CM insurance

No, everyone is welcome, regardless of age or pre-existing condition. You join without a prior medical examination or medical questionnaire.

The direct debit dates are the same for all insured persons. It is therefore not possible to change the direct debit dates.

Certainly, CM-Hospitaalfix and CM-Hospitaalfix Extra are ideal as a supplement to CM-Hospitaalplan or any other hospitalization insurance.

Do you pay the CM insurance premium by transfer? You will then receive a payment invitation for the new year in December.

Do you pay the CM insurance premium by direct debit? The premium will be deducted monthly, quarterly or annually using the number BE02 0688 9385 6340. Do you wish to change the payment method? Please contact us on 078 151 151.

You do not have to request the refund yourself. Payment is made automatically. CM will receive a signal from the hospital as soon as you are discharged. Based on this signal, the refund will be transferred to your account.

Children who are dependent on a beneficiary who is affiliated with CM-Hospitaalfix or CM-Hospitaalfix Extra are exempt from premium payments up to and including the second calendar year after their year of birth.

The connection is free from the fourth connected dependent.

Premiums start from 0.23 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.

You can calculate your premium yourself here. The table below gives an indication.  

 

Monthly premium

CM-Hospitaalfix

Monthly premium

CM-Hospitaalfix Extra

If you join before your 60th birthday
Up to 17 years old

0.23

0.63

From 18 to 24 years old

0.34

0.84

From 25 to 59 years old

2.00

5.32

From 60 to 64 years

3.48

6.60

From 65 to 69 years old

5.28

13.68

From 70 to 74 years old

6.06

14.25

From 75 years

6.93

19.67

If you join after your 60th birthday
From 60 to 64 years

4.18

7.90

From 65 to 69 years old

6.33

16.41

From 70 to 74 years old

7.28

17.09

From 75 years

8.32

23.61

If you join after your 66th birthday
From 66 to 69 years old

7.93

20.51

From 70 to 74 years old

9.09

21.37

From 75 years

10.41

29.50

If you join after your 76th birthday
From 76 years

13.18

37.37

The waiting period is three months.

Are you transferring from a similar hospitalization insurance policy? The waiting time will then be reduced by the period during which you were continuously affiliated with that insurance immediately prior to the switch.  

Here you will find the steps to change your account number.

Does your old account number no longer exist and was the direct debit refused? You will then receive a payment reminder from CM Insurance.

At www.cm.be/selfservice.be you can indicate which documents you want to receive by post and which you want digitally.

Is this the first invoice you have received for this insurance? Then your first payment is always made by bank transfer to confirm your connection.

If you provide CM with a completed and signed SEPA mandate, your next payment will be made by direct debit.

A nursing day is any admission day charged by the hospital with an overnight stay.

A nursing day is also one additional admission day if the hospital admission started before 12 noon and the discharge occurred after 2 p.m.

By law, the insurance premium must be paid before the period to be insured. This is included in the articles of association and is a general insurance principle.

The premium must be paid before the insurance takes effect.

You can freely choose your hospital, unless you are transported by 112 in an emergency. µ

If your doctor is affiliated with a hospital, your freedom of choice is also limited. In principle, your doctor contacts the hospital to record the admission and make the necessary medical arrangements (e.g. reservation of an operating room).

You can compare hospital rates with the ' Compare Hospital Rates ' application.

In principle, your doctor decides on the duration of your stay. But as a patient you have the right to leave the hospital whenever you want.

If this happens against the doctor's advice, you must sign a document stating that you are leaving at your own risk. The doctor then declines all responsibility for the consequences of your departure.

We speak of a medical accident when you experience abnormal damage during medical treatment, a hospital admission or a medical examination. You can receive compensation for this. If you have a complaint about a medical accident, you can contact Assistance to members.

A hospital is an institution that is legally recognized and where scientifically proven diagnostic and therapeutic resources are used.

The following institutions are not considered hospitals:

  • medical-pedagogical institutions;
  • retirement and care homes, rest homes for the elderly and hospitals and parts of hospitals that have special recognition as RVT;
  • thermal treatment institutions;
  • rehabilitation centers;
  • sanatoriums and preventoria;
  • psychiatric care homes;
  • private practices not recognized as general hospitals.

