The Belgian healthcare is based on the Social Security system. You pay the
visit at the surgery and prescriptions or medicines at the pharmacist. If
the system of direct payment (tiers-payant, see below) is not applied, you must
put the stickers of the medical boxes on your prescription and send everything
to the medical organisation in charge of giving the refund of what you pre-paid.
At the surgery, with the doctor (GP)
The amount of refund from the insurance in the cost of the act varies according
to the status of the doctor (General Practitioner or private practitioner),
the kind of act and the status of the patient. There are 3 types of practitioner:
- GP with convention: This category groups most
of the GP. They follow the rates agreed with the State in all their acts,
except if the patient has got specific requirements (e.g. visit at home).
- GP with partial convention: they are often specialists
that only apply the rates agreed at certain hours of the day.
- Private practitioner (no convention): They have
not agreed a specific rate and they can fix freely their fares.
The part that remains in charge of the patient is called quote-part
personnelle or ticket modérateur (share). Usually
it is 25 %.
People who are registered with a medical record (called dossier médical
global - DMG) and who have chosen a specific GP (it is always possible to
visit another GP but the chosen GP - médecin traitant - will centralized
the data of the DMG), get a 30% discount of the quote-part
for the acts in the surgery (medical visits at home are not counted). The patient
asks to update the record in the DMG at each visit.
At the pharmacy
With a prescription done by the GP, you do not pay usually the full amount.
The refund is automatically applied in advance. It is called the tiers-payant.
Pharmacies are open from Monday morning to Friday evening and often on Saturday
morning. Some pharmacies provides, in a rota, a 24h service on Saturday afternoon
and Sunday (addresses are displayed each month on the windows of the pharmacists).