Sickness benefits

If you have worked and paid health insurance contributions in another EU country, your period of employment and contributions already paid may be taken into account upon assessment of your entitlement to benefits.

You are eligible for an income replacement benefit when you are forced to stop working due to illness or accident as an employee or self-employed person.

Specific rules apply depending on your status as employee or self-employed person.

If you are an employee, you must meet the following conditions to be eligible for sickness benefits:

  • you must be affiliated to a health insurance institution (health insurance fund). In Belgium health insurance funds manage the mandatory medical health care insurance. Affiliation to a health insurance fund is mandatory for all those starting to work as an employee or blue collar worker, reaching the age of 25 but still studying, or receiving an unemployment benefit;
  • you must be able to prove that you have completed a waiting period of 12 months as an insured employee. Additionally, during this waiting period you must demonstrate a minimum work volume and you must have paid sufficient social security contributions. For full-time eployees the minimum working volume is 180 workdays;
  • you must produce evidence from the doctor working for the health insurance fund that you are incapacitated for work;
  • there must not be a gap of more than 30 days between the date you became incapacitated for work and the last day you were insured as an employee.

For self-employed persons, the following eligibility requirements apply:

  • you must be able to prove that you have paid social security contributions for at least six months;
  • you must be able to prove that you have paid sufficient social security contributions during a reference period prior to your incapacity for work;
  • you must have stopped working;
  • you must produce evidence from the doctor working for the health insurance fund that you are incapacitated for work;
  • there must not be a gap of more than 30 days between the date you became incapacitated for work and the last quarter (or equivalent period) for which you paid social security contributions.

Children up to the age of 25 years old are automatically affiliated to the health insurance fund via the head of the family, unless they are independant at an earlier age from a tax perspective.

If you are an employee, in the majority of cases there will be an initial period in which your employer will continue to pay your salary:

  • white-collar workers receive 100% of their salary in the first month;
  • blue-collar workers receive:
    • 100% of their salary during the first seven days of incapacity for work;
    • 85.88% from the 8th to the 14th day of incapacity for work;
    • from the 15th to the 30th day: 25.88% of their pay below the ceiling set by the sickness and disability insurance scheme and 85.88% of their pay above the ceiling.

At the end of this initial period of guaranteed salary paid by the employer, the health insurance fund takes over the responsibility for making the payments.

You must provide the advising doctor working for your health insurance fund with a medical certificate from your treating physician. This must be done at the very latest at the end of the initial period in which your employer continues to pay your salary. This medical certificate must state how long you have been incapacitated for work.

The amount of the benefit corresponds to 60% of your salary, and a daily capped amount applies.

From the seventh month of incapacity for work, the benefit amount can be increased so that it is in line with the minimum benefit amount.

From that date onwards, the daily allowance may not be less than a specific fixed amount. Depending on you situation specific minimal amounts apply.

If you are still incapacitated for work after 1 year, your sickness benefit is converted into a disability benefit.

If you are self-employed and fall ill, you must provide the advising doctor who works for your health insurance fund with a medical certificate from your treating physician.

Self-employed people are only entitled to benefits if their illness lasts longer than seven days.

The benefits are fixed amounts. The amount of the benefit depends on your family status (with family responsibilities, single person, sharing your household).

If you are still incapacitated for work after 1 year, your sickness benefit is converted into a disability benefit.

More information about sickness benefits can be found under the topic Incapacity for work on the National Institute for Health and Disability website (in French).

FPS Social Security

National Institute for Health and Disability Insurance (INAMI/RIZIV)

Contact the health insurance funds