Healthcare in Belgium

Hi,

how does the healthcare system work in Belgium ? Is it efficient ?

What are the main differences between public and private sectors?

Is it recommended to purchase private health insurance in Belgium?

Thanks in advance for sharing your experience !

Julien

Health insurance is obligatory in Belgium for Belgian social security payers and normal Belgian residents. It's pretty cheap, for 6 of us, we pay 156 euro a year. Many people get top-up hospitalisation insurance through work. Some people get top-up hopsitalisation insurance from the obligatory insurance provider. Some people also pay for top-up dental insurance. There isn't any straightforward public/private sector.

thanks for your post schoolmum !

Good questions! But to me, the healthcare system here is a bit of a mystery! You cannot get from the insurance company the info about the cost of service, the reimbursement and what services at what % are covered. Even if you get hospital insurance such as DKV, still, there will be things that DKV will refuse from a regular state hospital to pay and make you pay yourself.

Healthcare from my perspective is behind in cleanliness and sterility, and I am comparing that to the US.

Reimbursment amounts are available on the INAMI website. It's up to individual supplier to set their charges, if they are higher than the minimum, then you don't get that bit refunded.

Our child broke their arm recently, the total bill has now come to over 1000 euro for an operation, overnight stay, several follow-up xrays. We have paid personally about 100 euro. We were not covered by DKV insurance and had we been, it would have saved us perhaps an extra 70 euro.

I find standards of cleanliness at St Luc hospital in WSL very high, plus the service, plus the charges not exhorbitant.

I had to have a little dental work done last year..
A molar needed to come out and I needed to have 3 fillings..
The cost for the lot was less than €300 and I got about €240 (not sure on the exact cost) back from the mutuality (Insurance provider)

I pay something minuscule like €60 per annum for my cover.
Compared to Irelands A&E/dental surgeries and GP's (House doctors in Belgium) I would say the standard of care is much better in Belgium and the cost is considerably less here too.

Hi,

In order to help expats and soon-to-be expats, we would like to invite you to share your experience on this topic, with updated info on the healthcare system.

Thank you in advance,

Julie
Expat.com Team

I've used both the public and private insurance but i guess in my case it's a bit different from other people mainly because i work for a diplomatic mission.

By using the public insurance, we were covered for 75% of the invoices which includes in-patient "hospitalization" & out-patient visits, we had to pay 100% for dental and we were paying 350 Euros quarterly (we are 3). "The amount is determined by the insurance company" based on your needs.

My advice: If you can get a SIS card, go for a well reputed insurance companies.

As for the private insurance, we are now obligated to be covered by private one, we pay 500 Euros per month, it's an insane amount however, we are covered for in-patient, out-patient, dental,...etc "you pay for what you may not need"  with 100% reimbursement on invoices, but from time to time the insurance company drag an invoice "if it is related to blood tests" too long to be reimbursed.

My advice: Go for it ONLY if you REALLY need it.

I am very satisfied with the health care system and insurance in Belgium.  In fact, I am dreading my return to the US in this area,as my health care costs will quadruple!

From the quality of care-doctors, hospitals, etc. to the accessibility of care. to the cost- I rank Belgium way up their for ex-pats!  I should say that my company reimburses me for the cost, but what I cost is small compared to what companies in the US pay for my coverage.

I am not clear what is the public/private divide in Belgium. As someone mentioned previously, having an insurance is obligatory. We bought it from one of the vendors, with an optional top-up for hospitalization from my employer. For my wife and I we pay a total of EUR 108 / year.

I am an ulcerative colitis patient since last 5 years, and I moved from US to Belgium 3 years back. I visit the doctor at least once a month and I am permanently on medication. Once a year I have to undergo hospitalization for colonoscopy.

For the two years I worked in the US, I was practically destitute thank to the hospital bills, even though I had a decent coverage and cheap healthcare from my employer (a large public-funded US university). My life has regained some degree of sanity after my move to Belgium. In the opinion of my Belgian doctor, my treatment during my US stay was below par, since the advice I was given was influenced by the doctor's estimate of the implied medical costs. Although there could be some bias here, but it is possible that while I was in the US, I flushed money down the drain and suffered for it as well.

