The health system in Belgium

Health insurance in Belgium

Your family's health is paramount, especially if you're not in your home country. Thankfully, if you're moving to Belgium, you'll be pleased to know that this country has one of the best healthcare systems in the world. It was ranked #11 by Ceoworld. So you know your family will be in good hands, especially since around 99% of residents in this country get access to the public healthcare system.

Health insurance is mandatory in Belgium for residents. Social security contributions partially fund the Belgian public healthcare and insurance systems. Your residency is tied to your social security number, so you must be registered with the social security office before getting public healthcare.

As for social security contributions, employees and employers each pay a part. The first is via salary contributions, and the second is via employer contributions.

Two specific cases exist for expats:

• Unemployed expats: They must be affiliated with health insurance in their country of origin. The certificate allows you to get a residence permit. Social security in Belgium doesn't cover foreigners living in Belgium without a job.
• Employed expats: Those not eligible for the non-resident tax can avoid contributing to Belgian social security. If so, the employer's health insurance usually covers any medical treatment.

Read also Accidents and emergencies in Belgium

Registering for social security in Belgium

Any expat working in Belgium needs to register for Belgian social security. Here are the documents they need:

• Copy of ID paper;
• Copy of a work contract delivered by a Belgian employer (in the case of different work contracts, the oldest one is needed);
• Form H012 (or E104): You can find it at your healthcare insurance office;
• Your bank account number.

Keep in mind that this list isn't exhaustive. Depending on your country of origin, you might need additional documents.

Public health insurance: Mandatory for expats in Belgium

Every employee or independent worker in Belgium has to be affiliated with local social security and subscribe to a public health insurance scheme ("zeikenfonds" in Dutch or "mutuelles" in French). Many health insurance policies are available; your employer can help you choose. Some health insurance policies in Belgium are dedicated to specific populations (religious, political, or corporate).

Health insurance in Belgium applies similar preferential rates and refunds medical treatments at equal rates, too. You can expect to be reimbursed 50 to 75% of your medical costs. However, the delay to be refunded can differ, so expect to pay out of pocket first. Contributions to your health insurance policy are directly taken out of your monthly salary.

Each employee contributes to the National Office for Social Security. Employees give 13.7% of their gross salary to it and employers, from 22.65 to 26.61%. Independent workers give from 14.16 to 21.5% of their yearly income. In Belgium, any family member (spouse, children under 18) is automatically covered by this health insurance.

To use your health insurance policy, you must have been on it for at least six months. This condition doesn't apply if you had another public healthcare plan in the last six months in another EU country. It also counts if you were on a family member's public healthcare plan in an EU country.

There are many insurance companies to choose from, according to your needs and budget. You should know that health insurance companies usually are affiliated with certain political or religious groups, although that doesn't affect their offerings. Mostly, every organization will have similar (if not identical) services.

Usually, your employer will automatically sign you up with a "zeikenfond"/"mutuelle", but you can also make your own decision if you prefer a particular group.

Read also Elderly healthcare in Belgium

Those who qualify for public health insurance in Belgium

Not everyone will be covered by public health insurance, even if they're currently in Belgium.

As you'd expect, Belgian employees are covered through public health insurance. The same goes for those who are self-employed. This includes foreign nationals as well. If you opt out of public health insurance, you must show proof that you have some private health insurance policy. You need to have some form of health insurance to stay in Belgium.

If you have public health insurance coverage, the good news is that your spouse is also covered by default if they don't have their own health insurance. Also, any children under 18 will also be covered by your policy.

European Union (EU) residents

If you're a foreign student in Belgium, you can get health insurance coverage through your home country. This means you won't have to purchase an additional policy in Belgium.

Otherwise, for those in the country temporarily, EU citizens (EEA and Swiss ones) can use their European Health Insurance Card (EHIC). Should you need to see the doctor and get emergency treatment, this can significantly reduce your costs. In some cases, you won't need to pay anything at all.

Non-EU residents

For students, you'll have to check with your home country to see if it has an agreement with Belgium for health insurance. If it doesn't, you must purchase a private insurance policy while studying in Belgium.

Short-term visitors can check to see if their country has an agreement with Belgium. There are over 20 outside of Europe, so there's an excellent chance you won't have to purchase additional insurance before you visit Belgium. However, you'll need proof of a private insurance policy for some countries or be denied a visa or permit.

What's included with public health insurance in Belgium

There's a chance you'll need health care in Belgium, regardless of whether you're visiting or staying long-term. So, knowing what your public health insurance policy will cover is a good idea.

For regular visits to your GP, it'll be free. If you need to visit the hospital, this will also be free. What's great is you're not tied down to one GP or hospital either; wherever you go in the nation, you'll receive free medical care.

