In Belgium, it is standard practice to have a 'family' doctor who is a general practitioner, whom you visit when you are ill or when you need a medical prescription.
It is this doctor who opens your Global Medical dossier and can refer you to specialist doctors. Doctors' fees can vary depending on whether or not they are 'conventioned', but the reimbursements are fixed.
Belgian Social Security is funded by State subsidies and social security (NSSO – National Social Security Office) contributions, which are deducted from your salary if you are employed or covered by social legislation if you are self-employed.
The mutuality acts as an intermediary between the INAMI (National Institute for Health and Disability Insurance) and its clients and makes it possible to:
The fees charged by a healthcare provider depends on their status: "conventioned" or "non-conventioned".
'Conventioned' healthcare providers respect the official price set by the 'Medicomut agreement', which is an agreement between doctors and health insurance companies setting the official fees. '
'Non-conventioned' healthcare providers charge supplements on top of the official price. These supplements are never covered by compulsory insurance.
Do not hesitate to ask your doctor what their status is or check the tool of the INAMI.
You are free to choose your own general practitioner. Municipalities and embassies are sometimes able to provide you with more information on the doctors in your area.
They normally work on an appointment basis and also offer walk-in consultations without an appointment. If you need a doctor outside consulting hours, there is generally an on-call doctor available in your region.
Don't forget to open a Global Medical Dossier (DMG), which contains all your medical consultations and examinations in a single file. You will also receive a slightly higher reimbursement from the doctor responsible for your dossier.
Your family doctor can refer you to a specialist or hospital. However, this is optional for consulting a specialist in Belgium. Please note that if you see a specialist without a referral from your family doctor, you will pay more than if you have such a referral.
Preventive and curative dental treatment (consultation, oral examination, pit and fissure sealing, tartar removal, periodontics and X-rays) are partially covered by compulsory insurance. You must visit the dentist at least once a year to be reimbursed.
For orthodontic treatment, a medical request must be submitted to the medical advisor of your insurance company before the age of 15.
For a higher reimbursement of your medical costs, we offer supplementary insurance: Dentalia Plus.
Reimbursements of medical costs are based on the reference codes (INAMI/RIZIV codes) linked to the treatment.
You pay the doctor for the consultation and request reimbursement afterwards. Place an identification sticker onto the medical attestation (attestation de soins donnés / getuigschrift voor verstrekte hulp) that you received from your doctor. There are two options for receiving a reimbursement to your bank account:
Note: for reimbursements, you must send us your medical attestations at the latest two years after the consultation date. You can no longer receive a reimbursement after this period.
Check the overview of your reimbursements on MyPartena, your online desk, at any time.
The identification stickers allows us to guarantee that your documents are traceable.
Please add one to every document so that we can process them effectively.
What if you run out of stickers? Order more via your online desk or call our offices.