Am I entitled to reimbursement if I send my medical expenses to my health insurance fund upon return to Belgium?

Yes, during your stay abroad, your medical care is covered by the compulsory insurance and the complimentary insurance of your health insurance fund.

If you did not use your EHIC or an equivalent document to ask for a reimbursement in the country you have stayed in, you can submit your medical bills to your Belgian health insurance fund to ask for reimbursement.

The health insurance fund will first analyse your file before doing a reimbursement by the compulsory insurance and possibly the complimentary insurance. 

 

The reimbursement level and the reimbursment procedure may differ, depending on the country you have travelled to.

  • Member States of the European Union, Switzerland, Norway, Iceland, Liechtenstein, Albania, Algeria, Bosnia-Herzegovina, North Macedonia, Montenegro, Morocco, Serbia, Turkey, Tunisia:
    • if all of your medical expenses are lower than 200 €, the health insurance fund will reimburse 75% of the medical expenses, if these expenses are reimbursable according to the Belgian legislation  
    • if all of your medical expenses are higher than 200 €, the bills will be sent to the country you were treated in, with the request to clarify which amount would be reimbursed by this country, according to their legislation. A complimentary reimbursement is possible thanks to the complimentary insurance, if all conditions are met.
  • Andorra, Egypt, Israel, Jordan, Kosovo, Lebanon, Libya, Monaco, Palestine, San Marino, Syria, and Vatican City: the compulsory insurance reimburses urgent hospitalisations. A complimentary reimbursement by the complimentary insurance is possible for hospitalisations and urgent ambulatory care if all conditions are met.
  • Australia: we recommend to use the EHIC, since no reimbursement by the Belgian health insurance is applied upon return to Belgium.
  • Rest of the world: the Belgian health insurance fund will only reimburse a very limited amount under the compulsory insurance. Only expenses for an urgent hospitalisation qualify for a possible reimbursement. Therefore, we advise you to underwrite a travel insurance with an insurance company that offers sufficient coverage for medical expenses and repatriation, especially for countries like the United States of America, Japan or Canada.

 

The complimentary insurance of your health insurance fund offers the service Emergency Care Abroad (ECA). If all the ECA conditions are met, certain medical expenses qualify for complimentary reimbursement. The conditions are:

  • you have paid your contributions for the complimentary insurance before you left Belgium.
  • the medical treatment has to be urgent and unexpected, even for a chronical illness or an existing illness. If you suffer from a chronical illness or an existing illness, your health should be good enough for the trip not to worsen your condition. 
  • the medical expenses have to be done within three months starting from the first day on which the medical care has been administrated. For students who study in a Member State of the European Union or in Norway, Iceland, Liechtenstein or Switzerland, a 12-month-coverage period applies starting from the day of departure.
  • ECA offers a possible reimbursement of medical expenses if the medical treatment has been administrated in a EU Member State (except Belgium), in Norway, Iceland, Liechtenstein, Switzerland, Andorra, San Marino, Monaco, Vatican City, Albania, Libya, Egypt, Syria, Israel, Jordan, Palestine, Lebanon, Morocco, Tunisia, Algeria, Turkey, Serbia, Kosovo, North Macedonia, Bosnia-Herzegovina, or Montenegro. For all other countries, there is no reimbursement by the complementary insurance.
  • For urgent ambulatory care (all medical treatment for which you did not have to stay a night in the hospital), a maximum of 75% of the medical expenses will be reimbursed upon your return, if all the ECA conditions are met. Medical expenses for ambulatory care due to a winter sports accident are fully reimbursed. Hospitalisations and haemodialysis, oxygen therapy, radiotherapy and chemotherapy are fully reimbursed if a file has been opened by the assistance centre.
  • transportation expenses after an accident or illness (e.g. from the place of the accident to the hospital) are reimbursed. Transportation expenses for haemodialysis, oxygen therapy, radiotherapy and chemotherapy are reimbursed up to a maximum of 100 € per month.
  • If for a humane or medical reason, the presence of the partner or another family member is necessary, the stay expenses (hotel, meals, taxi, ...) will be reimbursed during a maximum of 10 consecutive days, for an amount of maximum 100 € per day.
What do I have to do to have my medical expenses reimbursed?

You need to send the original bills to the health insurance fund. A reimbursement can never take place based on copies.

If the exact nature of the treatment is not mentioned on the bill, it is advisable to ask the foreign doctor to write an explanatory certificate. You can always send the medical reports to your health insurance fund as well. When you buy drugs, the pharmacy’s bill must clearly mention the drugs you have bought. We advise that you to send the prescriptions as well.

Do not forget to add the proof of payments for all the bills.

How much time do I have to send my medical expenses to the health insurance fund?

You have 2 years to send all the bills to your health insurance fund. Example: you received medical care in Spain on 25/07/2019. Your health insurance fund needs to receive the bills before 01/08/2021.