Medical care - Living in Belgium and working in the Netherlands

Contents

What does your insurance cover? What if your family members do not have health insurance of their own? In which country can you receive medical care? In which country can your family members receive care? How will you be reimbursed for care? What do you have to pay? What if Stay informed Other useful addresses

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If you live in Belgium and work in the Netherlands, you will be automatically covered by Dutch insurance for exceptional medical expenses, such as a stay in a nursing home. You must also take out regular health insurance in the Netherlands. You can receive medical care in both Belgium and the Netherlands.

What does your insurance cover?

Everyone who lives or works in the Netherlands is automatically insured under the Dutch National Act on Exceptional Medical Expenses (AWBZ). Exceptional medical expenses are expenses that hardly anyone can afford, such as longterm nursing or care for the disabled. If you are covered under the AWBZ scheme, you do not have to pay these expenses yourself, although in many cases you will often have to pay a personal contribution. The Care Needs Assessment Centre (Centrum indicatiestelling zorg, CIZ) will assess whether or not you are entitled to care under the AWBZ scheme. You will also be covered under the Dutch Health Insurance Act (Zvw), which provides for reimbursement for the costs of regular care, such as care by a general practitioner, or medicines. For this, you need to take out basic health insurance with a Dutch health insurance company within four months of the date on which you started working in the Netherlands. The basic health insurance package offered by all health insurance companies in the Netherlands includes: -- care by a general practitioner; -- hospital care; -- specialist care; -- medicines. You can choose yourself whether and where to take out supplementary insurance. Dutch health insurers offer several types of supplementary insurance, while in Belgium you can take out hospitalisation insurance, which includes partial reimbursement for the personal contribu-tion you are required to pay in case of hospitalisation.

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What if your family members do not have health insurance of their own?

In that case, you and your family are legally obliged to register with a Belgian health insurance fund. For this, you need to apply to the Dutch Health Care Insurance Board (CVZ) for an S1 form. You must also register your family members with the CVZ.

In which country can you receive medical care?

Although you work in the Netherlands and are entitled to receive care in the Netherlands, you can also choose to receive care in Belgium. If you wish to receive care under the Belgian care system, you must register with a Belgian health insurance fund. You will only be required to pay a small membership fee for this, and the Belgian health care package is more extensive than the Dutch package. For example, it also includes dental care. To register with a Belgian health insurance fund, you need an S1 form, which you can obtain from your Dutch health insurance company.

In which country can your family members receive care?

If your family members are co-insured with you, they can choose to receive care either in the Netherlands or Belgium. If they opt for care in Belgium, they will receive reimbursement for care according to the rules of the Belgian health insurance fund. If they opt for care in the Netherlands, you are advised to apply to the CVZ for a European Health Insurance Card (EHIC). This way, you will not have to pay for the care yourself first.

How will you be reimbursed for care?

If you only have Dutch health insurance, you have to claim reimbursement in the Netherlands. You will only be reimbursed for care which is covered under your Dutch health insurance. If you are covered by basic health insurance in the Netherlands and are registered with a Belgian health insurance fund, you can choose to claim reimbursement either in the Netherlands or Belgium. Each country will pay reimbursement on the basis of its own rates and conditions. Personal contributions Certain expenses are only partially reimbursed. In addition, if you have health insurance in the Netherlands and you receive care in the Netherlands, you will have to pay a policy excess. No policy excess applies for family members who are co-insured with you. If you receive care under the AWBZ scheme, you will be charged a personal contribution. Health insurance funds in Belgium also charge personal contributions, called remgeld.

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What do you have to pay?

You have to pay percentage-rate contributions under the AWBZ and Zvw schemes, the amount of which depends on your income. Your employer will deduct these contributions from your pay and at the same time compensate you for the Zvw contribution. You also have to pay a monthly flat-rate Zvw contribution to your health insurance company. If you are registered with a Belgian health insurance fund, you have to pay a small annual membership fee. If you take out supplementary health insurance in the Netherlands or hospitalisation insurance in Belgium, the contributions for this will depend on the insurance package, your age and your state of health. If you have family members aged 18 or over who do not have compulsory health insurance, you have to pay a contribution for them to the CVZ. See the Figures appendix for the amounts and percentages. Health care allowance If your household income is below a certain level, you can apply to the Dutch Tax Administration (belastingdienst) for a health care allowance. You can claim health care allowance for yourself and for family members who are co-insured with you (your partner and/or children aged 18 or over). For more information, go to www.toeslagen.nl.

What if

you do not take out health insurance in the Netherlands within 4 months? In that case, you will receive a fine. In addition, you will have to pay any care expenses you incur during this period yourself. you have not paid your health insurance contributions for six months? Your health insurance company will inform CVZ about this, after which an extra amount will be deducted from your pay each month until the debt has been settled. you receive a bill from the Flemish health insurance fund? You do not have to pay this, because you are insured in the Netherlands. Family members older than 25 may be able to receive reimbursement for care from the Flemish health insurance fund, and therefore have to pay contributions to this fund. you need medical care while staying in another EU Member State? With your Dutch health insurance, you can get medical care in all EU countries, as well as emergency care worldwide. For this, you need a European Health Insurance Card (EHIC), which you can obtain from your health insurance company. You must apply to CVZ for an EHIC for your family members.

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Stay informed

This leaflet contains general information. Additional conditions and exceptions may apply to your situation, and rules and regulations are subject to change. We therefore advise you to check our website regularly (www.svb.nl/bbz). If you have any questions, feel free to get in touch with the Bureau for Belgian Affairs. We will be happy to assist you. Bureau for Belgian Affairs Rat Verleghstraat 2 Breda Postbus 90151, 4800 RC Breda +31 (0)76 548 58 40 email: bbz@svb.nl www.svb.nl/bbz

Other useful addresses

Agis health insurance company International entitlement division Agis Zorgverzekeringen Groep Buitenlands Recht Postbus 1725 3800 BS Amersfoort +31 (0)33 445 68 70 www.agisweb.nl Dutch Health Care Insurance Board (CVZ), International Department College voor zorgverzekeringen, afdeling buitenland Eekholt 4, Diemen Postbus 320, 1110 AH Diemen +31 (0)10 428 95 51 (questions about health insurance for people living outside the Netherlands) +31 (0)20 797 85 55 (other questions) Flemish Health Insurance Fund Vlaamse Zorgkas Koning Albert II laan 35, bus 36 B-1030 Brussel www.vlaamsezorgkas.be