Expats are in good hands in Belgium, which has one of the best healthcare systems in the world. Here is our updated guide.

• Doctors
• Dentists
• Hospitals
• Alternative healthcare
• Emergency treatment
• Pharmacies
• Insurance

BELGIAN HEALTHCARE

You can be assured of the highest-quality medical care in Belgium, regarded as among the best healthcare systems in Europe.  As in most countries, the system divides itself into state and private, though fees are payable in both, so you need to ensure that you are adequately covered through either the state insurance and/or private insurance.  The advantages of the state mutuelle/mutualiteit scheme is that you can choose any doctor, clinic or hospital you like, in any location and without referral, according to your needs in much the same way as you can with private insurance.

Doctors

General practitioners can be found in private practices or attached to clinics and hospitals and you are free to consult or register with any you like.  Similarly with specialist consultants. It may be a decision based on location, language or recommendation.  It's always worth speaking to neighbours or colleagues when you first arrive; everyone knows of a doctor, or has heard of one with a good reputation.  Also try asking on the expatica.com forums. Embassies usually keep lists of doctors who can work in your language, though it has to be said that most doctors have a good understanding of English.

It’s always worth checking whether a doctor is registered as national health service (conventionné/geconventioneerd) or private.  Some are both, perhaps working at a hospital and also in their own private practice.  One thing to remember is to take cash with you. Consultations usually end with a handing over of money and very few doctors offer payment by card of any type.  If you have state social security, reimbursement rates are calculated but only after you’ve paid up front.  If you are on a private scheme, or are uninsured, you pay the whole lot there and then.  It's always worth checking fees before you book an appointment.  

Dentists

The majority of dentists in Belgium are private, though there are those who accept part-payment on state insurance.  Make it a priority to check when registering as the fee differentials can be huge.  For any specialist work, such as crowns and bridges, the dentist may well ask how you will pay and offer you different quotations.  To qualify for health insurance reimbursement you'll need to visit the dentist at least once a year.  In the big cities, Brussels in particular, there are international dentistry practices , though they can be considerably more expensive. 

As with general practitioners, you can arrange to see a specialist of your choice at any hospital.  You can also walk into an emergency outpatients for immediate treatment, though as in other countries, do not use this as a GP  replacement.  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.  If you’re going into hospital for a stay, take everything you need – towel and soap included - as nothing is provided.  In Brussels the eleven big public hospitals are organised under the Iris association  (www.iris-hopitaux.be)

Alternative healthcare

The Ministry of Health recognises homeopathy, acupuncture, osteopathy and chiropractic as reimbursable alternative treatments.  The cost will only be covered, however, if the practitioner is registered as a qualified doctor, so check before treatment otherwise you will be liable for the full cost of treatment.

Emergency treatment

If you need to use the emergency 100 or 112 number, an ambulance will arrive quickly and take you to the nearest emergency centre.  Sometimes, a decision may be made to admit you to the best centre suited for your needs, for example, a specialist burns unit. 

Pharmacies

Chemists are ubiquitous in Belgium, with the green cross sign everywhere.

There is a rota system for chemists to open outside of usual hours and through the night.  Lists are available from any pharmacy or check newspapers for those open at night in your area.

Insurance

Healthcare insurance is a part of the Belgian social security system and to benefit you must join a health insurance fund mutuelle (mutualité) or ziekenfonds (mutualiteit).

Once you are employed by a Belgian company, your contributions and those of your employer will be automatically deducted from your salary by the National Office for Social Security.

Then you sign up with a health insurance fund, which will reimburse your medical costs. To take you on, they will need a written certification of employment signed by your employer.

You are free to choose any company you want. Although most of them are affiliated to a religious or political institution, there is no real difference because reimbursement rates are fixed by the Belgian government.

These funds do not, however, cover 100 percent of your bills; you may be compensated for about half to three-quarters of a typical doctors or specialists visit.

Check also with your doctor that what he or she prescribes is refundable. Pharmacies maintain a government-advised list.

Consequently many people opt for additional private insurance (complémentaire).

Once insured you get a standardised credit card style SIS card which you will need in pharmacies and hospitals. You also get a sheet of Dickensian stickers (vignettes) which you need to attach to a doctor's bill to get a refund.

Updated June 2008

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Subject: Belgian healthcare system, living in Belgium