Another comparison: my wife has recently moved to the UK. From what I hear, she is shocked at how overburdened and ineffective the UK healthcare is (vis-a-vis Belgium).

Lastly, I am very satisfied with the cleanliness and courtesy of the healthcare staff.

Conclusion: Welcome to Belgium :-)

India --> US --> Belgium

I at first was worried about surgical practices here in regards to cleanliness etc... BUT...I have just had a major surgery 2 weeks ago(main veins in my leg). The quality of care and service in St.Pierre (LLN) was great for the day surgery. The people were very polite and the OR was quite sterile if not a little older. They are in the midst of a complete refurb of all the surgery suites and so the age will be sorted very soon. I had a major surgery in the US and the quality of care was comparable if not better here. I had to do my own prep here(shaving) but otherwise my stay was quite pleasant aside from the surgical and recovery pains. The home care here has been nothing less than a complete pleasure and I found the home care nurse very personable and professional. As for the cost of the hospital stay I have yet to receive the statement but am not really worried. I have had quite a lot of medical services and like another poster have been reimbursed between 70% and 80%. My mutual fee is quite low, I think in the area of 100-150€ by  year as I haven't really kept track. I will keep everyone posted...

I have lived in Belgium for 20 years and I think the healthcare is wonderful. If I'm sick, no appointments, I just go and sit in the surgery during convenient before and after work hours and I'm seen usually within 30 minutes. I've had to call a doctor out late Sunday night and they came within 25 minutes and only charged 80 euros for the call out! I had my twins in hospital here (St. Pierre) and it was a wonderful experience, the staff showed me how to care for them and afterwards I had house visits twice a week for 6 weeks to make sure that I was coping. Belgium has a healthcare system that others can only dream of, and as others have written, it is affordable as well.

So I can only echo the words:- Welcome to Belgium! ;)

I believe the healthcare system in Belgium is at a quite good level, in respect to insurances and general level of doctors. However, there are some problems as well.
No so much attention is paid here to prevention of possible problems. For instance, you go to a doctor and you say you just want a blood-check up, to see if everything is fine. They are not so much willing to do that. You need to already have some problems, which make you feel bad, for them to investigate. With this ideas sometimes it can be already too late to examine your health, if no regular controles take place.
The waiting times for the appointment to the specialist are also too long..sometimes they say you can make an appointment within 3-4 months...?! If there is some serious issue it'll be too late for sure.
Also I have noticed that it's very common to prescribe antibiotics here...for the smallest issue you need to take antibiotics...which is also harmful for your health..
One more negative issue we had with the acute emergency care. The person was injured and was at that moment bleeding. We were waiting in the emergency room for quite some time..for somebody to come. Then there came a doctor with his assistant/trainee. And it was the trainee who put stitches in the wound..not very professional and therefore the scars are also very visible today after already several years...
On the other hand, I want to give some praise to the system as well. Healthcare is accessible, for the locals as well as for expats. You sometimes need to wait for some months, but you still have a chance to have an appointment with the best doctor in the field. The insuarance is in general not expensive and a great amount is paid back afterwards. That however also depends on the doctor. Some doctors are eligible to ask for more money for their services and to cover all this costs you then need to search for a more expensive insurance.

