The Belgian healthcare system

The Belgian healthcare system

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If you live and work in Belgium, you will be entitled to subsidised Belgian healthcare. Find out how to access healthcare in Belgium and claim your reimbursements.

If you're living and working in Belgium, you will typically be covered by the Belgian healthcare system if you carry out the proper registrations. The Belgian healthcare system is one of the best in Europe but you need to have state and/or private health insurance to use it. Expat health insurer Bupa Global provides a guide to explain how to register with Belgian health insurance, Belgian doctors, medical specialists and dentists, Belgian hospitals and Belgian pharmacies, plus details on what to do in a medical emergency in Belgium.

The Belgian healthcare system

The Belgium healthcare system is divided into state and private sectors, with fees payable in both, funded by a combination of social security contributions and health insurance funds. With mandatory health insurance, patients are free to choose their own medical professionals and places of treatment. Patients generally pay costs upfront and are reimbursed a proportion of the charges for medical and dental fees, hospital care and treatment, maternity costs and prescriptions through their health insurance fund (mutuelle / ziekenfonds). Some alternative treatments are also reimbursable if carried out by a qualified doctor. Many people top up their cover with private insurance to get a full refund of all medical costs.

Doctors work in public and/or private settings. Dentists are almost all private. Hospitals and clinics are private and usually managed by universities, religious organisations or mutuelle / ziekenfonds.

Health insurance in Belgium

As part of the social security enrolment process, all employees and self-employed must register and start making contributions to a health insurance fund (mutuelle / ziekenfonds). Contributions are 7.35 percent of your gross salary (3.55 percent deducted at source; 3.8 percent paid by your employer). Self-employed people pay the full 7.35 percent through social security payments. You and any dependents are covered. If you hold an EHIC (European Health Insurance Card) you can use this until you take up permanent residence and/or employment; then you have to register with a mutuelle / ziekenfonds like everyone else.

You will receive a social security card (known as Carte SIS, now eID) to take to the health provider of your choice. Charges are then partially or refunded by your health insurance fund. The amount of reimbursement varies according to the treatment and your personal circumstances but, for example, most people can claim up to 75 percent of the cost for a normal doctor's consultation or minor treatment. For hospital stays, you pay a fixed amount for accommodation; medical fees are paid directly by the insurer. You can take out extra insurance to cover amounts not refunded. Check the details of your cover with your own mutuelle / ziekenfonds; for example if you’re self-employed you will only be insured for major health problems and may want to take out extra cover.

Note: you may not be able to qualify for reimbursement for six months after joining a mutuelle / ziekenfonds unless you are able to provide proof that you have paid social security contributions in your home country.

To find out more about social security in Belgium, see Expatica's guide to social security in Belgium and Belgian health insurance.

Doctors, dentists and medical specialists in Belgium

Most doctors and dentists in Belgium work within the state health insurance scheme (conventionné/geconventioneerd) while some combine this with private work or work entirely in the private sector. You can choose your own general practitioner, and can also see a medical specialist without a referral but it will be cheaper if you do so through your GP/family doctor. Patients usually pay the doctor upfront and then get a refund later from their insurer.

To find out how to choose a doctor and a dentist in Belgium, and how to arrange refunds and referrals onto a medical specialist, see Expatica's guide to doctors, dentists and medical specialists in Belgium.

Hospitals in Belgium

In Belgium there are public and private hospitals (hôpitaux/ziekenhuisen), university hospitals and polyclinics. Some specialists are full time; others also work in private practice. As with general practitioners, you can arrange to see a specialist of your choice at any hospital but check if they are covered by your insurer to guarantee a refund.

You can also walk into ‘emergency outpatients’ for immediate treatment; though as in other countries, do not use this as a GP replacement. You may be charged a non-refundable small fee if you use emergency services without a referral. You should remember to have your insurance card or other identifiable means of payment with you, though emergency treatment will not be refused if you don’t.

For inpatient stays, most hospitals will charge a daily fee, which is dependent on your circumstances (unemployed pay less, for example), and the length of your stay (drastically reduces after the first day). You may also need to take things you need, such as a towel and soap. While you have to pay for daily hospital care in Belgium, your health insurer should cover the costs of medical treatment you receive while you’re in hospital.

When you’re admitted to hospital you have to pay a guarantee and show your SIS card or eID. Fees vary. If you choose a shared room you pay a set fee for the room and treatment that will be almost completely reimbursed. If you choose a single room then you pay extra for the room and the doctor may also set his or her own fee for treatment. Ask in advance for a breakdown of extra charges.

