Healthcare in Belgium
The quality of healthcare in Belgium is of the highest level. However, the system for accessing health care is rather different to that in the UK.
Most employees of private/public companies in Belgium are automatically enrolled in a Mutuelle or medical insurance company. There are several such Mutuelle companies, and people are given the choice of which of them to use. Some self-employed people, and people working in Belgium for an international organisation are not obliged to join a Mutuelle. They work for organisations such as NATO, the EU Institutions, or as a diplomat (at an embassy).
Choose your doctor
Everyone has a free choice of which doctors and dentists to see, and which hospitals to visit. Doctors and dentists operate in a competitive market, based on their reputation and, often, their working languages. Most work from a purpose-built “cabinet” (surgery or office) in their own home and do most of their administration for themselves. They are very local and accessible, and waiting time for appointments, if any, is minimal.
Not free at the point of use
The fees they charge will vary from doctor to doctor. Patients have a choice. Specialists also work in one or more hospitals, where fees charged by the doctors themselves are generally lower. There are often additional fees for other services and facilities used within the hospital.
Everyone pays something for any medical care they receive – nothing is for free at the point of delivery. After a routine GP appointment the patient pays the doctor in full by cash or card and obtains a receipt which they may then use to claim back all or part of the cost from their Mutuelle, or any other health scheme they may have.
The same process applies for prescriptions. Patients pay for their medicines and then claim back what they can. This applies also to visitors from other countries: who will normally either have an EHIC/GHIC card or travel insurance. The Mutuelle will pay almost the entire fees charged by the less costly GPs and dentists, but most people will end up paying perhaps 10€ or 20€ per visit for themselves.
Admission to hospital
Same thing for hospitals. A GP can give their patient a referral to any hospital and will normally choose one that has the best specialists or facilities needed for the required treatment, or the shortest waiting list. Once registered with the hospital, using an ID card and a credit card, a patient may choose the “quality” of the ward they use – private rooms come at extra cost – and which specialist they see, if pre-arranged.
Regular patients of a specialist need not consult a GP at all. Hospitals then invoice a patient for the total costs incurred. For more serious operations or expensive tests, it is often possible for the patient to arrange direct billing to the Mutuelle or insurance company. In the case of an accident or emergency this is not possible, so patients need to provide their ID and credit card in order to be treated.
Avoid ambulances at all costs!
Ambulance costs are very expensive and many mutuelles have specific rules on when the cost of these can be reimbursed. In general, it is best to avoid using an ambulance unless there is no alternative.
Healthcare in Belgium is quicker and more efficient
Patient records are shared online amongst the appropriate healthcare providers, and patients themselves normally keep a full record of all the treatment they receive.
In normal times – without Covid – Belgium is a very good destination for healthcare tourism. Routine treatments such as knee and hip replacements are usually available much faster there than in the UK. The NHS has itself been known to use the capacity available in Belgian hospitals to help reduce the most serious waiting times encountered in the UK.
Safety Net For People With No Income
A doctor or public hospital in Belgium cannot deny urgent medical treatment to a patient who has no means to pay. An organisation called CPAS (Centres Publics d’Action Sociale or public social services centres) has the responsibility of guaranteeing dignified living conditions for all.
To this end, they offer a wide range of measures, which are available to the most disadvantaged people in some, specific, circumstances. Applications for non-urgent assistance are assessed – means-tested – by a social worker and either approved or rejected by the CPAS’ Conseil de l’Action sociale (social work council).
For further details see https://be.brussels/about-the-region/les-centres-publics-daction-sociale-cpas