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How does the health care system of Belgium work?

Belgium is known for its well-organized health care system and ranks among the best in Europe and even the world. It is based on the fundamental right of accessible and affordable healthcare for everyone. We will guide you through the most important features of the Belgian health care system.

How does it works?

The Belgian health care system covers basic healthcare reimbursements for doctor visits, hospital and medication costs. Accessibility and affordability are made possible through a system of compulsory health insurance via health insurance funds (“ziekenfonds” in Dutch) and social contributions of employees and employers. For example, as an employee, monthly contributions for the social security in Belgium are retained from your income (3.55% from your own salary and 3.80% paid by your employer).

What is covered?

Belgian public health insurance covers:

- Doctor and hospital visits: 50 to 75% of the costs for doctor visits, hospitals and clinics. Anyone is free to visit a doctor or hospital of choice. This is beneficial for expats who have received recommendations for a English-speaking doctor.

- Dental care: on the condition that the dentist is on a state-approved list, insured people receive partial repayments for dental care in Belgium.

- Maternity care: when you have been insured for a sufficient amount of time, the insurance covers the cost of having a baby.

With health insurance funds often only covering up to 75% of medical costs, a lot of citizens also opt for a private health insurance to cover the remaining costs. In some companies and organisations, this additional health cover is offered as a part of the employee benefits package.

How does the (re)payment system work?

Generally, the fee must be paid upfront and a partial refund of the charges takes place through the health insurance fund. However, the third-payer system is compulsory in hospitals and public pharmacies. This means that the health insurance fund will directly pay the costs to the care provider. You only pay the amount that is for your account (the costs that are left). In case of the private health insurance, medical costs must be paid upfront and afterwards, a refund takes place.


If your doctor writes you a prescription, you will need to buy it at a pharmacy. Pharmacies are easily identifiable by an (often illuminated) large, green cross sign.

Medicines prescribed by a medical professional are refunded, while non-prescription medicines are not. Prescribed medicines have to be paid when buying them at the pharmacy, minus the percentage payable by the insurer. Some medicines are refunded up to 20%, while others are fully reimbursed.

How to register for healthcare as an expat?

If you live and work in the country, you must register at the social security. Your employer might do this for you. Otherwise, you can register yourself at the nearest social security office. Once you have done this, you need to choose a health insurance fund, which is mandatory for anyone wishing to receive health coverage. Everybody is free to choose their own health insurance fund. Most health insurance funds align with a political or religious group within Belgium, such as the socialist, christian and liberal health insurance funds. When contributing health insurance payments, access to subsidized public healthcare is assured.

When staying temporarily in Belgium, a necessary medical treatment (accident or acute illness) under the same conditions and at the same cost as the locals can be obtained through the European Health Insurance Card (EHIC). This card is valid in any of the 28 EU countries, Iceland, Liechtenstein, Norway and Switzerland, with again state-provided healthcare under the same terms and at the same price as the residents insured in that country.








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