When moving abroad, seeking healthcare in a new country can quickly become a source of stress. Good news: Belgium has an excellent healthcare system that is accessible, reliable, and well-structured. In this article, you will discover how the health insurance works, what it covers, which steps to take upon arrival, and how to get reimbursed after your medical care.
Introduction to the Belgian healthcare system
Belgium boasts a comprehensive and well-organized healthcare network, comprising both public hospitals, private hospitals, clinics, medical centers, and numerous individual healthcare professionals (general practitioners, dentists, specialists, etc.).
Hospitals
Public hospitals are predominant in Belgium. They are open to everyone and offer a wide range of services, from general consultations to the most specialized treatments. The staff is qualified and often multilingual, which is an advantage for expatriates.
Private hospitals operate similarly in terms of care quality and fees (often reimbursed by public insurance), but they are sometimes managed by religious orders or foundations. They may offer a quieter environment or additional services.
In both cases, the distinction between "public" and "private" is less pronounced than elsewhere: care is widely accessible and reimbursements function identically, provided you are insured.
Clinics and Medical Centers
Apart from hospitals, there are also private clinics or polyclinics, often specializing in certain types of care (ophthalmology, dermatology, physiotherapy, etc.). These are smaller establishments, sometimes offering shorter wait times for appointments. Most are accessible with a simple prescription from your general practitioner.
Medical houses or integrated health centers bring together various practitioners (doctors, nurses, psychologists, physiotherapists, etc.) in one location. Some operate on a monthly fee basis, which can be advantageous if you frequently consult.
Emergency and 24/7 Services
Hospital emergency services are open 24/7 in all major cities, covering vital emergency care. There is also a medical on-call number (1733) to reach a doctor outside regular hours. Some pharmacies are also open at night or on weekends according to a duty system.
Health insurance in Belgium
Your family's health is of utmost importance, especially if you are not in your home country. If you are considering moving to Belgium, you will be pleased to know that this country has one of the best healthcare systems in the world.
Knowing that 99% of Belgium's residents have access to this public healthcare system, you can be assured that your family will be well taken care of.
Health insurance is mandatory for all those residing in Belgium. Indeed, the Belgian public health and insurance systems are partially funded by social security contributions.
And since your place of residence is linked to your national register number (NISS), you will first need to register with the social security office in your municipality to benefit from public healthcare.
Regarding social security contributions, employees and employers each pay a share. The former via employee contributions and the latter via employer contributions.
There are two scenarios for expatriates:
Unemployed expatriates in Belgium
They must have subscribed to a health insurance valid in their home country. Its certificate will allow them to obtain a residence permit in Belgium. Social security in Belgium does not cover foreigners living in Belgium without employment.
Employed expatriates in Belgium
Non-residents not eligible for tax do not contribute to the Belgian social security. If this is the case, it is generally their employer's health insurance that covers all medical treatment.
Registering with social security in Belgium
Every expatriate working in Belgium must register with the Belgian social security. Here is the list of necessary documents:
- Copy of identity documents;
- Copy of a work contract issued by a Belgian employer (if you have had several contracts, provide the oldest one);
- Form H012 (or E104): you can find it with your health insurance fund;
- Your Belgian bank account number.
Keep in mind that this list is not exhaustive. Depending on your country of origin, you may need additional documents.
Public health mutuals: mandatory for expatriates in Belgium
Every employee or self-employed worker in Belgium must be affiliated with the local social security and subscribe to a public health mutual (ziekenfonds in Dutch). Many health insurance policies are available, and your employer can help you choose one.
Some mutuals are historically linked to political, union, or religious movements, but their benefits are similar and accessible to all, regardless of your choices.
Health insurances in Belgium apply similar preferential rates and also reimburse medical treatments at similar rates. Generally, you can expect your medical expenses to be reimbursed at tiered rates between 50 and 75%. However, the reimbursement period may differ, so expect to pay upfront. Note that contributions to your health insurance are deducted directly from your monthly salary.
Each employee contributes to the National Social Security Office (ONSS):
- Employees pay 13.07% of their gross salary;
- Employers contribute between 22.65% and 26.61% of the payroll.
- Self-employed workers contribute themselves between 14.16% and 21.5% of their net taxable income.
Your family members (spouse, children under 18) are automatically covered by your health insurance.
To benefit from your health insurance contract, you must have been affiliated for at least six months. This condition does not apply if, in the last six months, you had another public health care regime in another EU country. This also counts if you were covered by a family member's public health care regime in an EU country.
In principle, employees are automatically affiliated with a mutual through their employer. However, if you have a preference for a specific group, you can also make this choice yourself. Self-employed individuals must affiliate on their own initiative.
Who is eligible for public health insurance in Belgium?
Not everyone will automatically be covered by public health insurance, even if they live in Belgium.
Employees and self-employed individuals, whether Belgian or foreign nationals, are generally covered as long as they contribute to social security. If you choose not to join public health insurance, you must provide proof of equivalent coverage through private insurance.
Good to know:
In Belgium, it is mandatory to have valid health insurance to reside legally.
If you have public health insurance coverage, the good news is that your spouse will also be covered by default if they do not have their own health insurance. Additionally, all children under 18 will automatically be covered by your insurance policy.
For European Union (EU) Residents
If you are a foreign student in Belgium, you will need to obtain health insurance coverage in your home country. This means you will not need to subscribe to an additional policy during your stay in Belgium.
Otherwise, EU citizens (as well as those from the EEA and Switzerland) temporarily staying in the country can use their European Health Insurance Card (EHIC). If this is the case, and if you need to see a doctor and obtain emergency treatment, it can significantly reduce your costs. In some cases, you may not have to pay anything at all.