Vragen wrote:

I believe the healthcare system in Belgium is at a quite good level, in respect to insurances and general level of doctors. However, there are some problems as well.
No so much attention is paid here to prevention of possible problems. For instance, you go to a doctor and you say you just want a blood-check up, to see if everything is fine. They are not so much willing to do that. You need to already have some problems, which make you feel bad, for them to investigate. With this ideas sometimes it can be already too late to examine your health, if no regular controles take place.
The waiting times for the appointment to the specialist are also too long..sometimes they say you can make an appointment within 3-4 months...?! If there is some serious issue it'll be too late for sure.
Also I have noticed that it's very common to prescribe antibiotics here...for the smallest issue you need to take antibiotics...which is also harmful for your health..
One more negative issue we had with the acute emergency care. The person was injured and was at that moment bleeding. We were waiting in the emergency room for quite some time..for somebody to come. Then there came a doctor with his assistant/trainee. And it was the trainee who put stitches in the wound..not very professional and therefore the scars are also very visible today after already several years...
On the other hand, I want to give some praise to the system as well. Healthcare is accessible, for the locals as well as for expats. You sometimes need to wait for some months, but you still have a chance to have an appointment with the best doctor in the field. The insuarance is in general not expensive and a great amount is paid back afterwards. That however also depends on the doctor. Some doctors are eligible to ask for more money for their services and to cover all this costs you then need to search for a more expensive insurance.


I must stress I am in no way intending to be rude...
Hospitals are the same all over... They triage their patients as to the severity of issues. Some are better than others. You can potentially be bumped back if a more severe case arrives even hours after you have. As to the scarring if it was a severe wound with lots of damage there really isn't much more a seasoned practitioner could do than a trainee. If the trainee  has progressed to the point where they are allowed to work in the ER then they have been vetted in my opinion.
If you have already been to your primary care physician they can request an appointment for you based on urgency/severity of the issue. In my case I had a Thrombosis in my leg in the superficial veins. It took some time but seeing as it was not potentially life threatening I wasn't too worried. I needed to lose weight and tone my body and musculature a little anyways to improve the outcome of the repalcement surgery. If you make regular visits to your Dr. they can and will do preventive medicine. Most people only go when there is a reason, they are ill or in need.
Your comparison of the doctors is like apples and oranges in my opinion. Not trying to be rude but having your car repaired at the neighborhood garage and the dealership will be significantly different. The training required befits the pricetag in my opinion. I'd happily pay more for my vascular surgeon to have done my surgery than my general doctor. Once again not trying to be rude...

Also not intending to be rude, but I have scheduled an annual check-up with my doctor in Belgium without any problem at all! Women get gynaecological check-ups, free breast mammography over a certain age, and men get their prostates checked. You can schedule a colonoscopy to check for bowel cancer as well. As far as I understand, if you only asked your doctor for a blood test rather than a general check-up, he may well have been reluctant given that just a blood test on its own is not always useful. And that has nothing to do with Belgium...

Well...what can I say. I shared my experience. I'm glad there are better experiences. A lot depends on the hospital and the doctor, that's in every country.
As for comparisson of the doctors..I said some are eligible to ask for higher amounts, nothing wrong with that for me. I wrote this to inform those who have doubts regarding their insurances.
For appoinments..again my experience. Sorry for this point, but I am 99% sure not only mine. Gynaecological check-up you'll never find a person who can make an appointment with you the same week. If only by some occasion some other person cancels. Probably a good idea, if you have experience with doctors who normally do not have long waiting times, please share. That would be useful.

As for triaging of patients..sorry, but that's not fine to my mind. The person was bleeding, there were serious wounds and we had to wait for almost an hour. Also I had good experience with emergincy care  in a different hospital, 
so I tend to think that we just had bad experience with this particular hospital.

After my experiences in different countries, I can say that the Belgian medical services are not so bad as that. They are not perfect, but it's true there are worse elsewhere, much worse ...
By cons, there are some subtleties that must be taken into account. Like for example:
- If you take a private room in a hospital, it allows physicians to ask any price ... So when you receive the final invoice, you may be very unpleasantly surprised.
- In addition to the compulsory basic medical coverage, you can take out additional insurance to cover more risks. But we must take the time to compare because the terms are different in different societies ...
- Take the time to establish a global medical file to a general practitioner, it will centralize all of your medical information and help medical specialists to fine-tune their diagnosis.
- Mutual associations have their own clinics, so for a problem or a basic monitoring, go without fear rather than cluttering the emergency rooms in major hospitals.

There are still many more examples ...