  • malignant tumors (e.g. cancer);
  • malignant blood diseases (e.g. leukemia, Hodgkin's disease);
  • neuromuscular disorders such as MS (multiple sclerosis) and ALS (amyotrophic lateral sclerosis;
  • Parkinson's disease;
  • meningitis;
  • AIDS;
  • liver cirrhosis due to hepatitis;
  • diabetes type 1;
  • kidney disorders requiring kidney dialysis;
  • cystic fibrosis;
  • systemic scleroderma with organ involvement;
  • Crohn's disease and ulcerative colitis.

The direct debit dates are the same for all insured persons. It is therefore not possible to change the direct debit dates.

Premiums start from 4.22 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.

You can calculate your premium yourself here. The table below gives an indication:

If joining before the 60th birthday
Up to 24 years

4.22

From 25 to 49 years old

9.72

From 50 to 59 years old

11.31

From 60 to 64 years

19.45

From 65 to 69 years old

20.70

From 70 years

30.71

When joining after the 60th birthday
From 60 to 64 years

25.29

From 65 to 69 years old

26.89

From 70 years

36.86

When joining after the 66th birthday
From 66 to 69 years old

31.03

From 70 years

46.09

Children who are dependent on a beneficiary who is affiliated with CM-Hospitaalplan are affiliated free of charge up to and including the second calendar year after their year of birth.

From the fourth connected dependent, the premium is limited to 2.08 euros per month.

Here you will find the steps to change your account number. Does your old account number no longer exist and was the direct debit refused? You will then receive a payment reminder from CM Insurance.

Do you pay the CM insurance premium by transfer? You will then receive a payment invitation for the new year in December.

Do you pay the CM insurance premium by direct debit? The premium will be deducted monthly, quarterly or annually using the number BE02 0688 9385 6340.

Do you want to change the payment method? Please contact us on 078 151 151.

Is this the first invoice you have received for this insurance? Then your first payment is always made by bank transfer to confirm your connection.

If you provide CM with a completed and signed SEPA mandate, your next payment will be made by direct debit.

At www.cm.be/selfservice.be you can indicate which documents you want to receive by post and which you want digitally.

There is a general waiting period of three months starting from the date of connection. For fertility treatments, the waiting period is nine months.

During your waiting period you are already insured by CM-Hospitaalplan for hospital admissions for:

  • an accident;
  • a number of acute infectious diseases such as mumps, meningitis, measles, rubella, scarlet fever or chickenpox.

Are you transferring from a similar mutual insurance policy? Then the periods of three years or nine months (in the case of a pre-existing pregnancy) are reduced by the period during which you were continuously affiliated with that insurance immediately prior to the switch.

When switching from a similar mutual insurance policy, the waiting time for fertility treatments can be shortened.

Conditions that already existed at the time of joining CM-Hospitaalplan are not excluded.

Hospital admissions due to a pre-existing condition or illness are reimbursed during the first three years of membership as follows:

  • you choose a shared room or double room: according to the 'hospitalization' guarantee, including 'pre- and aftercare';
  • you choose a single room: according to the 'hospitalisation' guarantee, including 'pre- and aftercare', but without reimbursement for fees and room supplements.

Admissions as a result of a pre-existing pregnancy are reimbursed in the same way during the first nine months of membership.

Are you transferring from a similar mutual insurance policy? Then the aforementioned periods of three years and nine months are reduced by the period during which you were continuously affiliated with that insurance immediately prior to the switch.

No, anyone who is affiliated with CM-Hospitaalplan will not receive a ticket for this. So you don't have to bring anything with you, hand it in or mention anything at the hospital. Everything happens automatically. You do need a document for some other hospital insurance policies.

Newborns enjoy very favorable conditions if they are dependent on a beneficiary who is affiliated with CM-Hospitaalplan.

Advantages:

  • the date of birth serves as the connection date;
  • there is an immediate right to a refund because there is no waiting period;
  • the guarantee 'pre-existing condition' does not apply.

You make a number of choices on the admission statement that have an important influence on the final cost. The document is not specifications, the hospital cannot predict all costs in advance. But it is binding. So read the admission statement thoroughly before signing it and keep your copy carefully.

You will find a list of the items on the payment overview via this link.

By law, your insurance premium must be paid before the period to be insured. This is included in the articles of association and is a general insurance principle.

The premium must be paid before the insurance takes effect.

Since January 1, 2023, costs for reception and care in a short stay are reimbursed at 50% of the amount actually paid, with a maximum of 15 euros per day of short stay with overnight stay, for a maximum of 28 short stay days with overnight stay per calendar year.

