The Belgian Healthcare system
With a population of 10.8 million, Belgium has three official languages: Dutch, French and German. Dutch is spoken by around 59% of the population, French by around 40% and German by less than 1%.

The Belgian population is universally covered by statutory health insurance (mutualite or ziekenfonds). All individuals entitled to health insurance must join or register with a sickness fund. For historic reasons, some healthcare funds are limited to members of various religious, political or professional groups, but most funds are open to everyone.
Each fund charges the same basic contribution as well as providing similar benefits, but some take longer than others do to make repay the fees. Similar to France, healthcare is not free at the point of delivery. The patient first pays the full bill, submits the receipts for reimbursement and the money is then paid directly into the claimant’s bank account.

For people who are not in a specific preferred group, state reimbursement covers 75% of the fee. Therefore, most Belgians take out supplementary health insurance to cover the portion of their bill, which is not reimbursed.

Reimbursement for Procedures
Belgian healthcare providers will use the nomenclature of medical benefits, which is a coded list of medical services, reimbursed by the compulsory health insurance. The list is an annex of the Royal Decree of 14-9-1984. Updates to the list are published in the Official Gazette as amendments to that Annex and presented on the NIHDI (RIZIV/INAMI) website.
NIHDI stands for the National Institute for Health and Disability Insurance (also RIZIV / INAMI). The NIHDI manages the compulsory health insurance by allocating a prospective budget to the sickness funds to finance the health care costs of their members.

The fee-level for specialists working in hospitals is the same national negotiated fee-level as for office-based specialists. The extent of fee-sharing between the hospital and the specialist is variable and depends on elements such as relative scarcity/abundance of specialists in that specialty, extent of hospital facilities, the hospital’s reputation, the specialist’s reputation and experience.

Private hospitals may be reluctant to perform procedures that are not reimbursed well in Belgium.

Reimbursement for Implants
Recently, a few companies selling implantables in the Belgian market faced reimbursement difficulties due to new regulations requiring the listing of their products in the Belgian publication list of notified products. As of July 1st, implants that are not published will not be reimbursed by the compulsory health insurance.
To adjust to these changes, we wanted to share with you the steps that should be taken by any company selling implantables in the Belgian market.

* To get listed, each company or its distributor, should fill in a form that can be accessed via this link: https://www.riziv.fgov.be/webprd/appl/pimplants/.

* The required details include: the product’s name, the distributor’s and manufacturer’s name and the target price in Euro.

* Once the National Institute for Health and Disability Insurance (NIHDI) verifies the application, the products are published on the website and may be reimbursed in Belgium.

Mediclever’s team of European reimbursement experts can work with your company to prepare an application that matches your company’s interests (instead of the distributor’s).

Author Bio: Amir Inbar founded Mediclever (www.mediclever.com), which provides end-to-end reimbursement consulting services to life-science companies, selling pharmaceuticals and medical technology products in the US and Europe. As an expert reimbursement consultant Amir has consulted for organizations ranging from incubator startups to large, publicly traded companies, assistin

Category: Medical Business
Keywords: reimbursement,europe,belgium,implants