European directive 2011/24/EU
What if you have no European Health Insurance Card* (EHIC) or if you have not been able to use your EHIC* (because, for example, the healthcare was provided by an individual private healthcare provider or in a private hospital)?
Reimbursement will take place according to the rules and rates applicable under the Belgian compulsory health insurance system*. This means that:
- healthcare is only reimbursed if it is also reimbursed in Belgium;
- the reimbursement can not be higher than the sum reimbursed for this type of care in Belgium.
The amount repaid can not be higher than the amount which you paid for the healthcare in question.
What should you do?
Firstly, you should pay up front the full amount for the healthcare received abroad. On your return home, you should submit the invoices to your Belgian health insurance fund* and claim reimbursement.
You fall ill during a short stay in Spain and are admitted to a private hospital. You pay the full amount, and on your return you submit the original invoice to your health insurance fund*. Your health insurance fund* will reimburse the costs, according to the rules and rates applicable under the Belgian compulsory health insurance regime.
When can you claim reimbursement on the basis of the rules and rates applicable under the Belgian compulsory health insurance regime?
You can choose this type of reimbursement when:
- you have not been able to use your EHIC*;
- you receive healthcare during a short stay abroad and decide not to use your EHIC* (e.g. for healthcare supplied by a healthcare provider* working within the public health system). In this case, you must firstly pay the costs yourself and you may later claim reimbursement from your Belgian health insurance fund*.
If you live in Cyprus*, Finland, Ireland, the Netherlands, Portugal, Spain, the United Kingdom, Sweden, or Norway,
On your return home, you must submit the invoices to the health insurance fund* in your country of residence and claim reimbursement. Reimbursement shall be according to the rules and rates applicable under the public health insurance regime of your country of residence.
Contact your health insurance fund*.
* cf. Glossary