Healthcare in Belgium

Written by Lais Cattassini Moderated by Oleksandra Dosii

Lais Cattassini

Lais is a Brazilian journalist and copywriter with over 17 years of experience, writing about things she knows really well (travelling, cinema, social media trends) and things she loves learning about.

Oleksandra Dosii

Oleksandra is a dedicated marketer with a passion for growing HR-tech products. She believes content marketing is about delivering high-quality content that provides value—not just generating leads. Since 2016, Oleksandra has been involved in tech talent relocation.

Last update: September 14, 2024

Next update: Scheduled for February 1, 2025

Interesting facts:

• Belgium has implemented an eHealth platform, which allows for the sharing of electronic health records between patients and healthcare providers.
• Basic dental care is covered by the Belgian healthcare system, and regular check-ups and treatments are reimbursed.
• Most hospitals in Belgium are part of the non-profit sector.

Overview of the Belgian healthcare system

Belgium's healthcare system operates under a social health insurance system, which is predominantly funded through mandatory health insurance contributions and taxes. The system is designed to provide universal coverage to all residents.

Every resident in Belgium is required to have health insurance. The system is managed by mutual insurance funds (mutualités/mutualiteiten) or a public auxiliary fund. These funds act as intermediaries between the patient and the healthcare providers.

While compulsory insurance covers a significant portion of healthcare costs, many people also opt for supplementary insurance to cover additional services like dental care, private rooms in hospitals, and alternative treatments.

How to access the healthcare system in Belgium as an expat

Obtain residence status

Upon arrival in Belgium, you must register at the local town hall (commune/gemeente) within eight days. This applies whether you are from the European Union (EU) or a non-EU country.

You will receive a residence permit (foreigners card) once you've completed your registration. This card is essential for accessing many services in Belgium, including health insurance.

Social security registration

If you are employed in Belgium, your employer will automatically register you with the social security system and you will receive a Social Security Identification Number (NISS). This number is required for all social security and health care transactions.

Choose a health insurance fund

In Belgium, health insurance is provided by mutual insurance funds, known as mutuelles (in French) or mutualiteiten (in Dutch). You must choose one of these funds to register with. There are several options, including public, Christian, socialist, liberal, and neutral funds. While they all offer the same basic coverage, some provide additional services or benefits.

Below, we will explain the differences between health insurance funds and how to choose one.

After registering, you will receive a SIS card or an eID card (for residents). This card is used to access health services and receive reimbursements for medical expenses.

Self-employed and unemployed expats

If you are self-employed or unemployed, you must register with the social security system as a self-employed worker and then join a mutual insurance fund.

Types of health insurance funds in Belgium

Public Health Insurance Fund

Hulpkas voor Ziekte- en Invaliditeitsverzekering (HZIV) is the public health insurance fund in Belgium, which provides only compulsory basic health insurance. Unlike other funds, HZIV does not offer supplementary insurance, which means you won't have access to additional coverage for services not included in the basic package.

Christian Mutual Fund

Christelijke Mutualiteiten/Mutualités Chrétiennes (CM) is the largest health insurance fund in Belgium and is associated with Christian organizations. It offers a wide range of supplementary insurance packages that can include dental care, vision care, alternative medicine, and maternity benefits, among others.

Socialist Mutual Fund

Socialistische Mutualiteiten/Mutualités Socialistes (FSMB/Solidaris) is associated with socialist and labour movements. Similar to CM, it provides a broad array of supplementary insurance options, including mental health services, preventive care, and special programs for vulnerable groups.

It is popular among those who align with socialist principles, but membership is open to all. It is known for its strong advocacy for social equity in healthcare.

Liberal Mutual Fund

Liberale Mutualiteiten/Mutualités Libérales is linked to liberal political groups and offers a range of supplementary insurance plans that cater to individuals seeking more freedom in their healthcare choices, with options that might appeal to self-employed individuals and freelancers.