Another perk of the Belgian healthcare system is that it covers the costs of having a baby, which is excellent news if you plan on starting or expanding your family. However, you can't just move to Belgium and give birth immediately, expecting free medical care. You need to have had Belgian public health insurance for a certain amount of time (at least six months) before you're covered.

Dental care is an essential part of healthcare as well. However, there's not as much dental coverage as for general health for public healthcare in Belgium. You'll be able to get partial reimbursements, but you'll need to see a dentist on the state-approved list, and if you have more severe procedures done, you must first clear it with your insurer before proceeding.

Private health insurance in Belgium

As mentioned, many Belgian residents also take out a supplementary insurance plan to get total reimbursements for medical treatments.

If you have a Belgian employer, you can check with them first if you're interested. Many offer supplementary healthcare coverage as part of their benefits, so take advantage of this if that's the case for your workplace!

Otherwise, you'll want to determine which private health insurance is best for your lifestyle. For example, some might offer family packages, which is excellent if you have little ones. Others might provide extra coverage for out-of-country medical expenses, which is great if you're always traveling.

Some of the leading health insurance providers are:

• Allianz Care;
• April MTC (My Travel Cover) - for stays of less than 12 months;
• April MHI (My Health International) - for stays over 12 months;
• Cigna.

Consider looking at their offers according to your needs and get a free quote on Expat.com's Health Insurance for expatriates in Belgium page.

Medical treatments in Belgium

Clinics and hospitals in Belgium offer all types of medical treatments. The healthcare system is pretty excellent and well-developed. Both types of medical establishments are open 24/7. Your GP can care for you in a clinic (most GPs are affiliated with one or two clinics in their area).

To access medical treatment in private or public institutions, don't forget to take your ID with you and the social security card you've received. If you're covered by private insurance, don't forget the card or any document proving your subscription.

Medical treatments outside of Belgium

If you plan on traveling out of the country, you might be worried about having health insurance coverage during your trips. The good news is you'll get the same coverage in other EU countries. So, if you can claim 75% back for your medical costs in Belgium, you can claim 75% back if you need medical treatment in the Netherlands, for example.

Otherwise, if you're traveling to a non-EU country (like the United States), you'll need to take out additional coverage so you don't need to spend excessive amounts on medical treatment should you need it.

GP and special consultations in Belgium

Having a GP isn't mandatory in Belgium. However, in the case of medical analyses, results will automatically be sent to your GP. Medical treatments for specialized consultations are covered only with a prescription from a GP. Therefore, it's recommended to have one.

Read also Pregnancy in Belgium

Medical treatment payments in Belgium

In Belgium, you'll pay for the consultation first (you need to show your eID card), then send the treatment form to get a refund. However, it's a bit different if you're in the hospital for treatment. You'll be charged a daily fee instead of being charged for the treatment itself. The amount you pay will depend on your situation. For example, unemployed and disabled people will pay a lower rate. In any case, once you're discharged from the hospital, you'll pay for just the part you're responsible for. The hospital will then bill your insurance company for the remaining amount.

You should have a supplementary private health insurance policy to get higher refunds. Some supplemental policies (in combination with your primary policy) can get you 100% back in costs, so it's worth looking into.

If you wish to subscribe to a supplementary private health insurance policy, here are the two options:

• companies offer one to employees;
• independent workers ask professional associations or private insurance to get one.

Medications in Belgium

Sales of medicines and pharmaceutical products are highly regulated in Belgium. Medications can only be found in pharmacies, and self-medication is highly discouraged.

Usually, each town has a pharmacy on duty. Other pharmacies clearly state the address of that one.

Just like with medical treatments, you'll get a certain amount back from your health insurance policy for your prescription medications. In most cases, you'll get 20% covered. Do note that if you buy non-prescription medications, they'll cost more than the ones prescribed by your GP.

You won't have to worry about paying the total amount and getting reimbursed later as you would with GP consultations. Instead, payment for medications is the same as payment for hospital treatments. You'll pay your share, and the pharmacy will bill your insurance company for the remaining amount.

Refunds in Belgium

You send a treatment form or an invoice each time you pay for medical treatment. The timeframe to send these forms to your supplemental health insurance company is three to six months. The form is automatically transferred from the health mutual to the additional insurance. This way, you don't have to make copies of prescriptions, treatment forms, or invoices.

Useful links:

National Health and Disability Insurance Institute (RIZIV)

Belgian social security: NIHDI

Belgium Official Portal - Health Department

Federal Public Service: Health, Food Chain Safety and Environment

Fund of the Health and Disability Insurance (CAAMI)

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