The healthcare system in Belgium is mostly public. The system is mostly funded by social security contributions, and to a lesser extent, on general taxation and alternative financing related to the consumption of goods and services (VAT). Health insurance is mandatory in Belgium. Patients are free to choose their doctors and places of treatment. Patients generally pay the fee upfront and get a partial refund of the charges through their Belgian health insurance fund (mutuelle / ziekenfonds). 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.
Doctors work in private practices or at clinics and hospitals. Dentists are almost all private. Hospitals and clinics are public or private. The refund of the care is the same when obtained at a private or public care provider.
You can obtain medically necessary treatment by presenting the European Health Insurance Card (EHIC), when you are temporarily staying in Belgium. Medically necessary treatment refers to treatment that cannot wait for your return home. You may need such treatment in case of acute illness or accident. You can also receive treatment related to pregnancy and childbirth or to a chronic illness. The need for treatment must emerge during the course of your stay. If your illness requires regular treatment while you are temporarily staying abroad, agree with the treatment provider beforehand on the arrangement of treatment. Treatments that need to be arranged in advance include, for example, dialysis, oxygen therapy, specialised care of asthma and chemotherapy as well as echocardiography in chronic autoimmune diseases.
You will receive treatment on the same terms and at the same price as the locals. It is advisable to carry copies of your European Health Insurance Card with you, along with the card itself. If you didn’t have your EHIC with you or it was not accepted, and you were required to pay all the costs of treatment yourself, you might be able to apply for reimbursement from Kela retrospectively.
In Belgium, the procedure is for patients to pay medical costs themselves first and then apply for reimbursement from a Belgian health insurance fund. 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 (INAMI-RIZIV). Addresses of all local funds and additional information is available from INAMI-RIZIV´s website (in French).
You can obtain information about reimbursements from the regional offices of Belgium´s health and disability insurance funds Caisse Auxiliaire d’Assurance Maladie-Invalidité / Hulpkas voor Ziekte- en Invaliditeitsverzekering. 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.
Most doctors are self-employed. Find a doctor who has an agreement with the Belgian health insurance system (médecin conventionné / arts geconventioneerd). Pay the medical costs yourself first and ask for an official receipt for the payments made (in French/Dutch Attestation de Soins Donnés / Getuigschrift voor Verstrekte Hulp).
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 affix 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 certain cases, persons in particular social situation (for example pensioners and the disabled) and whose income does not exceed a certain threshold, receive a higher reimbursement rate.
In Belgium, you do not need a referral to see a specialist. You can book an appointment with your chosen doctor. Nevertheless, reimbursement for treatment costs is slightly higher if you have a general practitioner´s referral to see a specialist. You can also consult a doctor who does not have a treatment agreement with the health insurance system (médecin non-conventionné). However, in this case the doctor can set his or her 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. Thus your contribution varies according to the doctor´s fee level.
Almost all dentists are self-employed. Find a dentist who has an agreement with the Belgian health insurance system (conventionné/deconcentioneerd). You have to pay the dentist upfront and ask for an official receipt (in French/Dutch Attestation de Soins Donnés / Getuigschrift voor Verstrekte Hulp). Fees for dental treatment 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.
The reimbursement procedure for dentists is the same as for doctors. Patients under the age of 18 receive dental are 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.
Many doctors and dentists accept payment only in cash. The method of payment should be ascertained in advance.
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. 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 costs. 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.
A doctor’s referral is not required to get access to hospital treatment. Before going to a hospital, you may contact a health insurance fund. At the hospital, present your European Health Insurance Card and your ID. This will enable the hospital to obtain a payment commitment from your health insurance fund that will subsequently reimburse part of the costs of your treatment.
In an emergency, you can also go directly to hospital via the 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 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. Not all such supplies are always available, either. It is advisable to bring these items with you to the hospital. Hospitals have to inform you on the costs of such services.
The Belgian compulsory health insurance does not reimburse the costs of medical transport (ambulance). However, in the situation of emergency health service transport that was requested by calling the ‘alarm central 112’, the patient has to pay a flat rate (personal share).
Read more about suddenly falling ill in Europe.
Read more about reimbursement of costs of treatment abroad.
If you wish to travel to Belgium for the purpose of using healthcare services, you can find general information on seeking treatment abroad on our site. Some useful websites are also listed below. You should direct your questions about healthcare in Belgium to the Belgian National Contact Point.
You can search for hospitals or healthcare service providers such as doctors, dentists and nurses operating in Belgium on the website of the Belgian Health Insurance Institution (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 Belgian Health Insurance Institution (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.
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. Some of the hospitals in Flanders have published results regarding quality of treatment on their websites.
The Belgian Health Care Knowledge Centre´s (website in English, French or Dutch) reports and publications can also be useful in assessing quality and safety information.