  • The co-payment and the flat rate for your medicines will be fully reimbursed, regardless of your room choice.
  • The room supplement for your single room will be reimbursed up to 55 euros per day.

  • The costs for an overnight stay for one person in a member's hospital room will be reimbursed up to 35 euros per day.
  • The accommodation costs associated with the donorship that are medically required for the treatment of the member will be fully reimbursed

The reimbursement for admission to a psychiatric hospital is always limited to 1,250 euros per insured person and per calendar year.

The limitation of 1,250 euros does not apply to admission to a psychiatric department of a general hospital (PAAZ). The admission and the costs of pre- and post-care are reimbursed without limitation:

  • child neuropsychiatry (K, service code 340);
  • day care in a K service (K1, service code 350);
  • night nursing in a K shift (K2, service code 360);
  • neuropsychiatry service (A, service code 370);
  • day care in an A-shift (A1, service code 380);
  • night nursing in an A-shift (A2, service code 390);
  • psychiatric service (T, service code 410);
  • day care in a T-shift (T1, service code 420);
  • night nursing in a T-shift (T2, service code 430);
  • intensive treatment service for psychiatric patients (IB, service code 480);
  • psychogeriatric disorders service (S6, service code 660).

CM-Hospitaalplan reimburses costs outside Belgium up to 1,000 euros per calendar year and per affiliate. As a CM member you also enjoy travel assistance abroad.

Yes, the hospital may request an advance. The amount depends on your room type and is stated on the admission statement. After seven days, the hospital can ask you for a new advance. The amount may be higher if you do not have health insurance in order.

A hospital may not refuse you admission (in a communal room), even if you cannot pay the advance.

The maximum reimbursement is 22,000 euros per member per calendar year for both hospital admissions and pre- and post-treatment.

Yes, the reimbursement of costs during the pre- and post-treatment (1 month before to 3 months after admission) does not apply to:

  • admissions for dental care and wisdom teeth removal;
  • day admissions such as lump sum chronic pain;
  • day admissions for port catheter manipulation;
  • day admissions for basic oncological care.

  • Costs for the following services and their consequences and complications:
    • (purely) aesthetic care or treatment, rejuvenation treatments or care with aesthetic purposes;
    • preventive criminal investigations;
    • spa treatments (e.g. thermalism, thalassotherapy, hygienic diet cure);
    • breast enlargements;
    • treatments and medicines whose usefulness has not been scientifically proven;
    • dental prostheses and dental implants;
    • performances that are not necessary for the recovery of health;
    • costs resulting from the practice of dangerous sports and any sport as a professional activity, including training;
    • costs for deliberate medical treatments abroad without the permission of the advising physician.
  • Costs resulting from:
    • wars or disasters;
    • disturbances, riots, collective violence;
    • intentional or reckless acts, bets or challenges;
    • crime;
    • drunkenness or alcohol intoxication, use of narcotics;
    • facts caused by radioactive, toxic or explosive substances.
  • Costs that may not legally be charged.

  • Fertility treatments
    This applies to both the (day) admission and the pre- and post-treatment (from 1 month before to 3 months after the procedure). The total reimbursement is limited to 1,000 euros per member, regardless of the number of fertility treatments.
     
  • Breast reductions
    During the first three years of your membership with CM-Hospitaalplan, the costs are reimbursed in the same way as a pre-existing condition. Afterwards, they will be reimbursed according to the reimbursements for hospitalization and pre- and post-treatment. The total reimbursement is always limited to 1,000 euros per affiliate.
     
  • Procedures to treat obesity (e.g. liposuction, gastric banding, etc.)
    During the first three years of your membership with CM-Hospitaalplan, the costs are reimbursed in the same way as a pre-existing condition. Afterwards, they will be reimbursed according to the reimbursements for hospital admission and pre- and post-treatment. The total reimbursement is always limited to 1,250 euros per affiliate.

Only the costs related to your (day) admission for dental care and the removal of wisdom teeth will be reimbursed. This does not include the costs during the pre- and post-treatment.

In the event of hospitalization due to a serious illness or accident requiring dental care, the pre- and post-care costs are also reimbursed.

With a few exceptions, there is no reimbursement for dental implants.

CM-Hospitaalplan reimburses the following costs that are directly related to your home birth and that occur from 1 month before the birth until 3 months afterwards:

  • co-payment for medical care and treatment;
  • fee supplements (up to 100% of the established rate);
  • reimbursable medicines.

