Doctor
How does the healthcare system work and how do you consult a doctor in Belgium?
In Belgium, it is customary to have a regular general practitioner (GP). This is a general doctor you can visit when you are ill or need medication. In addition, there are specialist doctors who usually work on referral, often from a hospital, and who focus on specific conditions or parts of the body.
How does social security work?
Belgian Social Security is funded by:
- the Belgian State
- social security contributions (contributions to the National Social Security Office) that are deducted from your salary if you are employed, or paid through social contributions if you are self-employed.
The health insurance fund, the intermediary between the NIHDI (National Institute for Health and Disability Insurance) and its members, is responsible for:
- the reimbursement of medical care (hospital, doctor, pharmacy, …)
- the payment of replacement income in the event of long-term illness, an accident or childbirth
Who should you consult and at what cost?
Contracted or non-contracted healthcare providers
The fees charged by healthcare providers depend on their status: contracted or non-contracted.
- Contracted healthcare providers follow the official fees set in the national agreement between doctors and the health insurance funds.
- Non-contracted doctors charge an additional amount on top of the official fee. This is known as a fee supplement.
- Non-contracted doctors must clearly inform their patients that they are not contracted, for example by displaying a notice in the waiting room.
- Fee supplements are never covered by the compulsory health insurance.
- Some doctors are partially contracted, for example only in the hospital or only in their private practice. In that case, they must clearly indicate on which days and at what times their fees differ.
Don’t hesitate to ask your doctor about their status. Or check it using the NIHDI tool.
eAttest or paper medical certificate
Most GPs work with an electronic medical certificate: the eAttest.
- The doctor sends proof of your consultation directly to your health insurance fund in digital form.
- You don’t need to submit anything yourself.
- Helan automatically transfers the reimbursement to your account.
Did you receive a paper medical certificate? Attach a white Helan sticker and send it by post (Boomsesteenweg 5, 2610 Wilrijk) or drop it in a Helan letterbox near you.
Full payment or the third-party payer system
The third-party payer system determines how much you pay at the doctor’s. If your GP applies this system, they charge the largest part directly to your health insurance fund. You only pay the copayment, usually just a few euros.
In other cases, you pay the full amount first (around €25 to €35).
- If your doctor uses eAttest, the reimbursement is processed automatically.
- With a paper medical certificate, submit it as explained above.
How to request reimbursement for your medical costs with Helan?
A doctor’s visit, new lenses for your glasses or a hospital stay… These costs are sometimes part of life. Luckily, Helan Health Insurance makes your reimbursement as simple as possible. What you need to do depends on the type of reimbursement.
Compulsory health insurance
Have you visited your GP or a specialist and received a medical certificate (also called a certificate of care provided)?
- Attach a white Helan sticker.
- Send us the original document by post or drop it in a Helan letterbox near you.
- We’ll take care of the rest. As soon as everything has been processed, your reimbursement will be transferred to your account.
Most GPs and dentists now work with eAttest. As a patient, you no longer receive a paper medical certificate (also called a certificate of care provided), but a proof of payment. This makes things easier, because you don’t need to submit anything yourself to your health insurance fund. Your doctor arranges everything directly. Your reimbursement will appear in your account within 3 working days.
Extra advantages
For certain health and prevention costs, you can receive an extra reimbursement through your Helan advantages, for example for glasses or a visit to an osteopath.
You can arrange this quickly online:
- Take a photo of your proof of payment or invoice.
- Submit your request via the Helan app.
- No paperwork needed – just quick and easy.
Insurance
Is it about an accident, a hospital stay or dental care covered by your insurance? Then you submit your request through your insurance file. How you arrange everything depends on the type of insurance: Hospitalisation insurance or Dental insurance.
General practitioner
You are free to choose your own doctor. In some cases, municipalities and embassies can provide more information about doctors in your area.
In addition to open consultation hours, many doctors also work by appointment. Do you need a doctor outside consultation hours? Then you can contact the on-call GP in your region.
Don’t forget to open a Global Medical Record (GMR), which contains all your medical information (operations, chronic illnesses, current treatments, etc.). You benefit from a slightly higher reimbursement when you visit the doctor who manages your record.
Specialist doctors
In Belgium, alongside GPs, there is also a network of specialist doctors available. Your GP can guide you and refer you to the right specialist based on your needs.
Dentist or orthodontist
Preventative and curative dental care is partially reimbursed by the compulsory health insurance:
- You must visit the dentist at least once a year to qualify for reimbursement.
- For orthodontic treatment before the age of 15, you must submit a medical request to the health insurance fund’s medical adviser.
Dentalia Up dental insurance
A bright smile with healthy teeth is not only beautiful, it’s also important for your overall health. From preventative dental care to orthodontics and prostheses, Dentalia Up supports your dental care budget at every stage.