Note that non-prescription drugs are usually charged higher than those prescribed by your doctor.
Dentist treatments are also subject to partial reimbursements, provided the dentist is on a list of state approved dentists – ask your insurer for a list of approved dentists. More advanced treatments, such as crowns and bridges, usually result in the dentist offering you a variety of quotes on the work required, which must then be approved by your insurer. Read about dentists in Belgium
Choosing a doctor or hospital
Unlike public healthcare in most other countries, those seeking treatment in Belgium are free to visit any doctor or hospital, regardless of location or referral. This can be particularly beneficial to expats whom have received recommendations from colleagues, or who simply wish to find a doctor with a strong grasp of English. Read about doctors and medical specialists in Belgium, and hospitals in Belgium.
Private health insurance
With mutuelles covering between up to 75 percent of medical costs, private health cover remains a popular choice for many residents looking to cover the outstanding amounts. Some employers also provide supplementary health cover as part of their employee benefits package.
Private cover can be a useful way of topping up a mutuelle, particularly if you have an existing medical condition which is likely to require regular treatment. As you will be liable for at least 25 percent of the medical cost, it can be beneficial to find a private package which can supplement the state cover.
As ever, the cost of private health insurance varies, so it's important to thoroughly research your options prior to committing to a specific package. If you have a family then enquire about specific family packages which may help lower the overall cost.
If you frequently travel abroad, you may wish to purchase a package which covers your medical expenses while out of the country. Note that EU citizens can use their EHIC card when seeking medical assistance within the EU.
Bupa Global offers a variety of health insurance packages to expats around the world.
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Updated July 2015.
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