Belgium is a popular destination for expats. Not only does it offer a great work-life balance and affordable cost-of-living, it also has one of the highest standards of healthcare in Europe.
The Belgium's healthcare system is designed to be fair and give all residents access to high quality, efficient healthcare services. So, whether you’re starting a new job in the capital of the EU or starting a new life with your family, you’ll be in safe hands. We’ve put together a simple guide to help you understand the system and what you’ll need to do to access it when you move.
Belgium’s healthcare system is one of the best in Europe. With a combination of compulsory health insurance and social security contributions, Belgium has a very well-funded system. In fact, since 2009, Belgium has consistently been one of the few countries that spends over 10% of its GDP on healthcare.1
The public and private healthcare sectors operate side-by-side, with many doctors working across both. Belgium has a combination of public and private hospitals, polyclinics (health care facilities that provides both general and specialist examinations and treatments) and university hospitals.
Belgium’s public healthcare system is funded by social security contributions and mandatory health insurance, which anyone living and working in Belgium is required to register for. By paying into the public system, residents have access to heavily subsidised healthcare services, including doctors’ appointments, hospital care, prescriptions and maternity services.
As an expat working in Belgium, you’ll be required to make these health insurance payments and social security contributions. Insurance payments are made annually, while social security contributions are usually deducted from your salary. If you’re self-employed, you’ll need to register and make contributions independently.
The public healthcare system is overseen by the federal government, but individual public health insurance providers are managed on a regional level. Different regions have different official languages so, depending on where you are, you’ll be joining a mutuelle (French), or a ziekenfonds (Dutch). They’re technically private companies and are sometimes connected with a particular religion or political group, but they’re state-approved and heavily regulated. They all offer the same basic services, with additional benefits, which may vary (such as menstrual products, physiotherapy refunds and allowances for daycare). Your employer may assign one to you, but you can choose your own if you prefer.
You’ll typically pay for your consultation or treatment up front, then submit a claim to your mutuelle / ziekenfonds. Through this system you’re able to get reimbursed for some of the cost of hospital visits, doctors’ appointments, prescription medications and some dental services.
Public healthcare in Belgium isn’t free, but it’s designed to be fair and accessible to all. There are two main ways that you pay towards public healthcare services in Belgium:
If you want to be reimbursed for 100% of your healthcare costs, you can take out a separate, supplementary private healthcare policy. This is a popular option among expats who want to be fully covered for all their needs.
When you register with the Belgian healthcare system, you can choose your own GP, but you’re not limited to only seeing them, and you’re also free to see more than one doctor. On average you'll reimbursed for 75% of their fees through your public mutuelle/ziekenfonds.2
Similar to above, you’re also free to visit any hospital, regardless of where you are. And you’ll be reimbursed between 50% and 75% of the cost of your hospital visit. 2
The costs associated with having a baby in Belgium are generally fully covered under the public health insurance scheme, provided you’ve been paying into it for more than just a few months. Belgium’s compulsory insurance covers most birth-related consultations and services for you and/or any dependent spouse.
You’ll receive partial reimbursements through the public healthcare system for routine dental care in Belgium. Most Belgian dentists are private, so they’ll need to be on a state-approved list. And for more advanced treatments like crowns or bridges, you’ll need approval from your insurer and, if the procedure isn’t covered by your compulsory insurance, you’ll need a separate private healthcare plan.
For prescription drugs included on Belgium’s list of reimbursed medications, you’ll get a full or partial discount.
If you’re employed and living in Belgium, you’re not only entitled to access public state healthcare, you’re required to register with a state-approved health insurance company.
If you’re an employee, any dependent spouse or child will be automatically covered under your scheme and entitled to Belgium’s public healthcare benefits and subsidies.
If you’re self-employed in Belgium, the same rules apply. You’ll be required to register to the public system, and any dependent spouse and/or children will be covered too. The only difference is that you’ll have to do all of the registration and administration yourself, and you’ll need to pay a portion of your salary towards your health insurance, as you won’t have an employer making contributions for you.
If you’re an EU, EEA or Swiss citizen visiting Belgium for a short amount of time, your European Health Insurance Card (EHIC) gives you access to certain healthcare services in Belgium. But it doesn’t cover everything and, if you’re planning on staying in Belgium to live and work, your EHIC isn’t a substitute for the public healthcare system. As an expat, you’ll still need to register with a compulsory insurance provider and pay social security.
Belgium has agreements with over 20 other countries outside the EU, including Canada, Australia, the USA and Japan. In most cases, these agreements ensure short-term visitors the same (or similar) access to healthcare as Belgian residents, so check your status before you travel to see what your entitlements are. But, again, if you’re moving to Belgium permanently, you’ll need to register with the public healthcare system.
If you’re a visitor from another country, you’ll need to check what the requirements are with the Belgian embassy in your home country before you leave. You may need private insurance before you can get a Belgian visa.
In Belgium, you can register with any doctor. You’ll be able to claim reimbursements for treatment as long as they’re approved by a state insurance company and registered with the National Institute for Health Insurance (INAMI). Some doctors work across both the private and public sectors, so make sure you’re clear about which service you want and check that it’s covered.
Most GPs in Belgium operate a simple appointment system, and waiting times aren’t typically too long. You can book online or by calling their office, though some surgeries will also have walk-in consultation slots set aside and allocated on a first-come-first-served basis.
After your appointment, you’ll be asked to pay upfront and then request your partial reimbursement afterwards. Some don’t accept credit cards, so be sure to check.
In Belgium’s public healthcare system, you don’t need a referral from your family doctor in order to make an appointment with a specialist. But, while you can make an appointment directly with a specialist, be aware that the amount you get reimbursed could be different if you’ve not been referred by a doctor.
