Belgium

Accessing care

With the European Health Insurance Card (EHIC), you can receive medically necessary treatment when you are temporarily staying in Belgium. Medically necessary treatment means treatment that cannot wait until you return home. You may need such treatment, for example, due to sudden illness or an accident.

You can also receive treatment related to pregnancy, childbirth, or chronic illnesses. If you have a condition that requires regular treatment while you are staying abroad, contact a health care provider in advance to arrange the treatment.

The European Health Insurance Card does not guarantee free treatment and you will be charged the same amount as local residents. We recommend carrying additional copies of your card. If you do not have a European Health Insurance Card or if it is not accepted, you will need to pay the cost of treatment yourself. You can then apply for reimbursement from Kela afterward.

In Belgium, patients pay medical costs themselves first and then apply for reimbursement from a Belgian health insurance fund (mutualité in French, ziekenfonds in Dutch). 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 (Institut national d’assurance maladie-invalidité, INAMI-RIZIV). Addresses of all local funds and additional information is available from INAMI-RIZIV’s website (in French).

You can receive information about reimbursements from the regional offices of Belgium’s health and disability insurance funds i.e. Caisse Auxiliaire d’Assurance Maladie-Invalidité / Hulpkas voor Ziekte- en Invaliditeitsverzekering (CAAMI-HZIV). You can also contact the offices of local health insurance funds, Mutualité/Ziekenfonds.

The languages used in Belgium are French and Dutch. German is used in areas bordering Germany. In Brussels and the Dutch-speaking regions of Flanders, the majority of doctors and hospital staff speak English.

Sudden illness

Doctor

Most doctors are self-employed. Find a doctor who has a tariff agreement with the Belgian health insurance system (médecin conventionné in French, geconventioneerde arts in Dutch). Pay the medical costs yourself first and ask for an official receipt for the payments made (Attestation de Soins Donnés in French, Getuigschrift voor Verstrekte Hulp in Dutch).

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 attach 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 on average 75 per cent of treatment costs. In some cases, the reimbursement percentage can be higher for people in certain life situations (for example, pensioners and the disabled) and those whose income is below a certain limit.

In Belgium, you can directly book an appointment with a specialist without needing a referral. However, if you get a referral from a general practitioner, the reimbursement for treatment costs may be slightly higher.

You can also consult a doctor who does not have a tariff agreement with the health insurance system (médecin non-conventionné in French, niet-geconventioneerde arts in Dutch). However, in this case the doctor can set their own prices. 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. The amount you will have to pay can vary a lot depending on the doctor’s set prices.

Dentist

Almost all dentists are self-employed. Find a dentist who has a tariff agreement with the Belgian health insurance system (conventionné in French, geconventioneerd in Dutch). You have to pay the dentist upfront and ask for an official receipt (in French/Dutch Attestation de Soins Donnés / Getuigschrift voor Verstrekte Hulp). At dentists who have signed a tariff agreement, the price of treatment is the same as in health care covered under compulsory health insurance. You can also visit a dentist who does not have an agreement with the Belgian health insurance system (non-conventionné in French, niet-geconventioneerde arts in Dutch). In this case the fees can 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.

Apply for reimbursement for dental expenses in the same way as for medical expenses. Patients under the age of 18 receive dental care 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.

Medication

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. Medicine prescriptions are valid for three months in Belgium.

You can apply for reimbursement for the costs of medicines afterwards from a Belgian health insurance fund. Apply for reimbursement in the same way as for medical expenses. 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.

Hospital care

You do not need a doctor’s referral to get hospital treatment. Before going to the hospital, contact your health insurance fund. At the hospital, show your European Health Insurance Card (EHIC) and your ID. This allows the hospital to secure a payment commitment from your health insurance fund, according to which the health insurance fund will later reimburse part of your treatment expenses.

In an emergency, you can go directly to the emergency department of the hospital.

Hospital treatment in Belgium is not free of charge. You will have to pay a daily charge for treatment. You may also have to pay an admittance fee. Separate charges may apply for medicines or laboratory or imaging costs. Personal items such as towels, soap, a toothbrush and other costs (e.g. television) are always invoiced separately. It is advisable to bring these items with you to the hospital. Hospitals have to inform you on the costs of such services.

Urgent medical transportation (except by air) is not reimbursed by the Belgian public health insurance and you will have to pay a set lump sum regardless of the distance travelled. If you use medical air transportation (helicopters of CHU Sart Tilman and AZ Sint-Jan Brugge), you must pay a lump sum plus a fee per kilometre travelled. For medical air transportation the Belgian public health insurance scheme will reimburse 50% of the cost.

Read more about suddenly falling ill in Europe.

Read more about reimbursement of costs of treatment abroad.

Useful websites

If you want to travel to Belgium to use healthcare services there, you should read our website for general information about seeking treatment abroad. If you have any questions about healthcare in Belgium, contact the National Contact Point of Belgium.

You can search for hospitals operating in Belgium on the website of the Federal Public Service Ministry of Public Health (In French or Dutch), and for healthcare service providers such as doctors, dentists and nurses operating in Belgium on the website of the National Institute for Health and Disability Insurance (INAMI-RIZIV) (in French or Dutch).

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 National Institute for Health and Disability Insurance (INAMI-RIZIV) (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.

Quality and safety of treatment

In the event of treatment injuries, the legislation and patient insurance of the country providing the treatment is always applied. In case you are unhappy with the treatment you received, you should primarily try to sort the matter out with the treatment provider. The national contact point can help you with finding the right authority if you wish to make a complaint.

Data on the quality and safety of Belgian healthcare services is not publicly available. Some of the hospitals in Flanders have published results regarding quality of treatment on their websites.

The Belgian Health Care Knowledge Centre’s reports and publications can also be useful in assessing quality and safety information.

If you are seeking treatment at a Belgian hospital, you should ensure that the hospital providing the treatment is accredited. 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.

Healthcare system

The healthcare system in Belgium is mostly public. The system is financed by social security contributions and some general taxation, and goods and services taxation (VAT).

Those living in Belgium are obliged to take out health insurance. Patients are free to choose their doctors and places of treatment. Patients usually pay their treatment costs in advance and receive a partial reimbursement of the fees through the Belgian health insurance fund (mutualité in French, ziekenfonds in Dutch). However, the third-payer system is compulsory in hospitals and public pharmacies. Private insurance is optional for those who wish to get a full refund of all medical costs in the case of hospitalisation.

Doctors work in private practices or at clinics and hospitals. Dentists are almost all private. Hospitals and clinics are public or private. However, the amount of reimbursement paid to the patient is the same regardless of whether the treatment was received from a private or public health care provider.