A lump sum of 100 euros is awarded for the costs of medical-technical aids.

People with a pre-existing condition are not excluded from CM-Hospitaalplan.

However, no room and service fee supplements will be paid if:

  • you are admitted to a single room as a result of a pre-existing condition;
  • and this within the first 3 years of your membership of CM-Hospitaalplan.

If you want to limit your hospital bill for breast reconstruction, choose a hospital that has signed an agreement with the Riziv .

In these hospitals, expensive (aesthetic) supplements are prohibited for breast reconstruction with your own tissue in a double room. The charging of supplements in a single room is limited.

These supplements are reimbursed from CM-Hospitaalplan in accordance with the provisions of the general terms and conditions.

Yes, these costs are fully reimbursed, from 1 month before admission to 3 months after hospital admission.

Service fee supplements are reimbursed up to 100% of the established rate, regardless of room choice. Service fee supplements from 1 month before hospital admission until 3 months after admission will also be reimbursed up to 100% of the established rate.

The franchise, which is only applied to the reimbursement of service fee supplements for admissions to a single room, amounts to:

  • 0 euros for a hospital admission for childbirth;
  • 100 euros per hospital admission for a traditional admission with an overnight stay;
  • 175 euros per hospital admission for a day admission.

These franchises are applicable per hospital admission with a maximum of 350 euros per calendar year.

Fees for services that may be legally charged but that the health insurance does not reimburse will be reimbursed up to 200 euros per hospital admission if they do not fall under the insurance exclusions .

Yes, fee supplements are reimbursed up to 100% of the established rate upon recognition of serious illness. The co-payment for medical care and treatment will also be fully reimbursed in those cases.

The first refundable prosthesis or the first refundable orthopedic device prescribed by a doctor will be fully reimbursed.

The first prosthesis or orthopedic device is also reimbursed up to 3 months after hospital admission if not placed during the admission itself.

  • Refundable implants are fully reimbursed from 1 month before to 3 months after the hospital admission.
  • Non-refundable implants and parapharmaceutical products (e.g. support stockings, cervical collars) are fully reimbursed up to 2,500 euros per hospitalization if they can be legally charged and this for the period from 1 month before to 3 months after the hospital admission.

  • Reimbursable medicines are fully reimbursed from 1 month before to 3 months after the hospital admission.
  • Non-reimbursable medicines are fully reimbursed up to 2,500 euros per admission for the period from 1 month before to 3 months after the hospital admission.

Refundable medical equipment is reimbursed up to 1,000 euros per admission. If the costs increase, there will be an additional reimbursement from the CM services and benefits package.

Refundable plaster materials will be fully reimbursed.

Medicines, implants, synthesis materials, plaster materials, stoma and incontinence materials will be fully reimbursed if health insurance also reimburses.

The personal share for non-urgent patient transport requested from the Mutas service in the context of oncological treatment or kidney dialysis is reimbursed up to a maximum of 250 euros per calendar year. So you need recognition of serious illness.

Yes, you can also send the detailed invoice stating the reimbursement from the health insurance and your personal share (co-payment and supplement) to CM yourself.

Provide CM with the detailed invoice and the certificate of assistance provided or delivery, together with the prescription.

  • You only pay your personal share at the hearing care professional.
  • Your hearing care professional provides the delivery certificate to CM.
  • CM pays the reimbursement from CM-MediKo Plan.

  • 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 CM mailboxes . An envelope is not necessary. Sometimes your doctor or healthcare provider provides the certificate directly (electronically) to CM. Then you don't have to do anything.
     
  • You will receive the refund directly into your account.
    Repayment is made automatically and four times a year at fixed times.

Provide CM with the birth certificate from the municipality or city.

Provide CM with one of the following documents:

  • the BVAC certificate from the pharmacist;
  • the detailed invoice from the hospital or vaccination center;
  • the application form, completed and signed by yourself and the healthcare provider.

  • Have your doctor complete a reimbursement form
    The Riziv makes this document available for this purpose.
     
  • Submit the completed supporting document to CM for reimbursement
    The certificate for assistance provided is the note that you receive from your doctor or healthcare provider after your consultation. You use one of the CM mailboxes for this. An envelope is not necessary.
     
  • Provide CM with the certificate for assistance provided
    You can also use one of the CM letterboxes for this. An envelope is not necessary.
     
  • Orthodontics: have the doctor draw up a treatment plan
    This is mandatory 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.
       
