How does healthcare work in Belgium?

Great question!

Healthcare is partially funded through the social security contributions that you pay on your salary. This will cover 50-75% of your cost of treatment. Though this rises to 80% when it comes to prescription medication.

You can sign up to state-sponsored health insurance, commonly known as your mutualité or mutualiteit, which will let you claim some of your costs back. If you’re not a fan of paying part of your medical costs, you can take up private health insurance to cover all of the costs.

Once you have this in place, you’re covered for trips to the doctor, hospital and dental care. You’ll also receive maternity care as part of the insurance, provided that you have been insured for a qualifying period of time before becoming pregnant.

Applying for public health insurance

This is the easy bit. As the public health insurance is paid from your salary, your employer will do much of this for you. If not, then you will need to register yourself at your local social security office.

The only thing you need is an eID card, which you will receive as part of your visa application. You may then select one of the public health insurance companies to use. There’s little difference between them all. They mostly are formed around a specific political or religious group.

Note that, if your employer is handling the health insurance process for you, it’s common for them to sign you up to the company which they work with. But, as mentioned, all mutualities are reliable.

Taking private health insurance

If you prefer to have all costs covered, or have a pre-existing condition, it’s worth considering taking out private health insurance. This may cover your medical costs completely, giving you peace of mind around your health.

It’s worth asking your employer if they offer private health cover, so be sure to check before you sign-up yourself.

As with any insurance, there are many providers, and we recommend check to ensure which providers meet your needs. Some, for example, offer family plans to cover your spouse and children, whilst others offer international cover. Ideal if your job sees you travelling regularly.

What about this Zorgkas thing?

If you’ve been in Belgium a while, you might have found a bill for the Zorgkas landing on your doormat. But what is it and do you have to pay? In a word: yes.

In Flanders (not Brussels or Wallonia), all persons aged 25 and over must pay an annual contribution of €62 to the Zorgkas, or Vlaamse Zorgverzekering. It is not an optional thing.

This payment is additional to your own contributions to the mutualité and goes towards paying healthcare costs for those who aren’t able to or who need additional support. Think of the elderly, people who are chronically ill or those with additional care or mobility needs.

What’s next?

With all of your insurances and documents in place, it’s time to choose a family doctor and a dentist. It’s even possible, if you want, to register with multiple doctors, though you will need to pick one to hold your records.

You can find doctors on the Golden Pages website, though we would suggest asking colleagues or friends for recommendations. It’s common practice for you then to have an initial consult with your new doctor, just to ensure that you’re happy with them.

Where it’s fairly easy to find a GP local to you, dentists tend to have waiting lists for new patients, so try and register as soon as you arrive. It’s no fun trying to find a dentist when that sore tooth is playing up.

Accessing services

With all of your insurances in place, you’re ready to go. Most doctors work on an appointment system, though some do permit walk-ins, on a first come, first served, basis.

To access medical services, you need only present your eID card. From there, the provider can check the insurances that you have.

As a rule, you will need to pay for treatment at the point of consultation. These costs may then be claimed from your insurance provider, less any deductible. Just ensure to get and keep your receipt from the treatment, as you will need to submit this to your insurance provider with any claim for reimbursement.

Mental Health Services

And of course, sometimes it really is just a case of feeling a little lost and lonely in your adopted home country. Being able to talk to someone can make all the difference when you’re feeling anxious, are struggling to adapt to your new life abroad, or if the kids are playing up.

CHS, the Community Help Service, has a free 24hr anonymous helpline staffed by highly trained volunteers as well as an expert professional team of psychologists, psychotherapists, psychoanalysts, and coaches. Help is only a phone call away.

With that, you’re all setup for healthcare in Belgium.

Of course, we wish you good health and hope you never need it! If you hit any issues with setting up your healthcare, we’d recommend speaking to one of our members. Our relocation specialists are experts in helping people like you move to Belgium and settle in. You can find a list of all our members here.

ABRA Members CM and Partena Business & Expats are both national health insurance providers, or mutualités.

Whereas ABRA Members Expat & Co and Vanbreda Eurinsurances offer private health plans especially designed to meet expat needs.

