Questions about public health insurance in Belgium

I am far from an expert, but I would suggest that part of the negotiations with your company would include that they keep her on an American insurance plan (BC/BS?).  Then if you pick up some additional insurance (in addition to what the company supplies) in Europe, at least you could use the US insurance to pay for part.  You will have to pay more out-of-pocket, since the doctors will not be a listed provider, but it will be better than nothing.

You might consider asking your wife's doctors for a year's supply of medication.  They may or may not do it, depending on their relationship.

I have a medication that I must take in a 25 mg dose.  My doctor prescribed it in a 50 mg tab, and verbally told me to take half.  On the prescription form, he wrote "take as directed."  So, I get double the amount of medication and only have to refill half as often.  In order for this to work, pill integrity would have to be consistent throughout the pill.  Not all medications can guarantee consistency.

1. Would my wife would be covered under the public insurance through my employment contract/payment of social security, even if she doesn't work?         ---> YES. Your spouse (and kids if any) will be covered in the mutuality (that is what public medical insurance is called here ) .

2. Is it true that under the public insurance plan you can choose any doctor? Do all doctors participate?  ---> Almost all doctors participate. You can choose the doctor.

3. Is it difficult to obtain brand-name prescription medicine under the public insurance plan? We are generally fine with generics, but there is one medication my wife takes where she didn't respond to the generic forumulation, so her doctor in the US specifies the brand name when writing a prescription.
--> Doctors can give you brandname prescriptions. But mutuality does not cover the ones that are not tested and proved (for example herbal formulas, etc).
If it makes any difference, my wife is an EU citizen (I am a US citizen).

Another thing to note is, public mutuality re-imburses (on average) 80% of the costs. Most employers subscribe the employee to an additional private insurance to cover the rest 20%.

http://www.bepartena.be/en/home/?utm_ca … ver/expats   can give you some more info.

Thank you, pamelascot and aneeshks.  Pamelascot, that's a good idea regarding keeping our BCBS coverage, though I guess it would be a challenge to submit out of network claims from Europe.  Aneeshks, thank you for the link and your detailed responses.  I will check out the link. 

My main question remains:  would the mutuality (mutuelle?) public insurance cover costs for my wife's pre-existing medical condition?  I know that many private insurances do NOT, or will cover it only at great cost.  We need to make sure that she would not be denied coverage for the health condition she had before arriving in Belgium.  Is there a government agency we could call to get a definitive answer to this question?

Again, thank you very much!  I really appreciate your help!

Kind regards,

Sean

It may be worth posting a question here: http://www.bepartena.be/en/contact/

You must ask the question about per existing medical conditions to a potential mutuelle. Short of staying the conditions here and someone having the same condition and responding. Unlikely anyone can give an accurate answer

Top up insurance doesn't always cover remaining 20 per cent, usually only hospital and outpatients and you would need to check coverage of the top up policy

Hi Aneesh,

Thank you for you detailed resposes and simply the heart go out of your way to answer all expats noobs.

I opted for the "Mandatory Insurance" at BePartenaMut so do we have to pay for this insurance or is it taken care by the taxes/social security?

When we go to a hospital should we show them some kind of card stating that I have an insurance?

Deepak

Thanks Deepak !

Normally your employer deals with this contribution. The best way is to check with your HR or benefits team.

My employer pays for a complimentary insurance called DKV.

This is a mandatory insurance, but still I am the one paying for it. That is why I had a doubt about it.

Could you please explain what are the insurances an expat must normally take?
I think that would help me gain some clarity.

Thanks

Deepak

Yes. You are right. In my firm too, employees pay themselves the premium for mutuality and the extra coverage (like DKV) is paid by the employer.

In terms of what you should get - I use Partenamut +advantages. They have several plans and their website lists the coverage details for all plans. Based on your medical needs you may pick the best.

Thanks Aneesh. This clarifies things. I have the same insurance Partenamut + Advantages too and I pay the premium for it.

Thanks and Regards,
Deepak

Hey guys, wanted your feedback on Partenamut:

- Do you think it covers its cost of €125/year through reimbursements or other services it offers? How was your experience.
- If it's mainly for the 'mandatory insurance' part or doctor's visit reimbursement, did you explore CAAMI for which the subscription is free and it reimburses your doctor visits.

What I learned is that the basic mandatory insurance (which reimburses your medical visit to doctors) is always free. If mutualities (Partena etc.) have to charge for the subscription they should offer some services. Whether you use those services or not, is another thing to see. So if you just need basic mandatory insurance (with reimbursement to your visits) you can get it for FREE from CAAMI. Is that correct?

Rate of Refund: https://www.caami-hziv.fgov.be/fr/m%C3%A9decins
Membership: https://www.caami-hziv.fgov.be/fr/devenir-membre

Indeed you can just join CAAMI, if all you want is INAMI reimbursements and you don't mind that it is very small.

For my own situation, the extra reimbursements have added up to over 500 euro every single single year, so paying for a mutuelle pays for itself and makes me money too.

Joining CAAMI can seem financially interesting. But if you read well, they cover only the legal minimum with many conditions of execution.

If that's all you need, but if you ever have a medical problem that does not fit into their system, you're going to have a bad surprise.

In addition, the number of office is reduced to its most impeccable expression. This can lead to serious delays in the management of health records.

For my post, I prefer to deal with a private mutual and pay an additional contribution to have a better service.

Making a comparison between different mutuals is not really realistic because each has its strengths and weaknesses. At one moment in life, one will be more interesting than the other.

But let's never forget that health is priceless.

Great. Thanks for all the info.