What are the rules on the reimbursement of costs for dental care, new glasses or a scan? You can’t claim for these ‘ambulatory costs’ on your hospitalisation insurance, and your health insurance fund will only provide limited reimbursement. Because ambulatory costs can be high, 43% of Belgian employers now offer an ambulatory plan that covers these costs. In the latest episode of our video podcast, insurance expert Bert Van den Broeck talks about the importance and benefits of this insurance for employers and employees.
The original recording of this videopodcast is available in Dutch and French.
14% of Belgian families delay medical care for financial reasons.
In a country such as Belgium, this is a remarkably high figure, especially when you consider its social security and health care facilities. As an employer, you can provide a response to this with collective ambulatory health insurance. We’d go so far as to say that an ambulatory plan is good for your employees’ health. It removes the financial barrier, so that they seek professional help sooner and are therefore less likely to drop out of work.
An ambulatory plan covers all costs for medical care provided outside hospital and not paid or reimbursed by hospitalisation insurance. These costs are called ‘ambulatory costs’. We distinguish between two types of costs:
If you’re admitted to hospital, your hospitalisation insurance will intervene to cover the costs. The same goes for some 30 serious diseases such as diabetes and cancer. But what about all the other ambulatory costs of health care? These can be quite high, and are only partially reimbursed by the health insurance fund. An ambulatory plan can provide a solution for costs that are not reimbursed and therefore remain the patient’s responsibility.
After reimbursement from the health insurance fund, 19% remains to be paid by the family.
Around 80% of Belgian families have a hospitalisation plan today. The ambulatory plan is not yet so well established, but it is catching up fast, as is clear from these figures for the proportion of companies in our portfolio with an ambulatory plan: 14% in 2011, 34% in 2021 and 43% in 2023.
The value of an ambulatory plan will increase even further in the future. Hospital admissions are growing ever shorter and an increasing proportion of medical costs is incurred outside the hospital bill. You can use your ambulatory plan for these.
Every employee faces ambulatory costs, so everyone also experiences the benefits of an ambulatory plan:
On average, 50 euros per month would be covered by an ambulatory plan.
As an employer, you’re in the driving seat: you can offer a plan that’s tailored to the wishes and budget of your organisation. You can arrange limited cover or offer a full option plan that covers dental and/or optical care in addition to general medical care. As well as your employees, you can include their family members too. Finally, you can opt for reimbursement up to a certain maximum amount per year or as a certain percentage of the submitted costs each time.
As an organisation, you pay attention to your employees’ health and well-being so that they feel good and can be the best version of themselves. An ambulatory cost plan is the ideal way to make care as accessible as possible for them. At the same time, it can be an extra weapon in the war for talent.
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On 1 January 2025, the statutory retirement age in Belgium will rise from 65 to 66. Five years after that, it will be 67. How do these changes affect your company’s supplementary personnel schemes? A quick update.
The increase in the minimum guaranteed return on supplementary pensions has been officially announced. The change will take effect at the beginning of 2025. Here is an update.
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