 

 

 

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There are a number of types of insurance coverage that you are legally required to take out as a business, such as occupational accidents and general civil liability. Then there are the additional covers which will differ per organisation, and are dependent on risk. At the very least, you need a good general liability insurance to insure against all cases of non-contractual damage to third parties. How extensive it should be will depend on the type of business and the activity.

Spill water on a client’s laptop and it’s covered by your general liability insurance. If you’re serving snacks at an event and one of the suppliers has suffered from a salmonella outbreak, they’ll want to have product liability coverage. In addition to a good fire insurance, consequential loss insurance is also useful to compensate for turnover and loss of profit immediately after the fire or water damage.

For intellectual and liberal professions, contractual professional liability is often added. When there are employees, an occupational accident insurance policy is mandatory and every company car requires motor insurance. You can supplement this with comprehensive insurance and assistance.

GDPR and data processing agreements can hold large contractual liabilities, so what if you lose a client’s documents and accidentally disclose private data? Private liability insurance can mean the difference between bankruptcy and the survival of your business. After all, professional liability does not always require an error to have been made, simply failing a contractual obligation can be sufficient to trigger your contractual liability with a client.

Similarly, cyber crime is on the rise and a sudden attack by ransomware can see you held liable by your clients for not meeting your contractual obligations.

It can be interesting to insure the directors of the company under a directors’ liability insurance. An inexpensive insurance policy, it guarantees legal representation and assistance when the business owner (accidentally) causes damage to his business or a staff member. Under the new company law this is seen as not only a business accident but also falls under your personal liability because you are at fault. A business owner can, if he is not insured, lose everything. Not only is his business declared bankrupt, but his house can be taken too. We’ve seen it happen before.

Succinctly put: insurances are a form of precaution. They require you to take a closer look at all your possible risks so you can try to eliminate or reduce them. You transfer the residual risks to an insurance company in exchange for payment of a premium. The better your own precautions, the cheaper your insurance will be. So critically assess your risks and get advice from a specialist insurance broker.

“A good insurance package is not just an accumulation of policies. One policy must strengthen the other, not weaken it. Ask for guidance from an independent broker who can guide you through your risk assessments.” – Filip Declerq, Expat & Co

It’s hugely important that all the insurance policies included in a package are aligned. One policy must strengthen the other, not weaken it. Imagine your insurances for civil liability and legal assistance are under the same company. Now let’s suppose you have a civil liability car insurance with company A and company A is the market leader in Belgium. If you cause an accident, there is a good chance that the person involved is with the same insurance company. This creates a conflict of interest. Company A must represent both persons, without the control of a counter company. The tendency to compensate the customer with the smallest damage could be high.

If you’re the party who has suffered the greatest damage and are convinced that you are in your right, you can lodge an objection by appealing through legal aid. But, if that legal assistance is with Company A again, you have a problem. The legal assistance at A thus weakens the civil liability guarantee. It’s therefore best to take out legal assistance insurance with an independent legal assistance company. Of course, the disadvantage here is the cost. Separate legal assistance costs much more, but you are guaranteed that your files will always be handled correctly.

An example of reinforcement would be if your consequential loss insurance is with the same company as your fire insurance. Suppose a fire starts in your office, requiring you to close it for a longer period of time and on top of that a discussion has arisen with the damage expert. If you place the business damage insurance policy with the same company, the expertise becomes more urgent to the covering insurer. The longer the expert discusses details, the longer your company will suffer consequential damage. As a result, the insurance company will have to pay more for the loss of profit and the rental of replacement offices. It is therefore in the insurer’s own interest to reimburse you as quickly and effectively as possible.

“Focus on risk management and apply prevention measures.” – Alain Voets, Concordia Insurances

Of course, there is no insurance to help reduce insurance claims. A company can take measures, such as working with a prevention advisor, to reduce and manage the risk of, for example, accidents in the workplace. With less accidents, you suffer less damages and less damages helps lower your premium. Companies that work with machines, for example, receive additional conditions imposed by insurers in order to limit certain risks. After a year, these are revised and adjusted if necessary to ensure that the premium doesn’t need to be increased. You might also offer employees an incentive if there are less accidents than the previous year; this makes staff more alert for accidents.

