CM-MediKo Plan in detail
CM-MediKo Plan is insurance for medical costs that have nothing to do with a hospital admission.
Are you going to the dentist, ophthalmologist or physiotherapist? You don't think about it, but the costs for those visits can quickly add up to hundreds and even thousands of euros. Not to mention the costs of, for example, braces, glasses or hearing aids. With CM-MediKo Plan you also get a large part of these costs reimbursed.
I am not yet affiliated with CM-MediKo Plan
The biggest advantages of this insurance for medical costs are the premiums that start from 12.57 euros per month, the short waiting time, the very favorable membership conditions for newborns and the easy application for reimbursements. Moreover, everyone is really welcome!
What is insured within CM-MediKo Plan?
CM-MediKo Plan provides extensive coverage for:
- Co-payment: a reimbursement of 75% up to 1,500 euros per year for services provided by doctors, specialists, dentists, physiotherapists, speech therapists, nurses and other healthcare providers. Please note that supplements that the healthcare provider may request in addition are not eligible. A deductible of 30 euros per insured person is applied to the total reimbursement for the statutory co-payments for all services from the same calendar year.
- Orthodontics: up to 600 euros for all treatment plans started before the 18th birthday and up to 600 euros for all treatment plans started after the 18th birthday.
- Dental prostheses and implants: up to 600 euros per year
- Periodontics: up to 600 euros per year
- Monophonic hearing aids: up to 600 euros per device
- Stereophonic hearing aids: up to 1200 euros per device
- Corrective lenses: up to 120 euros per year
- Lens implants: up to 250 euros per year
- Surgical correction of your vision outside the hospital: up to 250 euros per year
- Travel vaccines against yellow fever, hepatitis A, typhoid fever, Japanese encephalitis, tick-borne encephalitis, polio and meningococcal ACWY up to 25 euros per year
- Childbirth allowance of 250 euros per birth
- Nutrition and diet advice: up to 40 euros per year
What is not insured within CM-MediKo Plan?
CM-MediKo Plan does not reimburse costs:
- with the co-payment guarantee and hearing aids for which there is no right to reimbursement from the statutory health insurance
- that occur within an admission period or during a day admission
- for services that are not prescribed in Belgium and are not provided in Belgium
- for services that have not been performed or not prescribed by a doctor.
How much does my CM-MediKo Plan cost?
Premiums start from 12.57 euros per month and depend on your age. In the calendar year of membership, your premium depends on your age on the date of membership. Afterwards, your premium depends on your age on December 31 of the calendar year preceding the premium period. From the 4th connected dependent, the premium is limited to a maximum of 8.90 euros.
You can calculate your premium yourself here . The table below provides an overview of the premiums per month in euros:
| If joining before the 60th birthday | |
| 0-9 years | 12.57 |
| 10-19 years | 16.84 |
| 20-34 years | 17.69 |
| 35-49 years | 21.80 |
| 50-64 years | 23.41 |
| 65-74 years | 26.62 |
| From 75 years | 29.24 |
| When joining after the 60th birthday | |
| 60-64 years | 28.08 |
| 65-74 years | 31.95 |
| From 75 years | 35.09 |
| When joining after the 66th birthday | |
| 66-74 years | 34.61 |
| From 75 years | 38.01 |
| When joining after the 70th birthday | |
| 70-74 years | 39.93 |
| From 75 years | 43.87 |
What are the limitations on the reimbursements of this insurance?
The right to a refund starts after the following waiting periods starting from the connection date:
- three months for the guarantees: statutory co-payment, travel vaccines and nutritional and dietary advice
- six months for the eye care guarantee
- twelve months for the guarantees: periodontics, dental prostheses and implants, orthodontics, hearing aids and the maternity allowance
Reimbursements are calculated exclusively on the basis of the statutory rates included in the nomenclature of the compulsory insurance for medical care and on the basis of the rate applied for those who have a global medical file with their GP.
Am I insured abroad?
The insurance only applies to services prescribed in Belgium and provided in Belgium.
What are my obligations?
- As an insured person, you must be and remain affiliated with CM Vlaanderen for the services and benefits offered and be in compliance with the CM contribution payment.
- You must sign the required insurance documents and pay the insurance premium.
- If you want to join the insurance, you must join the insurance not only yourself, but also all your dependents for statutory health insurance.
- If you wish to report a claim, you must provide all relevant documents about the claim to the insurer as described in the general terms and conditions.
How do I pay my insurance premium?
The premium can be paid by transfer per year or by direct debit. With direct debit you can choose between: annually, quarterly or monthly. The dates for direct debit are determined in advance and always occur before the start of the insured period.
When does the insurance start and end?
The agreement is concluded upon signature by the policy holder of the insurance application and the first premium payment.
The insurance commences on the commencement date and is valid for life, except in the event of cancellation by the policy holder, failure to pay the premium and in the event of fraud.
How do I cancel my insurance contract?
You can cancel the insurance by registered letter, by bailiff's writ or by issuing the cancellation letter against acknowledgment of receipt.
Do you have another question about CM-MediKo Plan?
Please review the frequently asked questions page. Is your question not listed? Then contact CM.
