In Belgium, the procedure is for patients to pay medical costs themselves first and then apply for reimbursement from a Belgian health insurance fund. There are a number of health insurance funds, and they reimburse the portion of medical costs confirmed by Belgium´s National Institute for Health and Disability Insurance (INAMI-RIZIV). Additional information is available from INAMI-RIZIV´s website.
You can obtain information about reimbursements from the regional offices of Belgium´s health and disability insurance funds Caisse Auxiliaire d’Assurance Maladie-Invalidité / Hulpkas voor Ziekte- en Invaliditeitsverzekering. You can also contact the offices of local health insurance funds, Mutualité/Ziekenfonds. Contact information can be obtained, for example, from the yellow pages of a telephone directory under Mutualités/Ziekenfondsen.
The languages used in Belgium are French and Dutch. In Brussels and the Dutch-speaking regions of Flanders, the majority of doctors and hospital staff speak English.
Find a doctor who has an agreement with a Belgian health insurance fund (médecin conventionné / arts geconventioneerd). Pay the medical costs yourself first and ask for an official receipt for the payments made (in French/Dutch Attestation de Soins Donnés / Getuigschrift voor Verstrekte Hulp).
You can apply to the health insurance fund for reimbursement of your costs. The application should be accompanied by a copy of your European Health Insurance Card and the receipt for treatment costs. If you have registered with a health insurance fund, you should affix to the application a sticker or label containing your insurance information, which the health insurance fund issues in conjunction with registration. In Belgium, health insurance funds reimburse 60 to 75 per cent of treatment costs. In certain cases, a higher reimbursement rate is received by old-age and disability pensioners, among other groups.
In Belgium, you do not need a referral to see a specialist. You can book an appointment with your chosen doctor. You only need a doctor´s referral for hospital treatment. Nevertheless, reimbursement for treatment costs is slightly higher if you have a general practitioner´s referral to see a specialist. You also can consult a private doctor who does not have a treatment agreement with a health insurance fund. You can apply for reimbursement of these costs too. The health insurance fund reimburses a fixed amount, which is equal to the rate for contracted doctors. This means that you pay the personal share of costs and the difference between public and private service. Thus your contribution varies according to the doctor´s fee level. Each treatment procedure has its own rate, and you can ask the health insurance fund about the amount of reimbursement.
Most dentists in Belgium are private. Some dentists will accept a partial payment when you present a European Health Insurance Card (EHIC). Fees for dental treatment vary considerably. International dental services are also available in the larger cities, such as Brussels. They can be far more expensive than other dental services, however.
The reimbursement procedure for dentists is the same as for doctors. Patients under the age of 18 receive dental are free of charge when they present a European Health Insurance Card. The prices of treatment services vary, depending on the kind of treatment as well as where (for example, at home, in a hospital or at a medical centre) and when (for example, in the evening or at the weekend) the treatment is provided.
Many doctors and dentists accept payment only in cash. The method of payment should be ascertained in advance.
When you collect medicines prescribed by the doctor from a pharmacy in Belgium, you pay the costs at the point of purchase yourself. Ensure that you receive a receipt for the medicines delivered and the amount paid, and the stamp of the pharmacy on your prescription. Present your European Health Insurance Card, if necessary. You can apply for reimbursement for the costs of medicines afterwards from your Belgian health insurance fund.
Apply for reimbursement in the same way as for medical costs. Send to the health insurance fund an application accompanied by a copy of your European Health Insurance Card and the prescription, and the receipts for the medicine. If there is a cheaper generic equivalent available for your medicine, you should choose this at the pharmacy.
You can access hospital treatment with a doctor´s referral. Before going to a hospital, contact your health insurance fund and, in addition to the referral, present your European Health Insurance Card or SIS card issued by the health insurance fund, and your ID. This will enable you to obtain a payment commitment according which the fund will reimburse part of the costs of your treatment.
Hospital treatment in Belgium is not free. You will have to pay a daily charge for treatment of approximately EUR 15. You may also have to pay an admittance fee, and be charged for medicines any laboratory or imaging costs.
Belgium applies a ceiling for medical expenses incurred during a year. The ceiling is determined on, among other factors, income.
In an emergency, you can also go directly to hospital via the emergency department.
If you were unable to contact your health insurance fund before having to go to hospital, show your European Health Insurance Card at the hospital as soon as possible and ask them to procure a payment commitment from your health insurance fund.
If possible, you should take with you, along with documentation relating to treatment, towels, soap, a toothbrush and other personal items, as the hospitals always invoice these separately. Not all such supplies are always available, either. In addition, it is recommended that you do not bring large amounts of money or valuables such as jewellery with you, as the hospital may not necessarily have lockable cabinets.
Under certain conditions, health insurance funds in Belgium may reimburse 50 per cent of patient transportation costs. The expenses consist of a fixed component and a kilometre-based component You will receive by mail an invoice for those costs that the health insurance fund does not cover.
If you have to pay all costs yourself
If you have to pay the full price for treatment at a local public healthcare unit for which you would have been entitled to reimbursement with a European Health Insurance Card, you can apply for reimbursement retrospectively. You can apply for reimbursement either from the health insurance institution of the destination country or from Kela on form SV 128.
You can search for hospitals or healthcare service providers such as doctors, dentists and nurses operating in Belgium on the following websites:
- Rechercher un dispensateur de soins (Service provider search) Service provider search in French on the website of the Belgian Health Insurance Institution
- Region-specific lists of hospitals in the Belgian public health portal (in French or Dutch)
Costs of treatment
The prices of treatments which are covered in Belgium by compulsory health insurance are the same in all hospitals. The prices of these treatments can be viewed on the website of the Belgian Health Insurance Institution in French or Dutch.
Hospitals are obliged to publish the prices of the treatments they provide on their websites. Hence it is a good idea to compare price data primarily on the websites of each hospital. Some hospitals also give an overall estimate of the costs of treatment in advance, at the patient´s request.
The prices of hospital treatment as well as treatment provided by general practitioners and specialists may vary depending on whether the doctor giving the treatment sets their prices themselves. Doctors who have agreed to the prices negotiated by the Belgian Health Insurance Institution are so-called contracted doctors (médecin conventionné / arts geconventioneerd). Treatment given by these doctors costs the same regardless of the doctor and the location of the consultation. Doctors can, however, act independently outside the agreement and determine the costs of treatment provided by them themselves. You can ascertain the contractual situation of each doctor through the service provider search service of the Belgian Health Insurance Institution.
Quality and safety of treatment
Data on the quality and safety of Belgian healthcare services has not been compiled, nor is such information publicly available.
If you are seeking treatment at a Belgian hospital, you should ensure that the hospital providing the treatment is accredited. You can check the situation in the Belgian public health portal. If the hospital is accredited, its operations will be regulated and monitored on a regular basis. Accreditation functions as a guarantee of minimum quality standards. It is worth comparing accredited hospitals on their own websites. Some of the hospitals in Flanders have published results regarding quality of treatment on their websites.
The Belgian Health Care Knowledge Centre (KCE) reports and publications can also be useful in assessing quality and safety information.