Belgium has one of the world’s best health care services. Health insurance is obligatory in Belgium for both employed and self-employed workers. This forms an essential element of the country’s mandatory social security structure, which ensures the well-being of the entire population. In the case of employed workers, the employer directly deducts contributions from their salary, whereas self-employed workers are required to pay contributions into a social security fund.
In order to access the social security system every worker has to join a health insurance association ("Mutualité-Ziekenfonds”), which refunds a fixed percentage of medical care and costs. Workers are free to join any one they choose. The associations represent the different political and religious groups in Belgian society: they can be christian, liberal, socialist or independent. All funds charge approximately the same amount, as they act as intermediaries between the National Institute for Sickness and Invalidity (“INAMI-RIZIV”) and its members.
Membership of a "mutualité" entitles you to a partial refund of medical, dental or psychological care costs, hospital care, surgical operations, maternity costs, and prescribed medicines. The amount reimbursed is based on a precise scale for each service provided. Some mutual insurance associations have their own polyclinics where virtually all of the patient’s costs are refunded.
Refunds on prescribed medicines are made at the time of purchase. You simply present your electronic Belgian residence card to the chemist, who will then deduct a set percentage from the cost.
In the case of medical and dental treatment, the refund is made by the "mutualité" after the patient has submitted a treatment certificate (“attestation de soins”) supplied by the doctor or dentist. To do so, members are issued with stickers ("vignettes") by their mutual insurance association. These should be attached to the "attestation de soins” when you send them to your "mutualité".
In some cases, you pay only the amount you have to pay (the "ticket modérateur"), without having to pay the full cost of the consultation in advance or request reimbursement from your mutual health insurance fund. The mutualité then pays the official consultation rate directly to the healthcare provider. This system is called “le tiers payant”.
As health insurance association does not cover the full cost of treatment, you can sometimes find yourself incurring large medical bills in the event of hospitalisation (even for childbirth) or for dental care for example. Some people therefore decide to take out additional hospital insurance or a complementary insurance. This is not compulsory, but strongly recommended. You will find more information in the "insurance" section.
Finally, for more information about doctors, pharmacies and hospitals, consult the page “health” in the section “practical daily life” of our website.