Healthcare refunds

Below you can find practical information about the right to reimbursement of healthcare in Belgium.

Compulsory health insurance

In Belgium, the costs including preventive and curative care are reimbursed by a compulsory health insurance.

The compulsory healthcare insurance scheme covers almost everyone:

  • employees and equivalent categories,
  • the self-employed and equivalent categories,
  • other categories: students, the disabled, those receiving income support and others,
  • the dependants of people in these categories.

To be regarded as a “dependent” you must meet certain requirements. More information about this is available on the page Dependents - Permitted income of the INAMI website (in French). In a cross-border context, the law of the country of residence determines who is a dependent.

The National Institute for Health and Disability Insurance (in French) organizes health and disability insurance in Belgium and redistributes the financial resources among the various insurance institutions. These institutions, which are responsible for the payment of medical costs and benefits, are the health insurance funds.

Remuneration and agreements

Fixed tariffs are set for preventive and curative care services under agreements between the care providers and the health insurance funds.

Care providers must state whether or not they will follow the negotiated tariffs.

  • Those that do are ‘contracted care takers’. You only have to pay the patient fee for their care services; you do not have to pay any supplementary fees.
  • Care providers that do not follow the negotiated tariffs are ‘not contracted care takers'. They are free to set their own tariffs which means that you may have to pay supplementary fees out of your own pocket, on top of the patient fee.
  • Some care providers follow the negotiated tariffs at some times but not others; they are ‘partially contracted’.

If you consult a contracted care provider (doctor, dentist, physiotherapist, etc.), you have a guarantee that you will only pay the official tariff.

You can use the application 'Find a care provider' on the website of the National Institute for Health and Disability Insurance (in French) to find out whether or not a particular care provider is contracted.

The reimbursement of medical costs and benefits is carried out by the recognized health insurance fund of your choice (a full list of health insurance providers can be found on the page Contact on the National Institute for Health and Disability Insurance (INAMI) website (in French), or the Agency for health and disability insurance (CAAMI) (in French).

Medical and dental care

You are free to choose your doctor, dentist or paramedical care provider. You are also free to consult a specialist, there is no need for a referral.

You pay the healthcare costs directly to the doctor, dentist or paramedical care provider. The health insurance fund you have selected will reimburse 75% of the total amount afterwards.

In some cases, the third‑party payment arrangement applies. This means that you only have to pay the care provider your share of the costs, while the health insurance will pay the rest of the amount directly to the care provider. Consult more information on the third-party payment arrangement on the website page about refunds from your health insurance fund on the National Institute for Health and Disability Insurance (in French).

More information about the refunding of medical costs can be found on the page Refunds for medical care on the National Institute for Health and Disability Insurance website (in French).

Pharmaceutical products

You are free to buy medicines prescribed by the doctor or dentist from any pharmacy.

You pay the pharmacy directly for the medicines and you will be given a receipt.

The amount paid by the health insurance fund depends on the social and therapeutic use of the medicine prescribed.

If you have a prescription, you only need to pay the pharmacy the amount not covered by the health insurance fund (third‑party payment arrangement). A prescription is an act by which a licensed health professional orders therapeutic recommendations for a patient.

Admission to a hospital

The healthcare costs are shared between you and your health insurance fund. The hospital bills your health insurance fund directly for the costs covered by your health insurance (third‑party payment arrangement).

If you are admitted to a hospital you have to pay a flat fee. The amount of this fee varies depending on your circumstances, for example whether you are unemployed, have dependent children or entitled to enhanced reimbursement. The enhanced reimbursement only benefits certain patients under certain conditions. More information can be found on the page Enhanced reimbursement on the INAMI website (in French).

More information about admission to hospital is available on the page Refunds for a stay in the hospital on the Social Security Portal (in French).

More information on the tariffs of medical treatment and the corresponding reimbursements as part of the compulsory health insurance (federal) can be found on the page Medical care: tariffs and reimbursement of the INAMI website (in French).

Medical transport

Medical transportation (except by air) is not covered by compulsory (federal) health insurance. You will have to pay a flat fee, regardless of the distance traveled.

