Social Security in Belgium
Belgium has a very extensive social security system. Foreigners also are entitled to certain allowances and to social services.
The benefits which you may enjoy as a foreigner are strictly dependent on the conditions under which you are resident on Belgian soil.
If you are planning to live, work or study in Belgium, your social security entitlements (such as family allowance, pensions, reimbursement of medical costs and work incapacity allowance) depend on agreements, if any, signed between Belgium and your country as well as on European legislation. Entitlements also depend on your personal situation and vary according to your nationality and employment status (salaried worker, self-employed, on secondment, retired, etc.).
You can use Coming2belgium(link is external), a special online tool developed by the social security institutions, to find out what you are entitled to under the Belgian social security system.
The Belgian social security system is based on the payment of social contributions on your income from work. These social contributions serve to finance the social security system.
Each month the employer pays a considerable amount on top of your salary into the social security fund. The employee also pays a proportion of his gross salary in social security contributions. This fund is then used to pay social security:
- allowances in the event of sickness
- unemployment benefits
- allowances in the event of incapacity for work through sickness or invalidity
- allowances in the event of accidents at work
- allowances in the event of industrial disease
- family allowances
The self employed can also claim social security. The self employed therefore pay a social contribution. This contribution is a lower percentage than the joint contribution of employers and employees, but gives fewer rights. However, the self employed may pay extra voluntary contributions which give them additional rights in certain cases. At the beginning, the self-employed pay “provisional contributions”.
For civil servants there are a number of rules which differ from those for employees and the self employed. Employees who work under contract for a government department may claim social security for employees.
There are also supplementary support systems. These supplementary support systems are not paid on the basis of contributions made, but are financed with government resources.
To receive these forms of support you must meet strict legal conditions. As a rule these forms of support are dependent on your available income. Foreigners cannot always claim Social Security and support to the same extent as Belgians.
The supplementary support systems are:
- income support
- the income guarantee for the elderly
- the guaranteed family allowance
- payments for people with a handicap
- payments for help to the elderly
Everyone in Belgium is entitled to social services from the public social welfare centre, CPAS/OCMW.
They provide social services so that everyone can live with dignity. They investigate what help is most appropriate given the personal or family circumstances, and offer the appropriate means to meet people’s needs.
For asylum seekers and people without legal residence there are limits to these services. For asylum seekers the government also subsidises a special reception structure in place of the usual CPAS/OCMW service. For people without legal residence the service is usually restricted to urgent medical help.
ADDRESSES AND WEBSITES
FPS Social Security
Health insurance in Belgium
Here’s a complete guide on how to apply for Belgian health insurance as an expat and choose from the many Belgian health insurance companies.
Read more on the official websites of the communities:
- – Flanders (Flemish or Dutch speaking community): https://www.vlaanderen.be/en
- – Walloon (French speaking community): http://www.wallonie.be
- – German-speaking community: http://www.dg.be/en
And on www.belgium.be/en for the country of Belgium
Official residents in Belgium can sign up to state-sponsored Belgian health insurance schemes, which then allow them to claim partial reimbursements of medical costs in Belgium and other European countries. To cover the personal share of medical costs (ie. claim back 100 percent of costs), some residents sign up for supplementary private insurance in Belgium.
Who needs Belgian health insurance?
Employees and self-employed
Upon commencing work in Belgium, all foreign nationals must join the state Belgian health insurance scheme or present evidence of private health insurance in Belgium (the same applies to the self-employed in Belgium).
EU, EEA and Swiss nationals visiting Belgium can temporarily use their European Health Insurance Card in Belgium (EHIC), however, they are required to make social security contributions once they start working in Belgium, which entitles them to the same healthcare rights as Belgian citizens.
For non-EU residents, Belgium also has agreements with more than 20 countries outside Europe, including Canada, Australia, USA and Japan, which enables the same healthcare access as Belgian citizens. Visit www.coming2belgium.be for information in several languages.
Spouses and children
Employees eligible for Belgian health insurance cover automatically receive cover for children up to the age of 18 and dependent spouses (providing they don’t have their own cover).
EU students are covered by the state health insurance system in their home country throughout their period of study. Non-EU students should check whether their country has an agreement in place with Belgium. Those who don’t qualify for cover must purchase their own insurance.
Expat pensioners may be entitled to state Belgian health care covered by their country of origin. It is important that you clarify what your entitlements are prior to moving to Belgium, as you will be required to provide evidence of health cover when registering for residency.
EU/EEA and Swiss citizens planning a short-term visit to the country may use their European Health Insurance Card (EHIC) in Belgium to receive emergency treatment either free of charge or at a reduced cost. Other visitors can check the requirements with the Belgian consulate or embassy in their home country; in some cases, private insurance may be required before a Belgian visa or permit is granted.
How to apply for Belgian health insurance
Upon completion of your residency registration at your local town hall, you will be issued with a Belgian eID-card (electronic ID), which replaced the previous Carte SIS (Social Identity Card) in January 2014. Your eID is an official identification card, which all Belgian residents aged over 15 must carry at all times. It serves a variety of purposes, including enabling doctors in Belgium and Belgian hospitals to digitally verify your insurance status.