In Brussels, the main public hospitals are organised under the Iris association (www.iris-hopitaux.be), or find your local hospital at the Belgian Hospital Association’s website www.hospitals.be.

For more information and a list of the main Belgian hospitals, see Expatica's guide to hospitals in Belgium.

Pharmacies in Belgium

In Belgium, a pharmacy is called a pharmacie or apotheek and you’ll recognise them by the green neon cross outside. They are usually open from Monday to Friday, often on Saturday mornings and on a rotating emergency service on Saturday afternoons, Sundays and out-of-hours. You can find your nearest 24-hour pharmacy by entering your postcode here or call 0903 99 000 for the chemist on-duty.

Non-prescription medicines are not refunded but those prescribed by a medical professional are. You have to pay for prescription medicines when you collect them from the pharmacy, minus the set percentage payable by the insurer. Some medications are reimbursed fully while others only up to 20 percent. For information about Belgian medicines, see the Federal Agency for Medicines and Health Products (FAMHP).

Pregnancy and birth

Go and see your general practitioner in the first instance. To find out more about pregnancy and birth in Belgium, including maternity benefits, see Expatica's guide to having a baby in Belgium. Otherwise, you can find support from the antenatal care authorities in the language communities, listed below.

In the Flemish community antenatal care is carried out by general practitioners alongside gynaecologists and obstetricians in private practice. Kind en Gezin, the Flemish children and family welfare agency, offers free advice and support to pregnant women and families with children under three years old.

In the French community antenatal care is mainly carried out by gynaecologists and obstetricians working in both public or private practice and your GP will be able to advise on your choice. See the French agency Office de la Naissance de l’Enfance (ONE) for detailed advice and information. During your pregnancy you may be allocated a Medical Social Worker (travailleur médico-social or TMS) who will help prepare you for the birth and breastfeeding and can advise on maternity benefits.

Contact the Brussels Childbirth Trust (BCT) for information and advice about healthcare during pregnancy and antenatal classes throughout Belgium.

Costs during pregnancy, the birth and post-natal care immediately afterwards, are covered by compulsory health insurance.

Terminations
In Belgium, terminations are legal up to 12 weeks after conception and can be carried out at family planning centres and hospitals. See La Fédération Laïque de Centres de Planning Familial (FLCPF) for family planning centres in Brussels and Wallonia, or Luna for Flemish family planning centres.

In an emergency in Belgium

Call the pan-European emergency number 112 (or 114 hearing assisted), free of charge from any phone, for any life-threatening situation. When you call they will need to know the type of emergency, address (municipality, street, house number, locality, etc.) and the number of people in danger.

An ambulance will take you to the nearest hospital but you will typically have to pay for this service, unless you have special or private health insurance that covers this.

Other emergency numbers:

  • Medical service  – 100.
  • Emergency doctor – 1307.
  • On-call pharmacy – 09 001 05 00 / 07 066 01 60.


Find more in emergency numbers in Belgium.

Useful phrases

  • I need an ambulance – J’ai besoin d’une ambulance (French); Ik heb een ziekenwagen nodig (Dutch).
  • I need a doctor – Il me faut un médécin (Fr); Ik heb een doctor nodig (D).
  • Heart attack crise cardiaque (Fr); Hartaanval (D).
  • Stroke Un accident vasculaire cérébral (Fr); Beroerte (D).
  • Accident Accident (Fr); Ongeluk (D).
  • Emergency – Urgence (Fr); Spoedgeval (D).


More information:

 

Expatica / Updated by Bupa Global

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Updated 2015.

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10 Comments To This Article

  • Anna posted:

    on 3rd July 2016, 22:31:03 - Reply

    Because that's how the system works here -_-
  • Beth posted:

    on 25th June 2016, 12:04:36 - Reply

    Hello! I will be moving to Brussels soon for work and am trying to establish a monthly budget. How much would you think a (normally healthy!) young professional should expect to spend on healthcare-related costs? (I apologize if this is a dumb question; I'm just trying to figure this thing out. :) )

    [Moderator's note: You can also post questions on our Ask the Expert free service.]

