FAQ

The vaccination campaign started several weeks ago in our country. 

Anyone residing in Belgium will have the opportunity to be vaccinated against Covid-19 free of charge. 

Click here to find the most frequently asked questions about the roles of health insurance companies in the context of this vaccination campaign. 

This regime entitles you to better refund for medication and health care (consultations, visits, hospitalizations, nursing services, etc.). 

Normally, services are refunded at more or less 75%. 

If you benefit from Supplemented Refunds, you are entitled to a refund of 80%, 85%, ... or often even 100%, depending on the service. 

For many years, several terms have been used popularly, which does not always make it easier for lay people to understand them. 

Initially, only VIPOs benefited from Supplemented Refunds. This name is the abbreviation of "widow-er, disabled, pensioner, orphan". 

Then, the right was extended to a series of new beneficiaries, including people entitled to “integration income” or the “guaranteed income for elderly people” (GRAPA). 

Since then, we will instead use the term  “Supplemented Refunds”. 
 

You do not have to take any action. 

The CBSS informs your health insurance company electronically that you are retired. 

Your health insurance company will contact you to find out your family income. 

Your gross annual taxable income as well as that of your spouse or life partner or legal cohabitant and that of your respective dependents cannot exceed a certain ceiling per person forming part of the household. 

You do not have to take any action. The CBSS notifies your health insurance company electronically that you are receiving integration income. 

The right will be granted to you automatically and your health insurance company will inform you that you now benefit from Supplemented Refunds. 

More information : The CBSS. 

Yes. Computer detection for holders with low income is carried out by your health insurance company. The family's income is therefore essential: the family must therefore have “low income”. You simply must meet the income requirement. 

If you submit a request to your health insurance company on January 5th 2021, for example, you will have to demonstrate that the gross taxable income of your household did not exceed 19,892.01 euros increased by 3,682.55 euros per additional person in the household. 

For example : 

Annick lives with her brother, who is in her care. 

The only income she has is her wage of €1,427.36 gross per month. Her brother has no income. 

On January 5th 2021, she requests Supplemented Refunds and demonstrates that her income between January 1st 2020 and December 31, 2020 amounted to €1,427.36 x 12 = €17,128.32. She adds her end-of-year bonus of €991.57 gross, which makes a total of €18,119.89. 

The ceiling amount not to be exceeded is (ceiling in force for Supplemented Refunds requests for the 2020 reference period): €19,892.01 (Annick) + €3,682.55 (1 dependent) = 23,574.56 (Annick’s household). Given that her household income is less than €23,574.56, she has the right to Supplemented Refunds from January 1st (i.e. the first day of the quarter of the request). 

This is the household made up of the applicant, their spouse or legal cohabitant or life partner, and their dependents. 

Thanks to a retrospective exchange of data between your health insurance company administration and the tax administration, your health insurance company knows perfectly all your family income. If it turns out that the information with which you provided us was not correct, your health insurance company could recover the difference between the price of the normal intervention and the increased rate in terms of a refund for your care. 

Sometimes these are very high amounts. 

In health insurance, you will also benefit from the “Maximum invoice”. 

This means that your Supplemented Refunds household (The media often talk about VIPO status. What is this status? Is it the same thing?) will never pay more than 487.08 euros in co-payments (for the year Maximum invoice 2021 ). 

Being in one of the following situations is considered an indicator: 

• being retired ; 
• being disabled 
• being a widow or widower; 
• receiving disability compensation; 
• being incapacitated for work, completely unemployed for at least one year ; 
• being part of a single-parent family. 
   

The isi+ card enables your pharmacist, doctor or hospital… to connect to your health insurance company to find out about your situation and to bill you accordingly at the correct rate (Maximum invoice). 

The existing electronic identity documents are as follows: 

• The electronic identity card (e-ID) issued to Belgians; 
• The electronic identity card issued to non-Belgian citizens from the European Union; 
• The electronic residence permit issued to citizens of a country outside the European Union 
• The Kids-ID issued to Belgian children under 12 years old. 

In Belgium, electronic identity documents are only issued to people domiciled on Belgian territory, in other words: who are registered in the population registers of a Belgian municipality. 

The isi+ card is issued to people who cannot qualify for an electronic identity document, but who are entitled to social security coverage to receive treatment in Belgium (e.g. cross-border workers, children under 12). 

If you meet the conditions to obtain an isi+ card, you will automatically receive it a few days after your affiliation. 

isi+ means "Identification system". The + (as superscript) accentuates the complement compared to Belgian electronic identity documents. 

Always have the identity document of the person requiring the medication with you! 

For your child under 12 years old, you can present their isi+ card or Kids-ID if they have one. 

If the pharmacist notices, when reading your e-ID, that you are "not in order", this means that you probably have a health insurance problem. 

You will then have to pay the full price of the medicine and your pharmacist will give you a “cash payment” certificate. Regularize your situation with your health insurance company and submit the certificate to obtain a refund.