Health insurance in Belgium is partly funded through social security contributions, and workers in Belgium will need to first register with the social security office before joining a Belgian insurance scheme. Read more in our guide to social security in Belgium.
The various Belgian health insurance schemes, known as a mutuelle, are state sponsored and are mandatory for any residents wishing to receive Belgian health cover. After joining, patients will typically be reimbursed between 50 and 75 percent of their medical costs by their chosen Belgian health insurance company.
Applying to Belgian social security
Before choosing a Belgian health insurance company, you must be paying Belgian social security. Registration for social security may be handled by your employer, otherwise you can register at your nearest social security office. Read how to sign up for Belgian social security. The Belgian government also provides a detailed guide.
Both employers and employees are responsible for making social security payments, with employers funding the majority of the fee. In 2017, employees paid 13.07 percent of their annual salary to social security, while employers were required to pay an additional 25 percent towards the fund. Employee contributions are automatically deducted from your earnings.
Contributions must also be made by anyone registered as self-employed, albeit at a lower percentage than the combined requirement of employers and employees. As a result, however, the self-employed enjoy fewer rights – hence why some opt to make extra contributions in order to receive additional cover. Read about taxes and social security for self-employment in Belgium.
Choosing a Belgian health insurance company
Once you are registered with the social security office you are free to join any mutuelle in Belgium (or ziekenfonds in Dutch) you choose. Each mutuelle is usually linked to a political or religious group within Belgium, such as Christian, socialist and liberal groups. All the mutuelle providers offer more or less the same services, hence why employers often enrol you in one automatically. You should clarify this with your employer as soon as possible, as you may wish to choose your own mutuelle, particularly if you wish to register with one that is affiliated to your particular religious or political views, or if you find a mutuelle that offers certain useful services, such as English-language services.
Registering with a Belgian health insurance company usually requires you to present a copy of your passport or ID card.
Each mutuelle in Belgium covers most medical treatments, such as specialists, hospitals, prescriptions, pregnancy and childbirth. Once you’re registered you must wait six months before being entitled to any reimbursements of medical costs. The six-month waiting period can be waived, however, providing you have been covered by a state health care plan in another EU country for the past six months.
Expatica provides a listing of health insurance companies in Belgium.
Some of the largest mutuelles in Belgium include:
- Mutuelle Chretienne
- Mutualite Socialiste
Some of the largest health insurance companies in Belgium (typically private) include:
- AG Insurance
- P&V Verzekeringen
Belgian health insurance reimbursements
The payment of medical services usually requires the patient to pay for each individual consultation or treatment upon presentation of their eID card, before submitting a claim to the relevant insurance company to reclaim part of the cost. In most instances, up to 50–75 percent of the cost can be claimed back through your Belgian health insurance, with the patient responsible for covering the rest. Claims are usually made by submitting a receipt alongside a claim form to your Belgian health insurance company.
Some mutuelles may have agreements in place with certain clinics which entitle you to a full reimbursement or even the reimbursement amount deducted at the point of payment. This varies from one insurer to the next, so check your policy first.
Payments for hospital treatment follow a slightly different system. Hospital patients are normally charged a fixed daily fee, which varies according to personal circumstances, for example, the unemployed, retired or disabled will pay less. At the end of your hospital visit you will only pay your personal share, with the hospital charging your insurance company (mutuelle) directly for the outstanding amount. Read more about visiting hospitals in Belgium.
You are also entitled to reimbursement on all medical prescriptions, whereby you pay up to 80 percent of the price at the counter, depending on your personal circumstances. The remaining percentage is charged directly to your Belgian health insurance company, much in the same way you would pay for hospital treatment. Note that non-prescription drugs are usually charged higher than those prescribed by your doctor.
Dental care in Belgium is also subject to partial reimbursements, provided the dentist is on a state approved list – ask your insurer for the list of approved dentists. More advanced treatments, such as crowns and bridges, usually result in the dentist offering you a variety of quotes on the work required, which must then be approved by your insurer. Read more on dentists in Belgium.
Private health insurance in Belgium
With mutuelles covering between up to 75 percent of medical costs, private health cover remains a popular choice for many residents looking to cover the outstanding amounts. Some employers also provide supplementary health cover as part of their employee benefits package.
Private cover can be a useful way of topping up a mutuelle, particularly if you have an existing medical condition which is likely to require regular treatment. As you will be liable for at least 25 percent of all medical costs, it can be beneficial to find a private package to supplement state Belgian health insurance.
As ever, the cost of private health insurance varies, so it’s important to thoroughly research your options prior to committing to a specific package. If you have a family then enquire about specific family packages which may help lower the overall cost; children are otherwise not generally covered under your insurance plan, unlike state Belgian health insurance.
If you frequently travel abroad, you may wish to purchase a package which covers your medical expenses while out of the country. Note that EU citizens can use their EHIC card when seeking medical assistance within the EU. Read more about insurance in Belgium.
Choosing a doctor or hospital
Unlike public healthcare in most other countries, those seeking treatment in Belgium are free to visit any doctor or hospital, regardless of location or referral. This can be particularly beneficial to expats whom have received recommendations from colleagues, or who simply wish to find a doctor with a strong grasp of English. Read about doctors and medical specialists in Belgium.