Your Healthcare Costs

The total cost of medical care for your baby's birth—including pregnancy, birth, and postnatal care—can differ significantly based on your choices and personal situation. While knowing the overall cost is important, you will need to explore what you will need to pay and what is covered by your insurance.

What’s covered here:

• Mandatory Healthcare and Indemnity Insurance

• What costs are covered for pregnancy and birth?

• What if you are NOT covered by Belgian social security?

• What can be covered with additional hospitalisation insurance?

• How much does it cost to give birth in Belgium?

• Benefits that can ease the financial burden

Mandatory healthcare and indemnity insurance

In order to benefit from cover under mandatory healthcare and indemnity insurance to and/or your partner need to be registered with a ’mutuelle’ or ziekenfonds’. Then you will be able to receive various allowances, including:

• refunds for consultations with a doctor

• fixed allowances for hospitalisation

• the payment of allowances in the event of being unable to work or pregnancy/maternity

These payments can differ depending on whether you are a salaried worker or self-employed 

Basic refunds

Mandatory healthcare cover entitles the policyholder to a basic refund, i.e. to a refund for certain types of medication, and an allowance for numerous healthcare services given by healthcare providers, such as:

• doctors

• dentists

• physiotherapists

• nurses

• midwives

The fees charged by healthcare professionals may differ, depending on:

• the category to which they belong (qualified, in training, etc.)

• their area of specialisation (dermatology, gynaecology, paediatrics, general medicine, etc)

• their place of the consultation (at the doctor’s practice, at home, etc.)

• the time of the consultation (evening, weekend, etc.)

How much does it cost to give birth in Belgium?

Your mutuelle/zienkenfonds covers approximately 50-75% of the majority of your healthcare costs, including most of the cost of your hospital stay after the birth if you choose a ‘shared’ room. In Belgium, a ‘shared’ room is usually only for two people.

For care that is:

• not related to the actual birth (e.g. consultations with your care provider, physiotherapy sessions etc.), you usually have to pay the full amount at the time, and then submit a claim for reimbursement. These claims usually have to be submitted within one year
  

• related to the birth (whether homebirth or hospital birth), a third-party payment system is usually in place. These medical bills are paid directly by your mutuelle, with any supplements either being paid directly by you, or by your ‘top-up’ hospitalisation insurance, if you have an additional policy

What if you are not covered by the Belgian social security system?

• If you work for the European institution, Eurocontrol, one of the European schools, the UN, NATO or SHAPE, please check with your employer which medical costs will be covered and how you need to submit claims.

• If you are an EU citizen and have a European Health Insurance Card (EHIC) you are entitled to any necessary medical care under the same conditions and at the same cost as someone who is covered by the Belgian mutuelle system as explained above.

• If you are not an EU citizen and/or do not have an EHIC, you may be responsible for all medical expenses incurred. If relevant, check with your employer which medical costs will be covered.

  In Belgium, even women without insurance find that their pregnancy costs are covered. This is courtesy of the Public Social Welfare Centre (Les Centres Publics d’Action Sociale, CPAS, in French, or Openbaar Centrum voor Maatschappelijk Welzijn, OCMW, in Dutch).

What can be covered with additional hospitalisation insurance?

You may also have additional ‘top-up’ hospitalisation insurance as part of your employment package or may have arranged this yourself. 

Top-up hospitalisation insurance often covers most, if not all, of your outstanding hospital bill, i.e. the part that your mutuelle does not cover. Under some policies, you may not need to pay any deposit at your hospital.

Often hospitalisation insurance reimburses ALL maternity-related medical bills you incur in the period starting one month before and ending three months after the birth (sometimes called the ‘hospitalisation period’), e.g. consultations with your care provider, pre and postnatal physiotherapy sessions, the presence of your physiotherapist at the birth

Check with your insurance company how their policy works and what you have to do to have these costs reimbursed. You may need to keep a copy of the bills you send to the mutuelle for reimbursement, and then send these to the hospitalisation insurance provider, who will reimburse the outstanding portion.

