The Belgian healthcare system

In case you've ever been curious about the "socialist" healthcare system that seems to define Europe, the article below may satisfy your curiosity.  It did mine.  And no, it's not free.

Health matters: the Belgian healthcare system

Being ill or having to go to the hospital ranges from mild worry to a life-shattering experience.  The good news is that you're in Belgium, a country with one of the world's best healthcare systems.  Here's how to make the most of it.

Insurance

To benefit from the healthcare system in Belgium, you have to join a health insurance

fund (mutuelle/ziekenfonds). The majority of these funds are linked to the country’s

political parties but they are accessible to everyone. You can choose from 20 Christian, 13

socialist, 10 liberal, seven independent and seven neutral funds from all over Belgium.

Contributions are withheld from your income if you are a salaried worker; the self-employed 

need to register with the social security fund of their choice. All funds

charge the same amount, as they act as intermediaries between the National Institute for

Sickness and Invalidity Insurance and its members. This state system provides basic

healthcare reimbursements for hospital, doctor and chemist costs – for example,

50-75% of the cost of a consultation with a doctor or specialist. While hospital and

pharmacy expenses are deducted when you pay, doctors’ fees usually need to be paid in

full and then the invoice sent to the insurance fund for reimbursement.

When you register, there is a six-month waiting period before you can be reimbursed

for any medical costs, though people who are entitled to benefits in another EU country

are covered during this period. Once insured you receive a SIS (social identity) card,

but these will gradually be replaced by an electronic identity card from next year.  

You can opt for an additional insurance. This covers repayments for non-urgent

care in hospital, the costs of glasses, dental care, vaccinations and registration at a

sports club. Alternative or complementary treatments such as homoeopathy, acupuncture, 

osteopathy and chiropractic are also recognised as reimbursable by the Belgian Ministry of 

Health, if the practitioner is a qualified doctor. The content and cost of this insurance 

varies for each fund. However, it is possible to choose complementary insurance from 

one of the private companies which come under the umbrella organisation Assuralia.

Allowances

The healthcare system covers benefits if you are not capable of working due to an accident, illness or childbirth. To qualify you need to inform your employer and deliver a certificate to your fund before the end of the employer-paid period of sick pay. If you’ve been off work for more than a year, this is termed invalidity and the benefits you receive in this case are tied to your family circumstances.

Female employees are entitled to 15 weeks’ maternity leave (17 for a multiple birth); nine

weeks must be taken after the birth and at least one before the date when the baby is due. They receive benefit of 82% of salary for the first 30 days and 75% for the remainder, subject to a maximum salary. The father has the right to 10 days’ paternity leave, seven of them paid for by the social security fund at 82% of his salary, which is also subject to a maximum figure.

Social welfare centres

The Public Centre for Social Welfare (CPAS/OCMW) is a public institution provided by the municipalities in Belgium. Every citizen of Belgium has the right to social assistance and

social integration, for example with medical help.

Hospitals

Belgium has a wide choice of hospitals and clinics with a total of 141 public and private general hospitals which are managed by universities, religious organisations, health insurance funds or social welfare organisations. The hospitals, which are open 24/7, can be identified by a sign showing a white H on a blue background. Large hospitals have an emergency centre, a maternity ward and separate sections dedicated to the treatment of children and the elderly. Smaller, specialised hospitals only offer care for specific

target groups like patients with neurological disorders. Elderly people can also find the care adapted to their needs in geriatric hospitals.

You can also be referred to a day hospital, where you receive specific surgery and are allowed to return home the same day, under certain conditions. At polyclinics, specialists offer consultations or small treatments, without the need for an overnight stay. Both day hospitals and polyclinics are usually departments of ageneral hospital.

Emergencies

In an emergency, call 100 or 112 and an ambulance will take you to the nearest emergency

centre. The Belgian compulsory health insurance scheme reimburses 50% of the cost of

emergency health service transport.

Doctors

General practitioners can be found in private practices or attached to clinics and hospitals.

You have the freedom to consult or register with whoever you choose. Embassies usually

keep lists of doctors who can work in your language, otherwise many doctors have a

good understanding of English. The Community Help Service (CHS) also offers a 24/7

helpline, providing contact details of local medical professionals, as well as general 

information and anonymous support. If you need a doctor outside normal practice

hours, visit or call a duty doctor (médecin de garde/wachtdienst). Local newspapers

publish this information. 

Specialist medical care

You may arrange to see a specialist of your choice; it’s not essential to have a referral from

a general practitioner, although he or she can advise you.

Pharmacies and medication

Chemists are ubiquitous in Belgium – look for the green cross sign. Most pharmacies operate normal working hours, with a number providing emergency 24/7 cover on a rota basis. Again, you can find this information in local and free papers. Medical prescriptions must be paid for on collection and the chemist issues a receipt for reimbursement purposes.

Dentists

The majority of dentists in Belgium are private. They have an agreed fee scale agreement, which sets the level of reimbursement for patients for basic treatment. For any specialist work, such as crowns and bridges, the dentist may ask how you will pay and offer you different quotes. To qualify for reimbursement you’ll need to visit the dentist at least once a year.

Mental health

You don’t need a referral from your GP before approaching a psychiatrist, psychotherapist

or counsellor, but it is advisable to ask for their advice first. There are 68 psychiatric hospitals and an attentive ear and professional advice are also readily at hand through the non-profit CHS.

CHS provides a confidential 24/7 information and crisis telephone service, staffed by a team of trained volunteers under the supervision of professional therapists. The mental health centre, in Brussels, has a professional staff of psychologists, psychiatrists and educational specialists.

Euthanasia

In September 2002, Belgium became the second country in the world to pass euthanasia

legislation. Patients must be over 18 years of age and if a person is not in the terminal stages of their illness, a third medical opinion needs to be sought.

Abortion

Abortion is legal until the 12th week of pregnancy and women are required to have counselling prior to the abortion.

Addiction

People struggling with addiction can seek help from their local chapter of Alcoholics Anonymous or drugs helpline Infor-Drogues.