European directive 2011/24/EU

Reimbursement

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.

Example
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*.
 

Attention !

If you live in Cyprus*, Finland, Ireland, the Netherlands, Portugal, Spain, the United Kingdom, Sweden, or Norway,
and
- you currently receive a Belgian pension or a Belgian disability allowance, and if you, and the members of your family, are entitled to receive healthcare in that country, the cost of which is to be borne by Belgium,
or
- if you are entitled, as a family member, to healthcare in that country, the cost of which is to be borne by Belgium, while the main beneficiary lives in another country of the European Union*, Iceland, Liechtenstein, Norway or Switzerland,
and
if you were, during your temporary stay in another country – with the exception of Belgium – unable to use your EHIC* (because, for example, the healthcare was supplied by a private healthcare provider or in a private hospital),
then
you must first pay the costs yourself up front.

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.

Example
You receive a Belgian pension and live in Spain, where you are entitled to healthcare, to be paid for by Belgium. You have an accident during a holiday in Italy and are admitted to a private hospital. You pay the full amount of the hospital bill, and when you get back home, submit the original invoice to the Spanish health insurance fund*, which will reimburse the costs according to the rules and rates applicable under the Spanish public health insurance regime.
 

 

More info?

Contact your health insurance fund*.

 

* cf. Glossary