Check the small print of your insurance policy to know what is covered, and to find out what extra services you may be able to take advantage of.

What costs are covered for pregnancy and birth?

The fees that a healthcare professional charge depend on whether or not they are ‘conventionné / ‘geconventioneerd’. A healthcare professional who is ‘conventioned’ adheres to the fee schedule fixed in the convention with the mutuelle. One who is not conventioned fixes his/her fees freely, and costs can vary considerably.

Some doctors are conventioned doctors in everything they do. Others are only partly i.e. they abide by the rates sets by INAMI on certain days, at certain times (e.g. for consultations at the hospital), whereas they are free to decide on what to charge in terms of fees at other times (e.g. for consultations at home).

Your mutuelle will reimburse you the same amount for e.g. a visit to a gynaecologist, irrespective of whether the care provider is conventioned, so your final ‘out-of-pocket’ costs will be lower if you choose a conventioned doctor.

At many care providers you will need to pay up front and then submit a request for reimbursement, while some offer a third-party payment system where you do not need to pay yourself.

Reimbursements are usually processed quickly, and are typically paid onto your bank account.

The two main factors that influence how much it costs to give birth are:

• whether you give birth at home or in hospital – giving birth at home will cost you virtually nothing, and some mutuelles even pay an extra bonus of up to €500 if you have a homebirth!
    

• whether you choose a 1-bed or shared room on the maternity ward – most hospitals offer a choice between a single room and a ‘shared’ room, which usually has only 2 beds (sometimes 3). If you choose a single room, not only do you pay a supplement for having a single room, but ALL the care that you receive during your time in hospital can be up to 200% to 300% more expensive. However, if you receive a single room without specifically requesting one, then the ‘shared room’ costs apply 
  
  Some hospitalisation insurance covers all costs related to the birth, including any single-room supplements. So it’s worth checking the small print of your policy before making a decision on the kind of room you would like

Another factor to consider may be the kind of hospital you choose (i.e. public hospital, private clinic or university hospital).

Some hospitalisation insurance policies cover all costs related to giving birth, irrespective of where you give birth or what kind of room you choose, so price need not be a factor in your choice of hospital. However, if you do not have such comprehensive coverage (e.g. if you will not benefit from reimbursement from the mutuelle), it might be worth keeping in mind that:

• university hospitals are generally more expensive that non-university hospitals (whether ‘private’ clinics or ‘regular’ non-university hospital), but the mutuelles reimburse a larger proportion of those costs.

• supplements (i.e. costs over and above the amount that the ‘mutuelle’ / ‘ziekenfonds’ will reimburse) in private clinics are generally higher than in public hospitals.

How do you know how much it will cost in the hospital you choose?

All hospitals should be able to provide you with a fee schedule, so that you can see how the costs are broken down – you will probably have to explicitly ask for this. A fee schedule will give you a guideline cost. The exact cost for your birth will be individual to you and depend on your care needs

Some mutuelles also provide hospitalisation cost simulators, which lets you compare hospital costs, and can give you a general idea of the difference between hospitals.

Benefits that can ease the financial burden

If you are covered by the Belgian social security system, make sure to take advantages of the following financial benefits:

• The Belgian state offers a generous one-off birth allowance (‘prime de naissance’ / ‘kraamgeld’) of around €1300 for each child that is born, paid by a family allowance agency.

• And as well as covering medical expenses, mutuelles and hospitalisation insurance policies also offer a range of benefits to help alleviate the financial burden of having a baby, and generally make your life easier! These include:

  • ‘birth bonus’ from the mutuelle and subsidised domestic help via ‘titres services’ / ‘dienstencheques’

  • subsidised babysitting if your baby is too sick to go to daycare

Check with your mutuelle what other benefits they offer for new parents. Depending on the mutuelle, you may find extra reimbursements for pre- and post-natal physiotherapy, bonuses for breastfeeding, rental of equipment such as breast pumps etc