Hospitalisation insurance: why your health insurance fund is never enough

Yes, in most cases. Compulsory health insurance (NIHDI) reimburses part of your care at agreed rates, but does not cover single-room supplements (often €100 to €300 a day), nor the fee supplements of non-contracted doctors (which can double or triple the cost of a procedure). Hospitalisation insurance fills exactly these blind spots.

Three items dominate: (1) the single-room supplement, set by each hospital, typically €50 to €250 a day; (2) fee supplements from non-contracted doctors, which can be charged without a cap for single rooms; (3) certain medicines, equipment and outpatient costs not reimbursed by the NIHDI. Hospitalisation policies cover these three items up to set ceilings.

Yes, and it is a key part of the cover. Standard policies cover outpatient care linked to the hospital stay for 1 month before admission and 3 to 6 months after discharge: consultations, tests, medicines, post-operative physiotherapy. This cover is essential for serious conditions (cancer, cardiology, orthopaedics).

No, unlike income protection insurance and professional liability insurance. An individual hospitalisation insurance premium taken out by a self-employed person as a natural person is not deductible as a business expense. If the premium is paid by your SRL/BV for you as director, it is a benefit in kind (BIK) taxed under personal income tax, and in most cases the financial advantage disappears.

A single plan covers only the self-employed person. A couple plan adds the partner (married or legally cohabiting). A family plan includes dependent children. Children can often stay covered up to age 25 if they are still studying. Premiums rise accordingly, but children usually get a reduced rate (often 50% of the adult rate).

The Belgian Act of 20 July 2007 protects policyholders: if you switch hospitalisation insurer after more than a year, the new insurer must accept you without a medical questionnaire and without new exclusions, provided there has been no break in your cover. This portability is fundamental: it stops you being stuck with an insurer whose prices drift upwards.

The best policies include "serious illness" cover, which reimburses outpatient treatment (chemotherapy, radiotherapy, immunotherapy) without a hospital stay being needed. This cover is becoming critical as more and more heavy treatments are given on an outpatient basis. Check the list of conditions covered and the annual ceilings.

Yes, most policies impose a waiting period of 3 to 6 months for planned hospital stays (except accidents, which are covered immediately). Pre-existing conditions are often excluded for the first few years, or even permanently. Read the exclusions section of the general terms and conditions before signing.