Planning your care abroad

If you are planning to receive scheduled medical treatment outside of Belgium, it is essential to be aware of your rights and duties as a patient.

Important notice :

• Hospitalizations of at least one night always require prior authorization
• In general, planned outpatient care does not require prior authorization from the medical council, except in the case of certain medical imaging.

What is a planned treatment ?

Planned care refers to medical treatments or services that are planned in advance in another country. This type of care is governed by guidelines other than those of urgent or unexpected care.

Plan your care within the European Union, Switzerland, Norway, Iceland and Liechtenstein

Plan your care outside the European Union, Switzerland, Norway, Iceland, Liechtenstein

Plan your care within the European Union, Switzerland, Norway, Iceland and Liechtenstein

As a general rule, European regulations offer citizens the opportunity to receive healthcare in another member country of the European Union, Switzerland, Norway, Iceland and Liechtenstein because they guarantee free movement within European territories.

However, coverage of your planned treatment is not guaranteed, and it is important to be aware of the specific eligibility conditions.

Indeed, some treatments require prior authorization from the medical advisor of your health insurance fund.

What is prior authorization ? 
Prior authorization is an authorization granted by the medical council of your health insurance fund, on the basis of the applicable regulations in force and in the context of certain scheduled treatments.

This authorization guarantees partial coverage of care by the Belgian compulsory health insurance.

Care subject to prior authorization
The NIHDI has drawn up a non-exhaustive list of treatments subject to the prior authorisation of the medical council.

To find out more, visit the INAMI website

• Prior approval does not automatically guarantee immediate financial support on site.
• A co-payment and any additional fees may remain at your expense

→ Procedure for requesting prior authorization

1. Send a written request to the medical service of your health insurance fund by registered mail or email. The written request can be made by a specialist doctor or by yourself.
2. Attach a medical report written by the specialist doctor in the context of the requested care.
3. The medical council will inform the insured person in writing of his decision.

Care not subject to prior authorization
To benefit from a financial contribution for your scheduled care abroad, with the exception of the list drawn up by the INAMI, you do not need to have prior authorization from your medical council.

To be able to benefit from any coverage of this scheduled care, you will have to :

• Introduce, a posteriori, a complete file including your paid invoices, prescriptions and medical reports to your Neutral Health Insurance Fund.
• Completing a sworn declaration "Care abroad"

Remark :

→ The refund will be made on the basis of the conditions and rates in force in Belgium
→ If the treatment received is not reimbursable in Belgium, or if you do not meet the Belgian reimbursement conditions, no reimbursement will be granted. (for example: it will be checked whether an agreement has been issued for services that require one within the meaning of Belgian legislation, such as, for example, a physiotherapy agreement or an agreement for a hearing aid.)  )
→ Supplements and a co-payment may remain at your expense

How to submit your application afterwards

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Plan your care outside the European Union, Switzerland, Norway, Iceland, Liechtenstein.

As a general rule, care scheduled outside the European Economic Area and Switzerland is not, by default, covered, regardless of the type of care scheduled.

               If you plan to receive care elsewhere in the world, contact your health insurance fund to find out if you are eligible for prior approval for coverage.

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