Joining a mutual health insurance fund (mutuelle or ziekenfonds) is an essential part of life in Belgium, as it guarantees access to health coverage. This can be a complex subject, especially if you are not that familiar with the ins and outs of the Belgian healthcare system. What do compulsory and supplementary insurance mean? When should you join a mutual insurance fund, and what are the different mutuelles available? No need to worry, our Expat Welcome Desk is happy to give you the lowdown.
In Belgium, compulsory insurance is a nearly universal system of basic insurance coverage that covers a large part of your medical expenses. Anyone living in Belgium (and that includes expats) must take out this insurance as soon as they move or start to work here.
Compulsory insurance covers a large share of people’s healthcare costs, such as a doctor’s visit, hospitalisation and certain other medical services. The payment of various benefits (sickness, incapacity for work, maternity, etc.) is also included.
This compulsory insurance is financed by social security contributions and the state. So you don’t need to pay a premium yourself to benefit from it. All you need to do is register with an ‘insurer’ (the law defines this as a mutual insurance fund or the CAAMI-HZIV). Your choice of insurer does not have an impact on the reimbursements and benefits you receive from the compulsory insurance, because the rates are set by the National Institute for Health and Disability Insurance (INAMI/RIZIV) and are the same for everyone.
Supplementary insurance allows you to top up your basic universal health coverage and benefit from additional reimbursements for treatment that is not or only partially covered by compulsory insurance. These treatments include dental care, prescription glasses, and alternative therapies (osteopathy, physiotherapy, etc).
This supplementary insurance cover varies depending on your mutual insurance fund. You can choose your level of cover depending on your needs. The cost depends on the options you choose and the mutual insurance fund you join.
As an expat, you must join a mutual insurance fund as soon as you are a resident of Belgium (registered with the commune) and work here. Membership of a mutual insurance fund means you have health coverage under the Belgian healthcare system and that any medical care you receive is eligible for reimbursement.
In Belgium, there are two types of mutual insurance funds:
Choose one depending on your needs, your family situation, and the level of service you require. You will find a list of all the mutual insurance funds in your area on this page of the INAMI/RIZIV website.
Joining a mutual insurance fund is not that expensive as the fee is mainly based on your social security contributions or deducted at source by your employer if you work. The fee is between €70 and €160 a year.
CAAMI (Caisse Auxiliaire d’Assurance Maladie-Invalidité) or HZIV (Hulpkas voor Ziekte- en Invaliditeitsverzekering) is a public social security institution that provides the same services and benefits as a mutual insurance fund in the context of compulsory health insurance and reimbursement. However, it does not offer any supplementary insurance services. This means that you will not be charged a membership fee. In Belgium, you are thus eligible for reimbursements and benefits from the compulsory insurance system without having to take out supplementary insurance.
In addition to supplementary insurance, private mutual insurers also offer optional health coverage, including dental care insurance, hospitalisation insurance and outpatient care insurance, all of which provide optimum coverage if you need such care. This optional cover can be taken out in addition to your main mutual insurance contract or independently with another mutual insurance fund or private insurer.
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