Is your health insurance fund good value for money?

Article by Johan Rasking in De Standaard, 30 January 2021

(translated and published with authorisation from the author, image Jasper Rietman)

Everyone over the age of 25 has to sign up to a public health insurance fund. This also applies to the under-25s if they are working or receiving benefits. Children do not have to pay membership fees.

The health insurance fund then (partly) reimburses your medical costs, for example the fee for a visit to your GP and the purchase of prescription medicines. Those reimbursements are regulated by law and are therefore the same for all health insurance funds.

In addition, all health insurance funds offer their members a package of additional insurance policies and services. Those extras are financed by membership fees. All those who pay an annual membership fee are automatically entitled to these extra services. For the most expensive options – such as hospitalisation insurance – you pay an extra premium in addition to your regular membership fee.

Hospitalisation insurance is not mandatory, but you will always pay for the additional health insurance fund benefits. There is only one possible exception to this: free registration to the Hulpkas voor Ziekte- en Invaliditeitsverzekering (Belgium’s auxiliary fund for health and invalidity insurance). This government agency offers no additional services.

Ziekenfondsen

Price differences & comparing services

The prices vary enormously between public health insurance funds. A sample of membership fees for inhabitants of the Mechelen region reveals that the (annual) cost price ranges from EUR 85.50 (socialist health insurance fund De Voorzorg) to EUR 102.48 (Onafhankelijk Ziekenfonds-OZ). In between there is Liberale Mutualiteit Plus (EUR 93), the Vlaams Neutraal Ziekenfonds (VNZ, EUR 94.80), CM (EUR 99) and Partena (EUR 102).

How should you assess these price differences when choosing your health insurance fund? In theory, you could go for the cheapest on the market. That will give you an instant price advantage, but you may be missing out on benefits that you could get from a different, albeit more expensive, fund. Conversely, those who choose the most expensive on the market, because logic dictates that this will offer them the best range of services, may well be disappointed. All those (more pricey) extras may not fit your family profile and you won’t enjoy the benefits. For example, do you need a higher reimbursement for orthodontic treatment if you don’t have children who are eligible for a brace?

So, it’s not just about comparing prices, it’s also about taking a good look at the difference in the insurance and services offer – as it applies to your individual needs and desires. Who knows, a cheaper health insurance fund might even have the most interesting portfolio for you. Do be aware, though, that comparisons are not that simple, because the benefits differ per region. At spaargids.be (Dutch only) you will find a useful online comparison tool.

The health insurance funds offer three main categories of benefits: additional reimbursements (from dental care or spectacles to alternative therapies), free rental of auxiliary care equipment (such as wheelchairs and crutches), and extras (such as a gift on the birth of your child, reimbursement for membership of a sports club or discounts on wellness packages). In line with the broad-ranging offer, CM no longer describes itself as a health insurance fund but a wellness insurance fund. 

Freedom of choice

Many young Belgians join, almost as a matter of course, the same health insurance fund as their parents and often remain a member for the rest of their lives. Every year fewer than 100,000 Belgians change health insurance fund. And yet it is free of charge and easy to switch to a different company. Your new health insurance fund takes care of the administrative side (in the same way as when you change phone provider).

There is, however, one restriction: you can only move at the beginning of a quarter (i.e. on 1 January, 1 April, 1 July, or 1 October). Moreover, the application period for each health insurance fund lasts a few weeks.

For those who are really looking for the best deal, you can even switch to a health insurance fund in a completely different region. If you live in Limburg, you can register with a health insurance fund in Ghent and vice versa. It’s important to be aware, though, that this is not particularly useful if you are looking for information about the medical services on offer in your area. In that case, you’re better off joining the health insurance fund just around the corner.