Health Care Insurers, health care, insurances…

Why shall I have a health care insurance (mutuelle)? What is it for?

Each Belgian citizen has a compulsory health care insurance, whether the citizen is employed or not. The Belgian population is to choose a health care insurer. It can be private (Mutuelle) or public (such as the Auxiliary Fund for Sickness and Disability - Caisse Auxiliaire d’Assurance Maladie-Invalidité - CAAMI).

Each individual being affiliated with a health care insurer can be reimbursed for his health care and the purchase of medicines.

The services covered by the health care insurance are listed in a nomenclature, adjusted according to developments and advances in medicine. It covers medical care, medical appointments with general practitioners and specialists, dental care, childbirth, provision of medicines, hospitalization and the likely requested care in the context of rehabilitation. Only services listed in this nomenclature are to be reimbursed (partially or fully), whether the individual has chosen a private or a public health care insurer.

Compulsory health care insurance falls under the jurisdictions of the Federal Public Service for Social Security, Health, Food Chain Safety and Environment. It is the National Institute of Sickness and Disability (INAMI – Institut National d’Assurance Maladie-Invalidité) that enforces the law.

The reimbursements for health care and medicines are effected by health care insurers (mutuelles), which are grouped in five national unions:

• National Alliance of Christian Insurance Fund (100) [website]

• National Union of Neutral Insurance Fund (200) [website]

• National Union of Socialist Insurance Fund (300) [website]

• National Liberal Union Insurance Fund (400) [website]

• National Union of Free and Professional Insurance Fund (500) [website].

Find all contacts in the website of the INAMI: http://www.inami.be

In practice, the affiliates are in contact with the health care insurers (mutuelles), not with the national unions of insurance funds.

Auxiliary Fund for Sickness and Disability (CAAMI) (600) [website]

Health Care Fund of the National Society of Belgian Railways (900) [INAMI website].