Belgium

Most doctors are self-employed. Find a doctor who has an 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 persons with disabilities) 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 an 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 also apply for reimbursement of these costs. The health insurance fund reimburses a fixed amount, which corresponds to the rate for contracted doctors. This means that you pay the personal share of costs, as well as any difference between the reimbursed rate and the doctor’s fees. The amount you will have to pay can vary significantly depending on the doctor’s fees.

Almost all dentists are self-employed. Find a dentist who has an 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 (Attestation de Soins Donnés in French / Getuigschrift voor Verstrekte Hulp in Durch). At dentists who have signed a tariff agreement, the price of treatment corresponds to the rates 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, fees can vary considerably. International dental services are also available in larger cities, such as Brussels. However, they can be significantly more expensive than other dental services.

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 type 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.

When you collect medicines prescribed by a 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 provided, the amount paid, and that the pharmacy’s stamp is placed 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 your application to the health insurance fund, accompanied by a copy of your European Health Insurance Card and the receipts for the medicines. If a cheaper generic equivalent is available for your medicine, you should choose this at the pharmacy.

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 hospital’s emergency department.

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 admission fee. Separate charges may apply for medicines, laboratory tests, or imaging services. 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 are required to inform you about the costs of such services.

Urgent medical transportation (except by air) is not reimbursed by the Belgian public health insurance system, and you will have to pay a fixed lump sum regardless of the distance travelled. If you use medical air transportation (helicopters operated by 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 system will reimburse 50% of the cost.

Remember to make sure that your patient data is transferred between countries. You can provide those responsible for your follow-up care or your health centre with the patient records concerning the treatment you received abroad. If the patient records need to be translated, you will be responsible for arranging that yourself.

In the event of a treatment injury, the legislation and patient insurance of the country providing the treatment always apply. If you are dissatisfied with the treatment you received, you should primarily try to resolve the matter with the treatment provider. The national contact point can help you find 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 hospitals in Flanders have published results regarding the 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 serves as a guarantee of minimum quality standards. It is worth comparing accredited hospitals on their own websites.

The healthcare system in Belgium is mostly public. The system is financed by social security contributions, some general taxation, and value-added tax (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 a 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 obtain 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 can be 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 healthcare provider.