Do I have to join a health insurance fund (ziekenfonds / mutualité) in Belgium?
In short
Yes. To get your doctor's, medicine and hospital costs reimbursed, you must be registered with a health insurance fund or with the public fund HZIV / CAAMI.
Video transcript
You have just arrived in Belgium. You need to see a doctor. Required: To get costs reimbursed, you must be registered with a health insurance fund or with HZIV / CAAMI. The right way: Choose a ziekenfonds / mutualité and register. HZIV / CAAMI is a public fund with no membership fee. If not registered: Fine: None; But: No reimbursement; Hospital bill: You pay it all.
What is not allowed, what is required?
- To get your medical costs reimbursed (terugbetaling / remboursement), you must be registered with a health insurance fund (ziekenfonds / mutualité).
- You choose the fund: a ziekenfonds belonging to one of the national associations, or the state-run auxiliary fund HZIV / CAAMI (Hulpkas / Caisse auxiliaire).
- HZIV / CAAMI does not charge a membership fee (lidgeld / cotisation), but nor does it offer supplementary insurance (aanvullende verzekering / assurance complémentaire).
- To benefit from a ziekenfonds's supplementary insurance, you must pay your membership fee regularly.
- Self-employed people must also join a social insurance fund. If they do not choose one, they are automatically enrolled with the National Auxiliary Fund (Nationale Hulpkas / Caisse nationale auxiliaire).
Penalty and indirect consequences
- Fine / payment
- No fine; but if you are not registered, you will not be reimbursed and will have to pay the bill yourself.
Legal basis:RIZIV – Aansluiten bij een ziekenfonds
- Court / prison
- No prison sentence.
What really matters: the indirect consequences
- Hospital and surgery costs can be very high
- Sickness and disability benefits (uitkering / indemnité) are also paid through this fund
Legal basis:RIZIV – Aansluiten bij een ziekenfonds
- If you do not pay the fee, you cannot benefit from the supplementary insurance services
Legal basis:RIZIV – Aansluiten bij een ziekenfonds
Why does this rule exist?
The health system is based on solidarity: everyone contributes, and those who are ill get support. Because you are registered, the system pays most of your doctor's and hospital bills.
Where can you go?
- The organisation that pays your benefitPension: Federal Pension Service (FPD / SFP) · Unemployment: RVA / ONEM or your payment organisation (trade union / HVW-CAPAC) · Sickness: ziekenfonds / mutualité
- OCMW / CPASQuestions about social assistance and social housing
- Social interpreterAt the municipality, the OCMW/CPAS, school and hospital, you can ask for an interpreter in your language; it is often free.
This site does not handle individual cases; it points you to the right service. All help addresses
Source and reliability
Official source- Source check
- 8 / 8 statements in an official source
- Checked: 12.10.2026
- Last checked
- 12.10.2026
- Rules can change
Show the 8 checked statementsopen
- Found in an official source
Geri ödeme hakkı için ziekenfonds üyeliği zorunlu
RIZIV – Aansluiten bij een ziekenfonds - Found in an official source
Ulusal birliklerden biri veya HZIV seçilebilir
RIZIV – Aansluiten bij een ziekenfonds - Found in an official source
HZIV aidat almaz, ek sigorta vermez
RIZIV – Aansluiten bij een ziekenfonds - Found in an official source
Ek sigorta için aidatta düzenli olmak gerekir
RIZIV – Aansluiten bij een ziekenfonds - Found in an official source
Serbest meslek: sosyal sigorta sandığı; seçmezse Nationale Hulpkas
Wikifin (FSMA) – De verplichte ziekteverzekering - Found in an official source
Ziekenfondsen hem sağlık hizmetlerini hem ödenekleri öder
RIZIV – Aansluiten bij een ziekenfonds - Found in an official source
Kayıtsızsa fatura kişiye kalır (para cezası yok)
RIZIV – Aansluiten bij een ziekenfonds - Found in an official source
Ek sigorta yalnız aidatını ödeyen üyeye sunulur
RIZIV – Aansluiten bij een ziekenfonds
The checked statements are in Turkish, as in the source text. This check does not replace legal advice.
General information, not legal advice. For your own situation, ask a lawyer or free legal aid. How was this information prepared?