Depending on your circumstances and location, you may find that the waiting times for an appointment with a specialist are longer than for a doctor’s appointment.
The phone number for the emergency services in Belgium is 112. This is the standard European emergency number.
In Belgium, the pharmacy will be called the “pharmacie” (in French – typically in the Brussels Region and the Walloon Region) or “apotheek” (in Dutch – typically in the Flemish Region) depending on the dominant language in your region. They’re easily identified by the large green cross sign outside. All medicines prescribed by a doctor need to be bought from a pharmacy. You’ll pay upon collection and, unlike other healthcare services, the percentage that’s covered by your insurer will be deducted up front when you pay.
Because Belgium’s public healthcare is subsidised, your compulsory insurance will usually only cover up to 75% of medical costs.2 For that reason, you may wish to take out a private healthcare plan to supplement your public insurance coverage.
If you choose that option, it effectively means you can get 100% of costs reimbursed or paid directly depending on your level of private cover. You’ll also be able to book private appointments with specialists, which often have shorter waiting times than the public system.
As public health insurance is mandatory for residents, once you’re registered onto that system, you won’t be required to take out any additional private cover. However, Belgium only provides partial funding towards public healthcare costs so many expats choose to opt out of additional voluntary private insurance.
It’s also important to note that the registration process can take a while, and you need to have been making social security contributions and paying for your compulsory insurance for around six months before you’re eligible to claim.
So, during that time, you may be required to have a private healthcare plan to ensure you’re able to cover any medical care or treatment you might need. Depending on where you’re from, you might also need to show proof of healthcare cover to be able to get a visa, whether you’re coming to Belgium for a short visit or for a long-term move. This is particularly relevant if you’re from a country outside of the EU/EEA, so you should check what the requirements are with the Belgian embassy in your home country before you leave.
There’s a lot to consider when moving to Belgium. But with our annual healthcare plan, you’ll have one less thing to worry about. We’ll help you settle into your new life with the peace of mind that comes from knowing you’ve always got somewhere to turn for help.
With the Virtual Doctor service, you can have a medical consultation with a real doctor wherever you are in the world – from the comfort of your home, hotel or office. Better still, there are doctors on call and available 24/7.3
Our Virtual Doctor service lets you speak to a real doctor from anywhere in the world in a number of languages. Ideal if you get confused trying to navigate Belgium’s three official languages.3
We think reimbursement should be simple. Provided we have all the right information, over 80% of all eligible claims are paid within 48 hours.4
From overnight hospital stays to emergency ambulance transport, our healthcare plans offer emergency cover. And with optional extras like dental care and out-patient services, you can choose a package that suits you.
Belgium may be a small country, but you don’t want to have to worry about what might happen in an emergency if you’re in the country or out of town. Our team can arrange for your evacuation and repatriation in an emergency.
It always takes time to settle in, so our Mind Health service is here to connect you to qualified psychologists for support when you need it.5
Our second medical opinion service is here for those times when you’re not quite sure. We can provide a full review of your diagnosis and/or treatment plan giving you the reassurance you have explored all your treatment options.6
Whether you’re relocating for a work assignment, or starting a business of your own, we offer comprehensive cover, as well as optional benefits that you can tailor to your needs.
If your family is moving to Belgium to start a new chapter, the last thing you want is to let a health worry interfere with your experience. Discover our long and short-term international health plans, which will cover you and your family’s general health as well as emergencies.
Belgium’s excellent standard of healthcare, laid-back way of life and affordable cost-of-living make it a popular destination for retirees. Our expat insurance plans include cover for prescriptions, annual health checks as well as palliative care and disability compensation.
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*Lines are open Monday to Friday, 8am-5pm (GMT).
Calls may recorded and/or monitored for quality assurance, training and as a record of the conversation.
The Virtual Doctor, Mind Health and Second Medical Opinion services are provided by Teladoc Health.
The Virtual Care from AXA service is now available to all Individual and SME members (excluding those whose health plan is insured by AXA General Insurance Hong Kong Limited).
Local insights have been provided by Oban International’s LIME (Local In-Market Expert) network’ - https://obaninternational.com/lime-network/
1 https://data.worldbank.org/indicator/SH.XPD.CHEX.GD.ZS?locations=BE
3 The Virtual Doctor service is part of our Virtual Care from AXA service. Appointments are subject to availability. You do not need to pay or claim for a consultation but you will be charged for the cost of the initial phone call when using the call back service. You won’t be charged if you request a call back using the app or online portal. Telephone appointments are available 24/7/365 and call-backs are typically within 24 hours. Video appointments in English, Spanish and Mandarin are available between 08.00 and 00.00 UK time, Monday to Friday. Video appointments in German are available between 08:00 -20:00 CET, Monday to Friday
4 80.6% of eligible claims submitted online between July 2022 and June 2023 were paid within two days.
5 Mind Health psychologist appointments are available in English and Spanish between Monday and Friday, 09.00 - 17.30 (UK time). If you are calling from the UAE, appointments are available between Saturday to Thursday, 09.00 – 20.00, and Friday 09.00 – 16.00 (UAE time). The service, provided in partnership with Teladoc Health, provides access to six sessions with a psychologist, per mind health concern, per policy year. The Mind Health service is part of our Virtual Care from AXA service.
6 Our Second Medical Opinion service is here for you anytime you’re unsure over a diagnosis or recommended course of treatment. It’s part of our Virtual Care offering, along with the Virtual Doctor and Mind Health services, so you might have already seen it on your plan or on the Virtual Care from AXA <app> or <portal>. Provided in partnership with Teladoc Health, the service unlocks access to a network of over 50,000 world-leading specialists and connects you to a doctor who will review your case alongside an expert. They’ll work with you to help you understand your diagnosis, make sure you know your options and support you throughout any treatment, wherever you are in the world.