In the case of medical transport by air (helicopters from CHU Sart Tilman and AZ Sint-Jan Brugge), you have to pay a flat fee and an extra rate per kilometer. The compulsory (federal) health insurance reimburses 50% of the costs.

Access to medical care for persons temporarily residing in Belgium

If you have health insurance covered by another Member State of the European Economic Area or Switzerland and fall ill whilst staying temporarily in Belgium (e.g. if you are on holiday, on a business trip or studying), you ask for a reimbursement of the costs of any medical care medically necessary, depending on:

  • the length of your stay and
  • the nature of your medical care.

Ask the health insurance fund in your home country for a European health insurance card or the provisional replacement certificate before coming to Belgium.

You are freeto choosea healthcare provider (doctor, dentist, physiotherapist, hospital, etc.) and a specialist doctor, a referral is not required.

If you consult a contracted care provider (doctor, dentist, physiotherapist, etc.), it is guaranteed that you will only need to pay the official rate. You can use the application 'Find a care provider' on the website of the National Institute for Health and Disability Insurance (in French) to check whether or not an individual care provider is contracted.

You pay the costs directly to the care provider. Afterwards, you can claim back your costs from a health insurance fund of your choice by submitting the certificate of treatment as well as your European Health Insurance Card (EHIC) or temporary EHIC. In some cases, the third-party payer scheme applies, so you only have to pay your share of the costs (e.g. hospitalisation).

More information on using the European Health Insurance Card in Belgium can be found on the European Commission website.

If you have any questions, contact the Directorate for International Relations of the Medical Care Service from the NIHDI by e-mail: rir@riziv-inami.fgov.be.

Access to healthcare in Belgium if you move your place of residence and have health insurance cover in another Member State

If you have health insurance that is covered by another Member State of the European Economic Area or Switzerland and you move to Belgium, in accordance with Belgian legislation you are entitled to receive medical care in Belgium that is paid for by the country where you are insured.

You must register with a Belgian health insurance fund of your choice, by presenting document S1 issued by the health insurance fund in the Member State where you are insured. This also applies to any family members who are accompanying you.

If you choose to register with a health insurance fund you must register for the general supplementary insurance and pay the corresponding premium. If you do not wish to pay this premium, you must register with the Agency for health and disability insurance (CAAMI) (in French).

Both preventive and curative interventions necessary to maintain and restore your health are covered under the compulsory health insurance.

More information about the costs of medical treatments and how to claim them back can be found on the page Medical care: costs and refunds of the INAMI website (in French).

Access to healthcare if you work here and transfer your residence to Belgium

Based on your type of employment you are covered by the social insurance in Belgium. In order to have the right to have your medical costs reimbursed, the following conditions must apply:

If you choose to affiliate with a health insurance fund in Belgium, you must register with the general additional insurance and pay the corresponding fee. If you do not wish to pay this fee, you must register with Agency for health and disability insurance.

The same rules are applied to the family members who accompany you. In this particular case, Belgian law determines who can be considered a family member (dependent).

More information about the costs of medical treatments and how to claim them back can be found on the page Medical care: costs and refunds of the NIHDI website (in French).

Access to healthcare when you work in Belgium and live abroad

Based on your type of employment you are covered by the social insurance in Belgium. In order to have the right to have your medical costs refunded, the following conditions must apply:

If you choose to affiliate with a health insurance fund in Belgium, you are obliged to register for the general additional insurance and pay the corresponding fee. If you do not wish to pay this fee, you must register with Agency for health and disability insurance (CAAMI).

You must request an S1 document at your Belgian health insurance fund or the Agency for health and disability insurance (CAAMI. This document needs to be handed over to your health insurance institution in your country of residence (another member state of the European Economic Area or Switzerland), so that you and the family members living with you can access medical care in accordance with the legislation of your country of residence on behalf of Belgium. In this case the legislation of your country of residence determines who is regarded a family member (dependent).

More information is available on the page You are moving abroad on the INAMI website (in French).

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