“On the one hand there is the element of chance, but on the other there are risks that you can assess and limit. If you’re organising an event or managing a project from A to Z, there are a myriad of things that can go wrong, before, during and after the event. ” – Alain Voets, Concordia

The number of things that can go wrong at any time are endless, but when we find ourselves needing to claim, we’re often quick to blame the insurer when we don’t receive the compensation (we think) we deserve. However, it’s important to note that this isn’t always due to the insurance company, but may also be attributed to the customer or the broker.

When things do go wrong with the insurer this is often to do with conflicts of interest, where the insurance company decides to pay out the lesser of two claims as previously discussed. A form of abuse of power then plays a role. The insurance company has an entire army of good lawyers at its fingertips, which the client usually doesn’t.

“Some customers try to cheat the insurer by not disclosing all the facts, but they usually end up deceiving themselves.” – Filip Declerq, Expat & Co

Things can go wrong from the customer’s side when they are careless or don’t receive specialist guidance by their broker. It’s easy to forget something, and accidents are quick to happen. If something happens, and you are not, or not sufficiently insured, you pay for the costs yourself. You cannot blame your insurer for your carelessness, negligence or oblivion, irregular control or follow-up.

Incomplete transparency can be contributed to the customer. Some customers try to cheat the insurance company by not disclosing all the facts. But they usually end up deceiving themselves, because insurers leave little to chance. The same applies for brokers. They too sometimes forget something. Nothing human is alien to them. But they do have professional liability insurance for this. If damage is caused by their fault or negligence, the client will be reimbursed under their professional liability insurance.

“The onus is on clients to inform us of changes. If you’ve bought a new car, you need to let us know so we can insure it. Companies evolve and communication between the insurer and insuree is hugely important.” Laurent Martin, ALLIA Insurance

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SOME USEFUL TIPS TO ENSURE A SUCCESSFUL CLAIM RESOLUTION

∞ Submit your claims in time
Many contracts have a limited time span after the accident or incident to submit your claim. If that time is up, the insurance company does not have to reimburse you.

∞ Be honest, correct and complete
Make sure your first version of the facts is always the correct version. People who change their version afterwards, when they feel things aren’t turning out the way they want, are always considered suspicious. Companies have the right to call in detectives to find out the truth. A well-known trick is to visit the neighbors: they’ll often share more than the customer would like. Anyone caught for fraud, concealment or misrepresentation of the facts can be sentenced and loses all entitlement to compensation.

∞ Ensure order in your own file
If you make a mess of your file, you can’t expect your insurance company to process it within the agreed time. Claims Adjustors are not your personal secretary. Also, don’t forget that you’re not the only customer. If we were to give priority to messy, and therefore time-consuming, files, we would build up more backlog. As a result, we would also have more dissatisfied customers. Priority is given to as many satisfied customers as possible and therefore to orderly files.

COMPLETING YOUR FILE CORRECTLY:
∞ complete in one file per insured person (not all insured persons mixed together), possibly clearly grouped into one large file;
∞ make sure your documents are arranged by date;
∞ avoid mixing invoices or supporting documents from previous files with new ones;
∞ report your form filled in as completely as possible: describe the cause of the accident, the diagnosis of the disease and such as accurately as possible, supplemented by witness statements, medical reports or other evidence;
∞ don’t forget to mention the account number on which the reimbursement can be deposited.

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The Recognised European License
Member countries of the European Union give out a European model driving license. These driving licenses are recognised throughout the European Union (EU) and European Economic Area (EEA) as well as many other locations around the world. In broad strokes, if you have a European driving license and are living in Belgium you need to exchange it before it runs out, or if you are settling here on a more permanent basis (exchange within 2 years of settling in Belgium).

Although you can drive here with your Guadeloupian license (yes, as an overseas department of France it’s part of the EU), it may be worth considering exchanging it for a Belgian one if you plan on being here for a while. At the very least you should get your license registered with your local commune, so that if you were to lose or damage it you can easily request a replacement. So far, so good. The matter gets somewhat more complex however as we venture further afield.

The Recognised non-European License
If you are the proud owner of a recognised non-European driving license then according to the conventions of Vienna and Geneva you may legally drive your car here. However, this only holds true providing you do not possess either a Belgian ID card, or an A, B, C, D, E, F, E+ or F+ card.

As soon as you are officially registered as living here you receive your Identification Number of the National Register (rijksregisternummer/numero national). Your newly acquired residential status automatically means you will need to exchange your license for a Belgian one as you are now a Belgian resident. This in theory should be a straight-forward exchange of licenses.

