Health insurance in Belgium for foreign expats

Belgium’s public healthcare system is funded by social security contributions and mandatory health insurance, which anyone living and working in Belgium must register for. By paying into the public system, residents have access to heavily subsidised healthcare services, including doctors’ appointments, hospital care, prescriptions and maternity services.

Expats working in Belgium are required to make these health insurance payments and social security contributions. Insurance payments are made annually, while social security contributions are usually deducted from your salary. If you’re self-employed, you’ll need to register and make contributions independently.

The public healthcare system is overseen by the federal government, but individual public health insurance providers are managed on a regional level. Different regions have different official languages so, depending on where you are, you’ll be joining a mutuelle (French), or a ziekenfonds (Dutch). They’re technically private companies and are sometimes connected with a particular religion or political group, but they’re state-approved and heavily regulated. They all offer the same basic services, with additional benefits, which may vary (such as menstrual products, physiotherapy refunds and allowances for daycare). Your employer may assign one to you, but you can choose your own if you prefer.

You’ll typically pay for your consultation or treatment up front, then submit a claim to your mutuelle / ziekenfonds. Through this system you’re able to get reimbursed for some of the cost of hospital visits, doctors’ appointments, prescription medications and some dental services.

Expat workers

If you’re employed and living in Belgium, you’re not only entitled to access public state healthcare, you’re required to register with a state-approved health insurance company. 

Dependent spouses and children

If you’re an employee, any dependent spouse or child will be automatically covered under your scheme and entitled to Belgium’s public healthcare benefits and subsidies.

Self-employed expats

If you’re self-employed in Belgium, the same rules apply. You’ll be required to register to the public system, and any dependent spouse and/or children will be covered too. The only difference is that you’ll have to do all of the registration and administration yourself, and you’ll need to pay a portion of your salary towards your health insurance, as you won’t have an employer making contributions for you.

EU and EEA citizens

If you’re an EU, EEA or Swiss citizen visiting Belgium for a short amount of time, your European Health Insurance Card (EHIC) gives you access to certain healthcare services in Belgium. But it doesn’t cover everything and, if you’re planning on staying in Belgium to live and work, your EHIC isn’t a substitute for the public healthcare system. As an expat, you’ll still need to register with a compulsory insurance provider and pay social security.

Some non-EU citizens

Belgium has agreements with over 20 other countries outside the EU, including Canada, Australia, the USA and Japan. In most cases, these agreements ensure short-term visitors the same (or similar) access to healthcare as Belgian residents, so check your status before you travel to see what your entitlements are. But, again, if you’re moving to Belgium permanently, you’ll need to register with the public healthcare system.

Other non-EU citizens

If you’re a visitor from another country, you’ll need to check what the requirements are with the Belgian embassy in your home country before you leave. You may need private insurance before you can get a Belgian visa.

Public healthcare in Belgium isn’t free, but it’s designed to be fair and accessible to all. It is funded by both health insurance and social secuirty contributions.

The amount your doctor charges will depend on whether they charge the usual price (prix conventionné), which is set by the government. Some healthcare providers may charge more than this, but they have to make you aware of this. You’ll only receive reimbursements for the official price, as additional costs aren’t covered by your compulsory insurance. If you want to be reimbursed for 100% of your healthcare costs, you can take out a separate, supplementary private healthcare policy. This is a popular option among expats who want to be fully covered for all their needs.

If you want to be reimbursed for 100% of your healthcare costs, you can take out a separate, supplementary private healthcare policy. This is a popular option among expats who want to be fully covered for all their needs. 

Doctor appointments 

When you register with the Belgian healthcare system, you can choose your own GP, but you’re not limited to only seeing them, and you’re also free to see more than one doctor. On average you'll be reimbursed for 75% of their fees through your public mutuelle/ziekenfonds.¹

Hospital visits 

Similar to above, you’re also free to visit any hospital, regardless of where you are. And you’ll be reimbursed between 50% and 75% of the cost of your hospital visit.¹

Maternity care 

The costs associated with having a baby in Belgium are generally fully covered under the public health insurance scheme, provided you’ve been paying into it for more than just a few months. Belgium’s compulsory insurance covers most birth-related consultations and services for you and/or any dependent spouse.

Dental care 

You’ll receive partial reimbursements through the public healthcare system for routine dental care in Belgium. Most Belgian dentists are private, so they’ll need to be on a state-approved list. And for more advanced treatments like crowns or bridges, you’ll need approval from your insurer. If the procedure isn’t covered by your compulsory insurance, you’ll need a separate private healthcare plan.

Prescription medication

For prescription drugs included on Belgium’s list of reimbursed medications, you’ll get a full or partial discount.

Doctors’ appointments

In Belgium, you can register with any doctor. You’ll be able to claim reimbursements for treatment as long as they’re approved by a state insurance company and registered with the National Institute for Health Insurance (INAMI). Some doctors work across both the private and public sectors, so make sure you’re clear about which service you want and check that it’s covered.

Most GPs in Belgium operate a simple appointment system, and waiting times aren’t typically too long. You can book online or by calling their office, though some surgeries will also have walk-in consultation slots set aside and allocated on a first-come-first-served basis.

After your appointment, you’ll be asked to pay upfront and then request your partial reimbursement afterwards. Some don’t accept credit cards, so be sure to check. 

Medical specialists 

In Belgium’s public healthcare system, you don’t need a referral from your family doctor in order to make an appointment with a specialist. But, while you can make an appointment directly with a specialist, be aware that the amount you get reimbursed could be different if you’ve not been referred by a doctor. 

Depending on your circumstances and location, you may find that the waiting times for an appointment with a specialist are longer than for a doctor’s appointment.

Emergencies

The phone number for the emergency services in Belgium is 112. This is the standard European emergency number.

Pharmacies and medicine

In Belgium, the pharmacy will be called the “pharmacie” (in French – typically in the Brussels Region and the Walloon Region) or “apotheek” (in Dutch – typically in the Flemish Region) depending on the dominant language in your region. They’re easily identified by the large green cross sign outside. All medicines prescribed by a doctor need to be bought from a pharmacy. You’ll pay upon collection and, unlike other healthcare services, the percentage that’s covered by your insurer will be deducted up front when you pay.

As public health insurance is mandatory for residents, once registered, you won’t be required to take out any additional private cover. However, Belgium’s compulsory insurance will usually only cover up to 75% of medical costs¹ so many expats choose to include the additional voluntary private insurance. 

If you choose to add voluntary private insurance, you can get 100% of costs reimbursed or paid directly depending on your level of cover. You’ll also be able to book private appointments with specialists, which often have shorter waiting times than the public system.

It’s important to note that the registration process can take a while for Belgium’s public health insurance, and you need to have been making social security contributions and paying for your compulsory insurance for around six months before you’re eligible to claim.

So, during that time, you may be required to have a private healthcare plan to ensure you’re able to cover any medical care or treatment you might need. Depending on where you’re from, you might also need to show proof of healthcare cover to be able to get a visa, whether you’re coming to Belgium for a short visit or for a long-term move. This is particularly relevant if you’re from a country outside of the EU/EEA, so you should check what the requirements are with the Belgian embassy in your home country before you leave.

Belgium’s healthcare system is one of the best in Europe. With a combination of compulsory health insurance and social security contributions, Belgium has a very well-funded system. In fact, since 2009, Belgium has consistently been one of the few countries that spends over 10% of its GDP on healthcare.² 

The public and private healthcare sectors operate side-by-side, with many doctors working across both. Belgium has a combination of public and private hospitals, polyclinics (healthcare facilities that provides both general and specialist examinations and treatments) and university hospitals.