  • Orthodontics: provide the treatment plan to CM
    Do this with the first request for a refund from CM-MediKo Plan.
     
  • You will receive the refund directly into your account

  • 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

Provide CM with one of the following documents:

  • the detailed invoice;
  • the application form (completed and signed by you and the healthcare provider), together with the certificate for assistance provided.

Provide CM with a detailed settlement statement from which the co-payment per provision can be derived. The co-payment will be transferred to your account.

Then deliver this to CM yourself.

Normally the refund will be made within three weeks after CM has processed the supporting documents.

Because with many hearing care professionals you only pay the personal share (co-payment and any supplement), the reimbursement depends on the time at which CM receives the certificates. As a result, the three-week period may be exceeded. The repayment never takes longer than three months.

The refund will always be made within three weeks after CM has processed the supporting documents.

If you only pay the personal share (co-payment and any supplement) to the care provider, the reimbursement depends on the time at which CM receives the certificates from the care provider. As a result, the three-week period may be exceeded.

The refund will always be made within three weeks after CM has processed the supporting documents.

If you only pay the personal share (co-payment and any supplement) to the ophthalmologist, the reimbursement depends on the time at which CM receives the certificates from that same ophthalmologist. As a result, the three-week period may be exceeded.

The refund will always be made within three weeks after CM has processed the supporting documents.

If you only pay the personal share (co-payment and any supplement) to the dietician or other healthcare provider, the reimbursement depends on the time at which CM receives the certificates from that same healthcare provider. As a result, the three-week period may be exceeded.

The refund will always be made within three weeks after CM has processed the supporting documents.

If you only pay the personal share (co-payment and any supplement) to the healthcare provider, the reimbursement depends on the time at which CM receives the certificates from that same healthcare provider. As a result, the three-week period may be exceeded.

The refund will always be made within three weeks after CM has processed the supporting documents.

Repayment is made four times a year and according to a fixed schedule:

Period of submission of certificateDate of refund
January 1 to March 31mid June
April 1 to June 30end of August
July 1 to September 30end of November
October 1 to December 31the end of February the following year

No, this is not possible. Both you as the beneficiary as all persons who are dependent on you for health insurance must join.

Premiums start from 12.57 euros per month and depend on your age. Do you want to join? Then all persons who are dependent on you for health insurance must also join.

You can calculate your premium yourself here. The table below gives an indication:

If joining before the 60th birthday
Newborns

-

0-2 years

-

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

39.91

From 75 years

43.87

Children are exempt from premium payments up to and including the second calendar year after their year of birth. From then until the age of 9, you pay a premium of 12.57 euros per month for children.

If you have more than three dependents, the premium is halved from the fourth dependent.

Do you pay the CM insurance premium by transfer? You will then receive a payment invitation for the new year in December.

Do you pay the CM insurance premium by direct debit? The premium will be deducted monthly, quarterly or annually using the number BE02 0688 9385 6340.

Do you wish to change the payment method? Please contact us on 078 151 151.

Yes, anyone who has both CM-Hospitaalplan and CM-MediKo plan enjoys a 5% discount on the premium for CM-Hospitaalplan. You don't have to do anything for this, it will be settled automatically.

There is no waiting period to join CM-MediKo if you switch from a similar insurance for outpatient costs.

If this is not the case, the following waiting times apply:

  • 3 months for co-payments, vaccinations and nutritional and dietary advice;
  • 6 months for eye care;
  • 12 months for dental care, hearing aids and maternity benefits.

No, everyone is welcome, regardless of age or pre-existing condition. You join without a prior medical examination or medical questionnaire.

Dependent children of a policyholder affiliated with CM-MediKo Plan are exempt from paying premiums up to and including the second calendar year after the year of their birth.

By law, the insurance premium must be paid before the period to be insured. This is included in the articles of association and is a general insurance principle. The premium must therefore also be paid before the insurance takes effect.

The direct debit dates are the same for all insured persons. It is therefore not possible to adjust this data.

Is this the first invoice you have received for this insurance? Then your first payment is always made by bank transfer to confirm your connection.

If you provide CM with a completed and signed SEPA mandate, your next payment will be made by direct debit.

At www.cm.be/selfservice.be you can indicate which documents you want to receive by post and which you want digitally.

Here you will find the steps to change your account number. Does your old account number no longer exist and was the direct debit refused? You will then receive a payment reminder from CM Insurance.