  • Anna posted:

    on 13th June 2016, 00:05:03 - Reply

    Well this is normal, you cannot just order breakfast, hospitals are not hotels. This is why our healthcare system is cheap, don't expect a menu to pick from. My mother was in the hospital last year and everything was perfect. She got a great operation, and could leave the hospital after only 3 days. So sorry but this is just exaggeration.
  • Lisa posted:

    on 13th June 2016, 00:07:42 - Reply

    That is the way it works. If I go to the doctor here I pay a certain amount and my insurance will pay almost everything back after a couple of weeks. You cannot get free healthcare, you will have to pay something. Especially if you are a tourist and not a legal citizen. This is how it works.
  • Phil posted:

    on 21st March 2016, 13:53:26 - Reply

    As with any other country, you need to pick and choose your doctors with care, recommendations are useful, but not failsafe. I had a knee specialist operate a torn meniscus and the butcher left it worst than it was before treatment, and then refused to conduct the follow up outpatient treatment - but they are good at getting their hands on your money first. Sadly malpractice is more common here than people think. Even when it results in death, recourse through the courts is slow and expensive.
    Local doctors can be very good, but if you get one with an attitude they can make you feel that they're doing you a favour instead of fulfilling their hippocratic oath.....
  • Maria posted:

    on 24th January 2016, 05:41:31 - Reply

    We have been in Belgium before (as tourists) and being holders of a European Health Insurance Card. My husband got a medical emergency and he had to be at the hospital. They charged us, despite our homecountry said that was not legal (they should charge out homecountry that would pay). Talking to the belgium hospital personnel was useless. Finally we paid to the hospital and we got it back from our homecountry.
  • Jan posted:

    on 15th August 2015, 06:47:26 - Reply

    So hoes does it work for the entire family? If I were to accept a job in Belgium and my wife would stay at home to care for the kids - how till my wife and children be covered?
  • Ariane posted:

    on 6th July 2015, 21:26:43 - Reply

    Oh my, I have my stories of the horrors I've experienced in regards to the Belgian medical system. I am an American and I moved to Belgium (Limburg) in 2009. Shortly after moving here I became sick. I was having problems with my balance and spinning. I saw at least 7 different physicians and no one really wanted to help me and a couple even stated I was homesick and/or had psychiatric problems. Most of them were more curious about why I was in Belgium and if I wanted to become a citizen, etc. vs. my medical problems which I found annoying. I went into a depression because no one helped me and then over time I got better. To this day I don't know what was wrong with me, but I do know the physicians I saw weren't very compassionate people. Don't get seriously sick in Belgium; in particular Limburg especially if you are a foreigner. Dogs get treated better in the states than I did here. We are stuck here until my husband retires unfortunately.
  • Petre posted:

    on 13th June 2015, 13:27:41 - Reply

    A quite horrible experience at the ORL (ear specialist) medical service of Parc Leopold. The follow-up of patients is extremely poor. After a year and a half of recurrent infections, they had not even introduced my medical file in the system (so for the clinic I was not existing). Seemingly, and according to other doctors, the various infections were resistant to a type of antibiotic, which was repetedly prescribed by the ORL -meaning that the infection became chronic because it was never totally cured. The personnel has not developped a basic quality patient care. The doctor never returns a call when you're enquiring about pending test results. So finally you have to go in person to have a copy of the results printed out by the receptionist (by the way, the printer is in one of the consultation rooms, so in case there is a consultation going on, they will make you wait until it is over, to have a simple print out...). As a matter of fact, I expected a much better care for the 65%u I pay for every basic ORL consultation. In my experience, the ORL service of Clinique Parc Leopold is the height of incompetence and inefficiency in the context of a private health care centre where it is obvious that business is more important than offering a quality and modern health care service to patients suffering from ORL diseases. It scares me to think that this hospital represents the Belgian health care system...

  • Susan Delanis posted:

    on 8th October 2014, 13:51:53 - Reply

    My 88 yr old mother is currently in the AZ Zeno Campus hospital in Belgium after having a stroke on the QM2: We cannot get her home fast enough!! She has been very badly bruised by the orderly dragging her by her unresponsive hand out to a hallway to scream insults at her about being a 'spoiled American' because she asked for a bowl of cereal and milk for breakfast instead of the 2 slices of stale bread (no condiments). They are billing the insurance company for 3 procedures they have not done..one including the imaginary suture of a non-existing laceration!!!! The Dr hasn't seen her for 3 days so won't release her but we are hoping to get her home by Friday. It is it is more of a prison for the elderly dementia Pts that are helpless instead of a healing place. In regards to the recent incident of a Belgium Dr. refusing to help a 90 yr old (July 2014) because she was Jewish, I am not in the least surprised...[Edited by moderator]