The health system in Belgium
Health care is a priority, especially when we expatriate to a foreign country. Here's how to take care of your health in Belgium.
Health insurance in Belgium
Your family's health is of utmost importance, 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. In fact, it was ranked #9 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. This is because the public healthcare and insurance system are partially funded by social security contributions. And your residency is tied to your social security number, which is why you must be registered with the social security office before you can get public healthcare.
As for social security contributions, employees and employers each pay a part. The first one's via salary contributions and the second one via employer contributions.
Two specific cases exist for expats:
- Unemployed expats: They need to be affiliated to 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 it's the case, the employer's health insurance usually covers any medical treatment.
Registering for Social Security
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 more 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 and your employer can help you choose. In Belgium, some health insurance policies are dedicated to specific populations (religious, political, or corporate).
Health insurances in Belgium apply similar preferential rates and refund medical treatments at similar rates too. Typically, you can expect to be reimbursed 50-75% of your medical costs. However, the delay to be reimbursed 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 make use of your health insurance policy, you must have been on it for at least six months. This condition doesn't apply if in the last six months, you had another public healthcare plan 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 the health insurance companies usually are affiliated with certain political or religious groups, although that doesn't affect their offerings. For the most part, every organization will have similar (if not identical) services.
Usually, your employer will automatically sign you up with a zeikenfond/mutuelle. But if you prefer a certain group, you can make your own decision as well.
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'd rather opt out of public health insurance, then you need to show proof that you have some type of private health insurance policy. Basically, you need to have some form of health insurance to stay in Belgium.
If you have public health insurance coverage, then the good news is, your spouse is covered by default as well if they don't have their own health insurance. Not only that, but any children under the age of 18 will be covered by your policy too.
European Union (EU) residents
If you're a student, then you can get health insurance coverage through your home country. This means you won't have to purchase an additional policy while in Belgium.
Otherwise, for those in the country temporarily, EU citizens (as well as 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 heavily 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, then you have to purchase a private insurance policy while you're 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 a very good chance you won't have to purchase additional insurance before you visit Belgium. However, do be aware that for some countries, you'll need proof of a private insurance policy or else you'll be denied a visa or permit.
What's included with Public Health Insurance
There's a chance that you'll need health care while you're in Belgium, regardless of if you're just visiting or staying long term. So it's a good idea to be familiar with what your public health insurance policy will cover.
For regular visits to your GP, it'll be free. If you need to visit the hospital, this will be free as well. 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 great news if you're planning on starting or expanding your family. However, you can't just move to Belgium and give birth right away, 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 important part of healthcare as well. However, there's not as much coverage for dental as there is for general health for public healthcare in Belgium. You'll be able to get partial reimbursements, but you'll need to see a dentist that's on the state-approved list. And if you have more serious procedures done, you must first clear it with your insurer before proceeding.
Private health insurance in Belgium
As we've mentioned before, many Belgian residents also take out a supplementary insurance plan to get full reimbursements on 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 do some research and figure out which private health insurance is best for your lifestyle. For example, some might offer family packages, which is great if you have little ones. Or others might offer 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 less than 12 months cover
- April MHI (My Health International) - for more than 12 months cover
- Cigna Global
Consider having a look 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 offer all types of medical treatments in Belgium. The healthcare system is pretty good and well developed. Both types of medical establishments are open 24/7. Your GP can take care of you in a clinic (most GPs are affiliated with one or two clinics in their area).
To access medical treatment, either 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 that proves your subscription to it.
Medical treatments outside of Belgium
If you're planning on traveling out of the country, then 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'll be able to 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
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.
Medical treatment payments
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, if you're in the hospital for treatment, it's a bit different. Instead of being charged for the treatment itself, you'll be charged a daily fee. The amount you pay will depend on your personal 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.
It's recommended that you 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. Medicines 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 full amount and getting reimbursed later as you would with GP consultations. Instead, payments for medications work in the same way as payments for hospital treatments. You'll pay your share and the pharmacy will bill your insurance company for the remaining amount.
Refunds
Each time you pay for medical treatment, you send a treatment form or an invoice. 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 supplemental insurance. This way, you don't have to make any 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
