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Healthcare costs and reimbursements

blood-pressure-pressure-gauge-medical-the-testIf you are want to know how to find an English-speaking doctor or specialist, or more about healthcare services for women and children, have a look at our special pages dedicated to these two questions.

Paperwork when seeing a doctor

When you register with a Belgian health insurance institution (ziekenfonds or mutualiteit), you will receive a number of stickers in the colour of your insurance company with your name and insurance number on them. You should have these stickers (klevertjes) with you whenever you see a doctor. You will always be asked to present your “passport,” they are actually referring to your Belgian residence permit (plastic identity card) which you should carry with you at all times. This card contains the information to prove your insurance status.

If you see a doctor in his office / private practice (i.e. not in a hospital), you will need to pay for his or her services on the spot. This applies to some basic examinations too, like ultrasound and X-rays. Some doctor’s practices accept bank cards as means of payment (bankcontact), but not all of them have this option. Also, they do not accept credit cards.

If you go to a hospital, you will first have to pass by the registration desk where they will check your insurance. In some cases, a small fee is paid upfront at the hospital. But most of the time, you will simply receive the invoice for any hospital treatment a few weeks later. You may also be given another set of stickers which the doctor or lab may ask you for later.

Any additional tests, prescribed by your doctor, will be invoiced to you after they have been performed. So if a doctor took a tissue sample for tests, you will receive a bill from the laboratory a few weeks later.

You should be aware that there are different fees, depending if the doctor has signed up to the fees contract with the insurance companies (‘geconventioneerd’) or not. For geconventioneerde GPs, the average fee for a normal visit is approximately 20-35€. You can find the list of current valid fees and doctors who signed up for the contract on the website of national insurance institute (RIZIV).

Reimbursement

Once you have paid all your invoices, gather the white (formerly, green) papers listing all the medical services provided (getuigschrift voor verstrekte hulp), apply a sticker from your insurance company on the top of each form and mail them to your health insurance company or put them in a mailbox attached to their offices. Don’t worry if the amount you’ve paid is not always legible – if the insurance company cannot make sense of it, they will contact your doctor for clarification.

After the insurance company has all the required information, they will reimburse your medical expenses directly to your bank account. You have two years from the date of service to request reimbursement.

Financial aid and safety nets

There are several ways in which the Belgian state makes sure that everyone has access to affordable basic health care. However, the rules can be quite complex, so the only solid piece of advice we can give you is – ask a lot and ask often. Rules change and not everyone is always up to date with them, which means it is good to talk to different people about your situation.

For those who are in a difficult financial situation, the Belgian health care system offers higher reimbursement rates. This arrangement, called verhoogde tegemoetkoming, depends on your income level and employment status in the previous year. It is granted by your health insurance company, so if you are unemployed or have very low income (under about 18,000 EUR per year for 2016), check with your health fund to see if you are eligible.

There is an additional safety net built into the Belgian health care system that prevents those who are seriously ill from falling into poverty. This is called ‘maximum amount ceiling‘ (maximumfactuur, or MAF) and is calculated per family: whenever the medical expenses of a family (in its broadest sense, be it co-habiting partners, or a single parent with a child) reaches this ceiling, all medical costs are covered. The ceiling amount is calculated based on the net taxable income of your family three years before the year of calculation. Yes, this is complicated! Usually, your health insurance company will keep track of this and let you know when you’ve reached the ceiling.

Additionally, if you have a chronic health condition, you can apply to have it officially recognised by your insurance company. This will grant you certain rights, like increased reimbursement rates and direct billing for your doctor’s visits.

Despite these safety nets, you should be aware that because of the co-payment system in Belgium, any serious illness will mean not only an emotional, but also a financial stress for your family, so it is good to invest in additional insurance in advance.

Last updated: October, 2016

Note: the information on this page is based on the information found on official government and local websites, and on the experience of the authors. While we have done our best to make sure it is accurate, rules and regulations change and each individual situation might be different, so it is always a good idea to check with appropriate authorities for the latest information. Consequently, the authors do not assume any responsibility or liability for any issues or damages stemming from the use of the information on this website.

Nina
Nina came to Ghent many years ago via several other countries, ditching the big city lights for the towers and rivers of Ghent. She has lived in Vienna, Cantabria (Spain), Maastricht, Luxembourg and Brussels. Now she enjoys creating beautiful design, exploring space and talking to people. She is also on a mission to make Ghent and Belgium more welcoming to expats. You can contact her at nina@thesquare.gent

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