Neutral Mutual Fund

Onafhankelijke Ziekenfondsen/Mutualités Neutres is independent of any political or religious affiliations and provides comprehensive supplementary insurance packages that cover various health services, including alternative medicine, maternity care, and more.

Free and Independent Mutual Fund

Onafhankelijk Ziekenfonds includes smaller, independent funds that are not affiliated with any specific political or religious group. They offer tailored supplementary insurance plans, often with a focus on flexibility and customer service.

Choosing a health insurance fund in Belgium

While the basic health coverage is the same across all funds, the choice of a health insurance fund depends on your specific needs, preferences, and values, particularly when it comes to supplementary insurance and customer service.

Initially, it is important to look at the specific benefits and services offered beyond the basic coverage. Some funds might have better options for dental care, vision, or alternative treatments.

Some people prefer to choose a fund that aligns with their personal, political, or religious beliefs, although this is not necessary.

Some funds also have more extensive networks of doctors and hospitals, which might be more convenient depending on where you live.

Private health insurance in Belgium

Private health insurance in Belgium typically serves as supplementary insurance to the compulsory public system. It can cover co-payments, private hospital rooms, extended dental and vision care, alternative therapies, and international coverage.

There are also extra policies offered by private insurance companies rather than mutual insurance funds, such as DKV Belgium, AG Insurance, AXA Belgium, and Allianz Care.

How much does health insurance in Belgium cost?

If you are employed, your contribution to the Belgian healthcare system is automatically deducted from your salary as part of your social security contributions. Typically, about 12% of your gross salary goes towards social security, which covers not only health insurance but also pensions, unemployment, and other benefits. Out of this, 3.55% is for health insurance.

If you are self-employed, you pay social security contributions directly, which include health insurance. The contribution rate is generally around 20.5% of your net income. The contributions are paid quarterly, and they vary based on your earnings.

Supplementary insurance costs vary depending on the health insurance fund and the level of coverage. On average, monthly premiums cost around €10 per person for basic supplementary insurance. More comprehensive packages that offer greater coverage, such as dental work, alternative medicine, or private hospital rooms, can cost over €70 per month.

For a standard private health insurance policy (which covers private hospital rooms, advanced medical treatments, and possibly worldwide coverage), the premiums can range from €30 to €70 per month.

Co-payments

In Belgium, patients often pay a portion of their medical expenses out-of-pocket, even with public insurance. This co-payment, known as the ticket modérateur, can range from €4 to €12 for a doctor's visit and more for specialists or hospital stays.

Public health insurance typically reimburses around 50% to 75% of medical costs, depending on the service. Supplementary or private insurance can increase this reimbursement rate.

Expat health insurance in Belgium

The Belgian healthcare system requires that all residents, including expats, have health insurance coverage to access healthcare services. Once you become a legal resident of Belgium (after obtaining your residency permit), you are required to register with a health insurance fund.

EU/EEA citizens who move to Belgium and are still covered by health insurance in their home country can use the European Health Insurance Card (EHIC) for a temporary period. However, once they become legal residents in Belgium, they are required to register for the Belgian health insurance system.

English-speaking doctors in Belgium

The British government offers an updated list of English-speaking doctors and practices available in Belgium.

Many hospitals in larger cities, such as Brussels, Antwerp, and Ghent, have international departments or clinics specifically for foreigners and expats, where staff and doctors typically speak English. CHIREC Hospital Group (Brussels), UZ Leuven (Leuven), and Saint-Luc University Hospital (Brussels) are big hospitals with English-speaking staff.

What to do in an emergency?

For any urgent medical emergency, you can call 112. This is the European emergency number, and it can be used for medical emergencies, fires, and police assistance. The operators usually speak Dutch, French, German, and English.

Ambulance services in Belgium may not be free. Typically, public health insurance will reimburse part of the ambulance cost, but there may still be a co-payment (around €50 to €100), which can be covered by supplementary insurance.