Here’s a complete guide on how to apply for Belgian health insurance as an expat and choose from the many Belgian health insurance companies.
This guide on health insurance in Belgium covers the following topics:
- The healthcare system and health insurance in Belgium
- Who needs health insurance in Belgium?
- Public health insurance in Belgium
- How to apply for public health insurance
- Private health insurance in Belgium
- Health insurance costs and reimbursements
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The healthcare system and health insurance in Belgium
Who needs health insurance in Belgium?
Official residents in Belgium can sign up to state-sponsored schemes for health insurance in Belgium.
These allow them to claim partial reimbursements of medical costs in Belgium and other European countries. To cover the personal share of medical costs (i.e., claim back 100% of costs), some residents sign up for supplementary private insurance in Belgium.
Health insurance in Belgium receives partial funding through social security contributions. Workers in Belgium must first register with the social security office before joining a Belgian insurance scheme. Read more in our guide to social security in Belgium.
The various Belgian health insurance schemes, known as mutuelles, are mandatory for any residents wishing to receive Belgian health cover. After joining, patients receive reimbursements between 50 and 75% of their medical costs by their chosen Belgian health insurance company.
Public health insurance in Belgium
Who is covered by public health insurance in Belgium?
Employees and self-employed
Upon commencing work in Belgium, all foreign nationals must join the state Belgian health insurance scheme or present evidence of private health insurance in Belgium (the same applies to the self-employed in Belgium).
EU, EEA and Swiss nationals visiting Belgium can temporarily use their European Health Insurance Card in Belgium (EHIC), however, they are required to make social security contributions once they start working in Belgium, which entitles them to the same healthcare rights as Belgian citizens.
For non-EU residents, Belgium also has agreements with more than 20 countries outside Europe, including Canada, Australia, USA and Japan. This enables the same healthcare access as Belgian citizens. Visit www.coming2belgium.be for information in several languages.
Spouses and children
Employees eligible for Belgian health 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 receive coverage 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 Belgian 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) in Belgium to receive emergency treatment either free of charge or at a reduced cost. Other visitors can check the requirements with the Belgian consulate or embassy in their home country; in some cases, private insurance may be required before a Belgian visa or permit is granted.
What is covered by Belgian public health insurance?
Anyone seeking treatment in Belgium are free to visit any doctor or hospital, regardless of location or referral. This is particularly beneficial to expats whom have received recommendations from colleagues for a high-quality English-speaking doctor. Read about doctors and medical specialists in Belgium.
Dental care in Belgium is also subject to partial reimbursements, provided the dentist is on a state-approved list. More advanced treatments, such as crowns and bridges, usually result in the dentist offering you a variety of quotes on the work required. These require approval from your insurer. Read more on dentists in Belgium.
How to apply for public 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, including enabling doctors in Belgium and Belgian hospitals to digitally verify your insurance status.
Before choosing a Belgian health insurance company, you must be paying Belgian social security. Your employer might register you for social security; otherwise, you can register yourself at the nearest social security office. Read how to sign up for Belgian social security. The Belgian government also provides a detailed guide.
Both employers and employees are responsible for making social security payments, with employers funding the majority of the fee. In 2017, employees paid 13.07% of their annual salary to social security, while employers were required to pay an additional 25% towards the fund. Employee contributions are automatically deducted from your earnings.
Contributions are mandatory for anyone registered as self-employed. Self-employed individuals pay a lower percentage than the combined requirement of employers and employees. As a result, the self-employed enjoy fewer rights. This is why some opt to make extra contributions in order to receive additional cover. Read about taxes and social security for self-employment in Belgium.
After registering with the social security office, you can join any mutuelle in Belgium (or ziekenfonds in Dutch).
Each mutuelle aligns itself with 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 enroll you in one automatically; clarify this with your employer as soon as possible. You can choose your own mutuelle, particularly if you wish to register with one based on your religious or political affiliation. You may also find a mutuelle that offers useful services, such as English-language services.
Registering with a Belgian health insurance company usually requires you to present a copy of your passport or ID card.
How to choose a public health insurance provider
Each mutuelle in Belgium covers most medical treatments, such as specialists, hospitals, prescriptions, pregnancy and childbirth.
After registration, 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.
Expatica provides a listing of health insurance companies in Belgium.
Some of the largest mutuelles in Belgium include:
- Mutuelle Chretienne
- Mutualite Socialiste
Private health insurance in Belgium
With mutuelles covering between up to 75% 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 is a useful way of topping up a mutuelle, particularly if you have an existing medical condition. As you are liable for at least 25% of all medical costs, it is beneficial to supplement Belgian health insurance with private coverage.
As ever, the cost of private health insurance varies; 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; children don’t generally receive coverage under your insurance plan, unlike state Belgian health insurance.
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.
Who should get private health insurance in Belgium?
The advantages of getting private health insurance coverage in Belgium
How does private health insurance work?
How to choose a health insurance provider
Some of the largest health insurance companies in Belgium (typically private) include:
Health insurance contributions and reimbursements
Patients pay for consultations or treatments after showing their eID card; in general, patients submit a claim to their insurance company afterwards to reclaim part of the cost. In most instances, Belgian health insurance reimburses up to 50–75% of the cost; the patient responsible for covering the rest. Patients make claims by submitting a receipt alongside a claim form to your Belgian health insurance company. Some mutuelles offer full reimbursement or even reimbursement at the point of payment with certain clinics.
Payments for hospital treatment follow a slightly different system. Hospitals charge patients a fixed daily fee. This varies according to personal circumstances; for example, the unemployed, retired or disabled will pay less. At the end of your hospital visit, you only pay your personal share; the hospital charges your insurance company (mutuelle) directly for the outstanding amount. Read more about visiting hospitals in Belgium.
Health insurance entitled you to reimbursement on all medical prescriptions. Patients pay up to 80% of the price at the counter, depending on your personal circumstances. Your Belgian health insurance company pays the remainder, much in the same way you would pay for hospital treatment. Note that non-prescription drugs cost more than those prescribed by your doctor.