In Belgium, health insurance is mandatory. Basic cover is provided by the national social security system, which is known as the mutualité or ziekenfonds.
Contributions are paid by both employers and employees and they amount to 7.35 % of each person’s gross salary. The employee must pay 3.55 % directly from their wages and employers must pay the remaining 3.8 %. Self-employed people have to pay the full 7.35% on a quarterly basis.
Cover is automatically provided for unemployed dependent family members and children up to the age of 18. The unemployed, old age pensioners and people on long-term sickness benefit or maternity leave do not have to pay healthcare contributions. Foreigners immigrating to Belgium without jobs must produce proof of private health insurance in order to obtain their residence permit.
For historic reasons, some healthcare funds are limited to members of various religious, political or professional groups, but most funds are open to everyone. Each fund charges the same basic contribution as well as providing similar benefits, but some take longer than others do to make repay the fees.
People have to wait six months before they are able to claim benefits, unless they previously belonged to a health scheme as a dependant or if they were covered by a state health care plan in another EU country for at least six months before their arrival in Belgium.
People have to pay a certain amount of their medical bill themselves and they usually pay fees directly to their doctor or the hospital. They must submit their receipts for reimbursement and the money is then paid directly into the claimant’s bank account.
Most Belgians take out supplementary health insurance to cover the portion of their bill, which is not reimbursed. Many employers provide supplementary health insurance cover as an employment benefit.