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How does sickness and incapacity insurance work in Belgium?

10:09 09/10/2018

So you’ve moved to Belgium and started a wonderful new job. Heaven forbid you fall ill or have an accident and need a substantial amount of time off work for treatment or to recuperate.

But if you do, it’s good to know that Belgian healthcare system is one of the highest ranking in Europe and provides a substantial degree of support regardless of your health insurance policy or provider. A high percentage of the cost of treatment is covered by the national health system, with the shortfall passed on to patients. In most instances, basic healthcare insurance will pick up or reimburse the shortfall. 

Getting your health insurance sorted is fairly easy once you arrive. Compare a few policies and buy the coverage with a mutuality that you like. If you fall sick or have an accident out of work, the key thing to remember is to tell your employer within 48 hours so as not to lose out on the amount of reimbursement you receive. If you’re an independent, notify your mutuality as soon as possible.

Heading to hospital 

Being hospitalised is daunting wherever you are, home or abroad. In Belgium each hospital treatment has a corresponding code that reflects the amount that will be reimbursed by the national health system.

The reimbursement is in the region of 90%, but the shortfall passed onto patients can be quite considerable depending on what sort of hospital services you sign for on admission and whether they are covered by your mutuality health insurance policy. For instance, you need to check which sort of hospital room is covered by your provider before signing for anything at a hospital.

Private rooms are not covered by basic policies and what’s worrying is that if you choose a private room it also means your doctor can charge private fees. According to an expat advisor at Partena, “This is something expats don’t realise. If you want to pay the extra for a private room, doctors can also charge up to 300% more for your treatment, than if you were in a public room.”

Partena’s special expat division has a helpline in English should you need advice. It runs a Defence of Members service which can assist in verifying your hospital bill and intervene on your behalf if necessary – also on issues of medical damage.  A quick call could save you a fortune. 

If you already know you’ll want to go private, Partena and other health insurance providers also offer policies at higher rates, to cover private hospital rooms and the associated treatment fees.

Sick pay 

Under Belgian law, if you’re employed in Belgium and have already been in the job for a month when you get ill, your salary is safeguarded for the first 14 days of your illness. Once your condition has been verified and medically reviewed, your mutuality will then takeover to pay up to 60% of your salary for up to a year of incapacity.

However the maximum salary is capped and changes every year with inflation. If you usually earn more than the salary cap each month, your employers may have a salary guarantee agreement in place to safeguard a replacement net salary of 80% of what you were earning. If things go really awry and you’re still unable to work after a year, don’t worry, you become eligible for invalidity payments after a medical review. The amount of replacement salary then becomes dependent on the financial state of your partner and any dependents you may have, as well as what you were earning. 

Photo: Philippe Agnifili/Flickr. Licensed under Creative Commons

Written by The Bulletin with Partena



Invalidity benefits get watered down to make funds available for the new comers etc.

Nov 24, 2018 19:21