After discussion about fee supplements: even with hospitalization insurance you can still cost a lot: « Many people don’t know that »
If the doctors had not threatened with a strike, the discussion about their fee supplements seemed a discussion far from their hospital bed for many people in recent days. Because almost nine in ten Belgians have hospitalization insurance. « Without worries in a single room » or « Hospital, doctor and room type: the choice is yours », it says in advertising texts of the insurers. They just pay your invoice, right?
The answer is no. « Many policies exclude the coverage of supplements above 150 percent to 300 percent. Many people don’t know that, » they say at the Solidaris Health Insurance. « For those who do not have hospitalization insurance, it is of course even worse. Tarificness and affordability are completely searched for such supplements. »
Deep in the policy conditions are often restrictions on reimbursement. Some insurers have a list of « expensive hospitals » where they only pay half of the invoice, others include in their policy conditions that they only repay 100 percent or 150 percent in fee supplements.
And that while doctors in many hospitals are allowed to charge 200 or even 300 percent extra to those who take a single room. « Those excesses must be removed, » said Vandenbroucke in parliament. He speaks of a ceiling of 125 percent of fee supplements in the hospital. This means that the invoice in a single room per 100 euros in set rates is still a maximum of 225 euros.
But even that is already higher than the ceiling that imposes different insurance policies. « It is often captured among the mutual insurance companies, » says Barbara van Speybroeck of Insurerskoepel Assuralia. « With the insurers it depends on the product. The major players have different products. There are products that cover up to 125 percent and there are that up to 300. The choice is up to the customer, the premium will be corresponding. »
Policy conditions
It is difficult to find out how many people can stand for extra costs after a recording. Around four in ten Belgians have an additional hospitalization insurance through their health insurance fund, the CM alone has 1.2 million in Flanders. Almost five in ten are insured with a private insurer, usually through the employer as part of the wage package.
To give you an idea, we checked the policy conditions of insurers that they publish online. At Ziekenfonds Helan, your premium is twice as high for insurance that refunds 300 percent in supplements as when you are satisfied with 100 percent. CM reimburses up to 150 percent in the basic option and up to 200 percent if you pay a quarter extra. Solidaris also has two options – 100 percent or 200 percent.
“The large insurers have different products. There are products that cover up to 125 percent and there are that go up to 300. The choice is up to the customer, the premium will be corresponding”
Barbara van Speybroeck
Insurers dome Assuralia
With Ethias, the premium is half higher for insurance that intervenes for supplements of up to 300 percent (and 100 percent for day admission). The cheapest option gives you a ‘joker’ after one year as a customer to get to a one -off up to 300 percent repayment.
KBC Insurance and AG Insurance both work with a list of expensive hospitals, where they only intervene for 50 percent of the invoice. It is always almost exclusively about Brussels hospitals that work with fee supplements of 300 percent. In a few hospitals, « this personal share can be bought off with the payment of an additional premium, » says AG.
The Flemish hospitals charge on average lower fee supplements in their single rooms, but there too it is often more than 150 percent. In Aalst or Heusden-Zolder it even goes up to 300 percent. And fee supplements are also charged to around 200 percent in Antwerp.
