MEDICAL CARE INSURANCE FORMALITIES, COMPLEMENTARY AND PRIVATE INSURANCES

Please go to the admissions office so as to receive all relevant documents for reimbursement by the medical care insurer and your complementary or private hospitalisation insurance. Keep all receipts of paid amounts for admission and renewal deposits if the child has spent more than a week in a hospital. You receive your final invoice approximately two months after the hospitalization of the child.

The majority of the costs is directly refunded to the hospital by the medical care insurer in the context of the  third-party payer system. The patient receives an invoice for his personal payment share. In all correspondence with the hospital, quote the reference and date of the invoice. Private insurers require itemized bills, which you can ask to the billing department.

How does a bill is to be read?

1. The heading related to the stay expenses indicate the number of hospital days and the amount paid per day, meals, heating, nursing, etc. These costs are largely refunded by medical care insurer.

The amount the patient is to pay for each day of hospitalization is different: a specific amount is applied in the day of admission; another amount is applied from the 2nd day until the 90th day of hospitalization and the amount still differs from the 91st day of hospitalization.

Cf. : http://www.mutsoc.be/Mutsoc/MaSituation/Argent/Hospitalisation/Cout-hopital/frais-fixes.htm

(01 january 2011) The first day is charged € 41.70 for recipients with or without dependents, € 32.39 for unemployed and his  descendants and € 5.12 for MTB and Omnio. From the second day, the amounts are € 14.43 for recipients with or without dependents and 5.12 € for unemployed, MTB and Omnio.

The drug expenses subheading includes the fixed costs of medications, consumed or not (daily rate of € 0.62). The consumed drugs are charged in the pharmaceuticals expenses subheading.

The standard medical fees per day of hospitalisation subheading will be fully supported by medical care insurer.

2. Pharmaceutical expenses

The pharmaceutical and para pharmaceutical expenses subheading includes charges for drugs that are administered during the stay.

The refundable products subheading includes the total amount of drug that are to be billed to the medical care insurer, without detail.

The non refundable subheading gives details of each medication (name, quantity and price).

The implants, prosthetic devices and medical non-implantable heading presents the expenses for which refund is very limited. However, some items such as endoscopic and viscerosynthesis equipments used in many operations are refundable to up to 10%. This means that 90% of the cost of this material is at your expense. However, this amount comes into account for the MTB.

3. The medical and para medical expenses heading bills various fees.

The admission fee subheadings include the standard fees charged by period of hospitalization. They are supposed to better distribute and limit medical expenses such as radiographies and clinical laboratory tests. These expenses are to be paid by the patient and are fixed to € 7.44 for the clinical laboratory tests and to 6.20 € for medical imaging. For beneficiaries of the preferential tariff, the amounts involved are respectively to €0 and € 1.98.

The expenses heading shows the chargeable fees for the services of doctors, dentists, physiotherapists and midwives. Monitoring fees (limited to € 8.68 per day) will be charged. They concern the availability of a doctor even when the child has not seen the doctor. The law allows a supplement for technical services at an amount of 16.40 €, only charged on the first day of hospitalization.

The other cares heading includes medical benefits (plaster, breast milk, blood, prostheses if they are not charged in pharmaceutical expenses) that are not detailed elsewhere on the bill the invoice.

4. Other expenses: non-medical expenses such as telephone, television, accompanying meals, etc. These costs are reimbursed by the medical care insurer or by the hospitalization insurance. Hence, the need to read the contract you signed with a private insurance company.