How to get proper medical care when living in a foreign country? This is one of the uncertainties of living overseas. Here is an overview of how expats in Belgium access healthcare.

State-run

The medical care system in Belgium is funded through a mandatory insurance scheme run by the government. The premiums are automatically deducted from salaries. The scheme encompasses expat professionals on work visas. This state-run insurance typically reimburses up to 75% of the costs associated with treatments. Belgians and expats often get top-up and private insurance policies to supplement the state-provided mandatory medical cover. This is one of the reasons why Belgium has a booming medical insurance sector. The nation spends 10% of its annual budget on healthcare. The amount is disbursed through what is known as mutuelle, or the public health insurance fund.

Eligibility

Expats who live and work in Belgium on visas sponsored by employers are automatically covered by the country's state healthcare system. Belgian hospitals are considered very expensive. Without health insurance many of the hospital treatments would be simply unaffordable. For example, a knee replacement surgery in Belgium can cost EUR 13,700. With health insurance (75% reimbursement) it would cost EUR 3,425. State health insurance is the Belgian government's way of ensuring that all residents of the country can afford and access quality healthcare.

Many foreign nationals in Belgium choose not to subscribe to the Belgian national insurance scheme. This is because it does not provide cover outside of Belgium. These expats choose one of many international private health insurance options instead. Expats who qualify for ‘non-resident’ tax status in Belgium may not be required to contribute to national social security. They are covered by their employers' healthcare plans.

Public health insurance

Belgium prides itself on its high quality healthcare system. The Euro Health Consumer Index (EHCI) is a comparison of European health care systems. It is based on a number of factors like waiting times, results, and generosity. Belgium was ranked fifth on the 2018 EHCI. Public health insurance receives partial funding through social security contributions. Both employers and employees make social security payments, with employers paying the majority. Temporary visitors to Belgium from the EU/EEA/Switzerland can get discounted healthcare through their European Health Insurance Card (EHIC).

Private health insurance

Belgium is home to vast communities of migrant workers. These expat professionals regularly send money home as remittances via the Ria Money Transfer App and similar channels. Many Belgians and expats buy private health cover to manage any costs not covered by the state insurance. This is particularly useful for those who have an existing medical condition. Some international health insurers offering private health cover in Belgium are Aetna Global, Bupa Global, Cigna Global, and Pacific Prime. When getting a treatment, the usual system is to pay the healthcare provider upfront and get reimbursed later by the insurer. Private insurance covers all manner of treatments including advanced dental treatment and elective cosmetic surgery.

Cost

Many variables can have an impact on the total cost of private health insurance in Belgium. These include age (more expensive with age) and area of cover (just Belgium or other countries too).  If other areas include the US, Caribbean, Singapore, China, or Dubai, the overall price of insurance is significantly higher. Product choice is also a factor. Higher-end insurance products that cover more conditions cost more.

For the state health insurance expats pay 7.35% of their gross salary. 3.55% is deducted at source while 3.8% is paid by the employer. Self-employed expats must pay the complete 7.35%. Medication is also covered by health insurance. Medicines are available at reasonable rates from private pharmacies. Expats usually pay up to 80% of the price at the counter. Belgium’s emergency medical services respond promptly.