Planned care abroad
Before a planned treatment abroad starts, you must first obtain permission from the advising doctor.
Even if the care is provided abroad, CM will still reimburse if the care is included in the Belgian insurance package.
If the foreign care is not included in the Belgian insurance package, but does meet the criteria of the Special Solidarity Fund, you can always submit an application to the board of doctors-directors (RIZIV). This request is made through CM's medical advisor.
This application is made with the following documents:
- a detailed medical report;
- a cost estimate or invoice;
- a statement on your honor that you cannot obtain a refund in any other way.
In the European Union, Iceland, Liechtenstein, Norway, Switzerland
In the European Union, Iceland, Liechtenstein, Norway and Switzerland, you are usually free to choose your healthcare provider.
For hospitalization with at least one overnight stay, CM's advising physician must give prior permission. This can be for two reasons:
- due to the long waiting lists, the necessary care for your medical situation is not available 'in time' in Belgium;
- the advising physician is of the opinion that the care should continue abroad because the medical-technical conditions are better there .
In principle, you can request permission for all outpatient care. This is on condition that the necessary care for your medical situation is not available 'in time' in Belgium due to long waiting lists. Experience shows that this condition is rarely met.
- Scanners, MRI, radiotherapy, pet scan and cath lab
Prior permission from the advising physician is always required.
- Other outpatient care
No prior authorization is required. The patient pays for the care provided and submits the invoices and certificates to CM. Reimbursement is made according to Belgian rates and regulations. Unless you are entitled to the increased allowance. In that case, the rates of non-conventional care providers do apply for the reimbursement. As a result, outpatient care can be more expensive than with a conventional care provider in Belgium.
Arguments of a social nature, comfort or the extent to which certain care is reimbursed do not play a role in the assessment by the advising physician.
For hospitalization with at least one overnight stay, the advising doctor must give prior permission. This on the condition that the medical-technical circumstances of the required care are more favorable there, and that the advising physician deems this necessary.
There is no refund. The costs are entirely at your expense.
What should you do?
Before treatment abroad starts, you must obtain permission from the advising doctor.
You send the application to the advising physician. It includes:
- a written request signed by you or your legal representative;
- a comprehensive medical report from a physician specialist in the condition to be treated.
You must wait for permission before you are treated. The application procedure takes a maximum of 45 days, unless additional information is requested.
Genetic research abroad
Genetic testing by a foreign laboratory can be reimbursed by the Belgian health insurance. This thanks to an agreement with eight Belgian centers for human genetics.
The condition is that a medical specialist refers you to one of the eight Belgian centers. These reference centers are responsible for contact with foreign centers and for billing.
If this procedure is not followed, no reimbursement for genetic testing by a foreign laboratory is possible.
Belgian reference centers
- Leuven: Center for Human Genetics KUL, Herestraat 49
- Brussels (1200): Center de Genetique UCL - Tour Rosalind Franklin Entrance F, Av. E Mounier
- Gosselies: Center de Genetique Humaine - Institut de Pathologie et de Genetique, Av. G. Lemaitre 25
- Brussels (1090): Center for Human Genetics VUB, Laarbeeklaan 103
- Edegem: Center for Medical Genetics UZA, Prins Boudewijnlaan 43
- Brussels (1070): Center de Genetique ULB - campus Erasme, Route de Lennik 808
- Ghent: Center for Medical Genetics UG, De Pintelaan 185, Ghent
- Liège: Center de Genetique Humaine Ulg, CHU Sart Tilman