Non-EU residents
As students, you should inquire with your country of origin to see if there is an agreement with Belgium for health insurance. If not, you will need to subscribe to private insurance during your studies in Belgium.
Short-term visitors should also check if their country has an agreement with Belgium. There are over 20 outside of Europe. Therefore, there is a good chance that you will not have to subscribe to additional insurance to stay in Belgium.
Additionally, nationals from certain countries will need to prove they have valid private insurance, otherwise they risk being denied a visa or permit.
What does public health insurance cover in Belgium?
You may need healthcare during your stay in Belgium, whether you are just visiting or staying longer term. Therefore, it is a good idea to familiarize yourself with what your public health insurance policy will cover.
Routine consultations with a general practitioner are partially reimbursed: you pay the fees upfront, and then you are largely reimbursed by your mutual. The same applies to most specialized care and hospitalizations.
Another advantage of the Belgian healthcare system is that it covers maternity expenses, which is excellent news if you plan to start or expand your family. However, you cannot simply move to Belgium and give birth immediately, expecting free medical care. You must have subscribed to Belgian public health insurance for at least six months before being covered.
Dental care is also an important part of healthcare. However, there is not as much coverage by public health insurance in Belgium for dental care as for general health. You can obtain partial reimbursements, but you must consult a dentist listed on the state-approved list. And if you have more serious procedures to undertake, you must first discuss it with your insurer before proceeding.
Private health insurance in Belgium
As mentioned earlier, many Belgian residents also subscribe to supplementary insurance to obtain full reimbursement for medical treatments.
If you work for a Belgian employer, start by checking if supplementary coverage is included in your salary package. Many companies offer private health insurance as an extra-legal benefit, sometimes even for your spouse and children.
If not, we invite you to research and determine the type of private health insurance that will best suit your lifestyle. For example, some offer family packages, which is great if you have dependents. Others may offer additional coverage for medical expenses abroad, which is great if you travel constantly.
Medical treatment in Belgium
Clinics and hospitals in Belgium offer various types of medical treatments. The healthcare system is very developed and efficient. Both types of medical facilities are open 24/7. Your general practitioner can take care of you in a clinic (most general practitioners are affiliated with one or two clinics in their region).
To access medical care, whether in private or public establishments, remember to bring your identity card and your social security card. If you are covered by private insurance, do not forget the card or any document proving your membership.
General practitioners and apecial consultations in Belgium
It is not mandatory to have a designated general practitioner in Belgium. However, in the case of medical tests, the results will automatically be sent to your attending physician. Medical treatments for specialized consultations are covered only upon prescription from a treating general practitioner. Therefore, it is recommended to have one.
Payments for medical Treatment in Belgium
In Belgium, you pay for the consultation first (you will need to present your eID card), then submit the treatment form for reimbursement.
However, if you are hospitalized, the system is a bit different:
- You will not pay directly for the entire treatment.
- Only the daily hospitalization fees will be charged to you, generally at a fixed rate.
- The amount you owe will depend on your personal situation: for example, unemployed or disabled people often benefit from reduced rates.
After your hospital discharge, you will only pay your share. The establishment will bill the remainder directly to your mutual or private insurer, as applicable.
It is recommended to have supplementary private health insurance to obtain higher reimbursement rates. Some additional policies (in combination with your main policy) may allow you to recover up to 100% of your medical expenses, so it is worth looking into.
If you wish to subscribe to supplementary private health insurance, know that there are two ways to do so:
- Ask your employer. Some companies offer them to their employees.
- Contact a professional association or an insurance company.
Medications in Belgium
Sales of medications and pharmaceutical products are highly regulated in Belgium. Medications are dispensed only in pharmacies and self-medication is strongly discouraged.
Generally, each city has a pharmacy on duty system. Other pharmacies are required to clearly indicate the address of the on-duty pharmacy.
Just like with medical treatments, you will recover a portion of your expenses for prescription medications through your health insurance policy. In most cases, you will be covered up to 20%. Note that if you purchase over-the-counter medications, they will cost more than those prescribed by your general practitioner.
Good to know:
Some medications available in your home country may not be marketed under the same name (or at all) in Belgium. It is therefore recommended to bring a small initial stock of your usual treatments, especially for specific or uncommon medications.
In any case, consult your doctor before leaving, and remember to bring your translated prescriptions. Once there, a Belgian doctor can offer you a local equivalent if needed.
Belgian pharmacies are well-stocked, but it may sometimes be necessary to adapt your habits to locally available medications.
You will not have to worry about paying the full amount to be reimbursed later as you would for general practitioner consultations. Instead, payments for medications work the same way as payments for hospital treatments. You will pay your share, and the pharmacy will bill your insurance company for the remaining amount.
Reimbursements for medical treatment in Belgium
When you pay for treatment (consultation, care, or examination), you must submit the care form or invoice to your mutual for reimbursement. The deadline for sending these documents is 3 to 6 months, depending on the case.
If you have also subscribed to supplementary health insurance, the mutual will automatically forward the information to your supplementary. This means you do not need to send the documents twice. The whole process is generally automated.
Medical treatments outside Belgium
If you plan to travel outside of Belgium, you may worry about having Belgian health insurance coverage during your travels. The good news is that you will benefit from the same coverage in other EU countries. Thus, if you can recover 75% of your medical expenses in Belgium, you will be able to recover the same 75% if you need medical treatment in the Netherlands, for example.
Otherwise, if you travel to a non-EU country (like the United States), you will need to subscribe to additional coverage to avoid spending astronomical amounts on medical care you may need.
We do our best to provide accurate and up to date information. However, if you have noticed any inaccuracies in this article, please let us know in the comments section below.