I am affiliated with my employer's hospitalization insurance. But it does not reimburse my medical costs outside the hospital. I contacted CM, and they told me that I can combine any hospitalization insurance with CM-MediKo Plan without any problems. I joined immediately.
Karim, 37
I am affiliated with CM-MediKo Plan
Thanks to CM-MediKo Plan, you will also receive a large portion of the costs below reimbursed.
Co-payment
Submit the certificate of assistance provided to CM. The certificate for assistance provided is the note that you receive from your doctor or healthcare provider after your consultation. You deliver it to CM via one of the white CM mailboxes. An envelope is not necessary.
You will receive the refund directly into your account. The refund is made automatically and four times a year at fixed times:
- Costs from January 1 to March 31 will be refunded in mid-June.
- Costs from April 1 to June 30 will be refunded at the end of August.
- Costs from July 1 to September 30 will be refunded at the end of November.
- Costs from October 1 to December 31 will be refunded at the end of February the following year.
Orthodontics
Have your dentist complete the 'harmonization document' or 'proof of treatment(s) performed'. The RIZIV makes this document available.
Deliver the completed supporting document to CM via the My CM app or a CM mailbox. An envelope is not necessary.
A treatment plan is required for orthodontic treatments without the right to reimbursement from health insurance. This plan includes:
- The diagnose
- The description of the treatment plan
- The equipment to be installed
- The creation date
Have the orthodontist draw up a treatment plan and submit it to CM, at the latest together with the first application for reimbursement by CM-MediKo Plan.
You will receive the refund directly into your account.
For treatments that are reimbursed by the health insurance, the co-payment on the RIZIV services is reimbursed within the co-payment guarantee. Have you received a certificate for assistance provided? Deliver this to CM via a CM mailbox. Your orthodontist can also pay directly with CM. In both cases, the refund of the co-payment will be deposited into your account. This happens quarterly .
Periodontology
Have your dentist complete the 'harmonization document' or 'proof of treatment(s) performed'. The RIZIV makes this document available.
Deliver the completed supporting document to CM via the My CM app or a CM mailbox. An envelope is not necessary.
You will receive the refund directly into your account.
If you are entitled to reimbursement from your health insurance, the certificate of assistance provided is also required. Deliver this to CM via a CM mailbox. Your dentist or periodontist can also pay directly with CM. In both cases, the refund will be credited to your account.
Dental prostheses and implants
Have your dentist complete the 'harmonization document' or 'proof of treatment(s) performed'. The RIZIV makes this document available.
Deliver the completed supporting document to CM via the My CM app or a CM mailbox. An envelope is not necessary.
You will receive the refund directly into your account.
For dental prostheses and implants that are entitled to reimbursement by health insurance, the certificate for assistance provided is also required. Deliver this to CM via a CM mailbox. Your dentist can also pay directly with CM. In both cases, the refund will be credited to your account.
Glasses or lenses
Provide CM with the optician's detailed invoice.
If there is a right to legal intervention, the certificate of assistance provided or delivery is also required, together with the prescription.
You will receive the refund directly to your account.
Lens implants or laser treatment
Provide CM with the detailed invoice or application form. Complete it, sign it and have it signed by your doctor or other healthcare provider.
Provide CM with the certificate of assistance provided or delivery.
You will receive the refund directly into your account.
Hearing aids
You only pay your personal share at the hearing care professional.
Your hearing care professional provides the delivery certificate to CM.
You will receive the refund directly to your account.
You may also provide CM with the detailed invoice showing that you only paid the personal share. If you paid the full amount to the hearing care professional, you will receive a delivery certificate yourself. Submit this to CM to receive the refund.
Travel vaccines
Provide CM with one of the following documents:
- The BVAC certificate from the pharmacist via the CM letterbox
- Or the detailed invoice from the hospital or vaccination center via the My CM app or the CM mailbox
- Or the application form, completed and signed by yourself and the healthcare provider via the My CM app or the CM mailbox
You will receive the refund directly into your account.
Childbirth allowance
As a mother, you automatically receive the childbirth allowance together with the premium or gift card that you choose via the CM 'Birth' benefit.
Nutrition and diet advice
Provide CM with one of the following documents via the My CM app or the CM mailbox:
- a detailed invoice
- the application form (completed and signed by you and the RIZIV-approved dietitian). Did you receive a 'certificate for assistance provided'? Deliver this via the CM mailbox
You will receive the refund directly to your account.
Do you have another question about CM-MediKo Plan?
Please review the frequently asked questions page. Is your question not listed? Then contact CM.
Knowing more? Read all about it here:
CM Hospital Plan
CM-Hospitaalplan is a cost-covering insurance that provides reimbursement for the costs of your (day) admission, the pre- and aftercare during your admission and the medically necessary costs without admission in the event of serious illness.
- Anyone can join, young or old or whatever medical history you have
- Excellent price-quality
- Favorable membership conditions for newborns and adopted children
CM-Hospitaalfix Extra
With CM-Hospitaalfix Extra you receive an extra reimbursement of 25 euros per day that you are in hospital or admitted. The waiting period is only 3 months and we consciously keep the monthly premium as low as possible.
- Additional hospitalization insurance
- CM arranges everything directly, you do not have to submit invoices
- Fixed reimbursement per day in the hospital: 25 euros