The non-Recognised non-European License
The same system applies with a non-recognised non-European driving license: you can legally drive here with your foreign driving license until you are awarded residential status. As soon as you have received your national number you will need to exchange your driving license for a Belgian one.

However, as your license is not recognised here, you will need to sit both theory and practical exams before it can be considered for exchange. Unfortunately, a letter from your embassy attesting to the validity of your license is of absolutely no value in this process.

The International Driving License
If you are here on a business trip visa (90 days max) then you may want to request an international driving license from your home country to cover the duration of your stay. Check with your home country whether you need an international driving license to go with your national license in Belgium. This will differ from country to country, but your embassy will be able to advise you.

The international driving license has no actual legal value in Europe. It merely serves as an additional document to go with your national license. An international driving license is valid for one year only and must be collected in person from your home municipality, which means you should have obtained it before coming over.

The Exchange Process
The process of exchange is simple in theory: you go to your local municipality with your current driving license and your Belgian ID card and request an exchange. Your license is sent off for a check and then exchanged for a Belgian one.

It is important that your license meets the following requirements: you have the same nationality as your license – or you can prove you were residing in that country for at least 185 days in the year you received it – you received it before moving here, it is valid, and the categories awarded are recognised here.

If your license is not in one of the recognised national languages, you may need to have it translated by a sworn translator before it can be considered, especially if it is not in our Latin alphabet. If your country does not follow the Gregorian calendar (as we do in Europe) then the valid from/to dates will also need translating. Some embassies provide standard translations of national driving licenses, so it is worth checking with your embassy.

Your license is then sent off to the FOD Mobiliteit en Vervoer who will verify that your driving license is not counterfeit. Providing your license is real and you do not need to sit any additional tests it will be exchanged for a Belgian one. This usually takes between six and eight weeks. The commune essentially acts as a letterbox, so how quickly they send it on to the Ministry can also depend on their own backlog.

If you have to sit both theory and practical tests, then you will need to pass these before your license can be exchanged for a Belgian one. Larger cities such as Brussels and Antwerp offer driving tests in a number of different languages, or you can bring a sworn translator along at your own expense.

Again, much depends on how long it takes for you to book (and sit) your exams and receive your test results. Bring your results along with your national license (and any translations) to your local commune and ask for the exchange process to be initiated. You should have your new license within 6 – 8 weeks.

Practical Advice
Good to know: a national foreign license (whether recognised or non-recognised) always exempts you from driving lessons, providing you are requesting a license with the same categories (AM, A, B, C, D, G) given out in Belgium. You may however still need to take theory and practical tests, depending on the license you hold.

You can start taking theory lessons online even before you arrive in Belgium and can book your exams the day you receive your national number. Sending off proof of passing with your current license gets things moving as quickly as possible.

We have to remind expats that driving without a license is illegal in Belgium and leaves you open to fines if you are stopped by the police, and worse: potentially uninsured should something happen. Although some communes provide a document stating your license has been sent off for exchange, we are told this has no legal value at present.

Leaving Belgium
You can request your national license back when you leave Belgian territory and give up your residential status. Should you come back again in future years, you will have to start the exchange process again. Until you have physically received your Belgian license you can still change your mind and request your national license back.

Useful Websites

List of recognised EU and EEA driving licenses:
https://mobilit.belgium.be/nl/wegverkeer/rijbewijs/vreemde_rijbewijzen/europese_rijbewijzen
List of recognised non-EU and EEA driving licenses:
https://mobilit.belgium.be/nl/wegverkeer/rijbewijs/vreemde_rijbewijzen/niet_europese_rijbewijzen
FOD directive on exchanging European driving licenses:
https://mobilit.belgium.be/sites/default/files/downloads/hoofdstuk_27_europese_nationale_rijbewijzen.pdf
FOD directive on exchanging foreign driving licenses:
https://mobilit.belgium.be/sites/default/files/downloads/hoofdstuk_28_buitenlandse_rijbewijzen-niet_europese.pdf
Exams with an interpreter:
http://www.goca.be/nl/p/rbw-tolk

Read about how ABRA is hoping to speed up and simplify the driving license and exchange issue and get behind our cause.

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