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Coronavirus (COVID-19): FAQ
What happens to your insurance covers if you take coronavirus parental leave?
Due to the coronavirus outbreak and the resulting school closures, parents with a child under the age of 12 or a disabled child under the age of 21 are now entitled to take coronavirus parental leave until 30 June 2020. AG considers coronavirus parental leave to be the equivalent of ordinary parental leave. This means that the rules for ordinary parental leave also apply to coronavirus parental leave.
Your employer needs to inform you of the consequences this leave may have on your insurance covers (retirement, death, hospitalisation, guaranteed income protection and waiver of premiums).
Does your hospitalisation insurance cover medical expenses related to epidemics or pandemics such as coronavirus (COVID-19)?
All medical expenses associated with coronavirus are refundable. This includes treatment in Belgium or abroad, but only if in connection with a hospital admission.
The treatment must be curative, administered by an accredited physician and eligible for statutory compensation under the Belgian Social Security system.
If you have outpatient care insurance through your employer, then any medical expenses that you incur outside of a hospital setting will also be covered, provided that they fulfil the above-mentioned criteria.
Is the cost of screening and testing for coronavirus also covered?
If your employer has taken out hospitalisation insurance with AG for you and/or your family, then the cost of such tests will be refundable if they are an essential part of a curative treatment, carried out an accredited physician and eligible for statutory compensation under the Belgian Social Security system. The government has given instructions not to charge for COVID-19 diagnostic tests. These costs will be covered in full by the INAMI/RIZIV.
Preventive screening tests for coronavirus do not fulfil these criteria and are therefore not covered under our policies.
What if you are quarantined due to COVID-19? Can you claim coverage under your hospital plan in that case?
If you need to be quarantined for some time due to COVID-19 even if you are not actually sick, these expenses are not covered by your hospitalisation insurance. A quarantine is a preventive measure and does not require a hospital stay. In principle, the cost will be covered by the local or Belgian federal authorities.
If you are sick and need to be hospitalised, regardless of whether you have been quarantined or not,your hospital plan will refund the hospital expenses.
Given the extraordinary circumstances, many medical professionals may now diagnose patients with symptoms of coronavirus infection by telephone. Will these teleconsultations be refunded?
Teleconsultations will temporarily be recognised by the INAMI/RIZIV as a specific type of doctor's appointment. The cost for consultations with a general practitioner will be directly billed to the patient’s Sickness Fund. As the patient will not be charged any co-payment or additional out-of-pocket expenses, there are no costs to claim back from AG.
For other consultations, the usual terms for claiming a refund will apply. The services or treatment must be prescribed by a doctor and recognised by the INAMI/RIZIV as curative therapy. Any entitlement to a refund and the amount that may be claimed will depend on the type of plan (hospitalisation or outpatient care coverage).
Hospitals are postponing admissions for non-life-threatening conditions and operations in order to prioritise care for coronavirus patients. How does this affect refunds for pre-admission outpatient care expenses that you incur in connection with these hospitalisations?
If your scheduled admission has been postponed due to the coronavirus outbreak, AG will temporarily refund outpatient care expenses incurred in the pre-admission period applicable to the initially scheduled inpatient stay. Outpatient care expenses incurred between the initially scheduled admission and the new admission date will also temporarily be covered. Outpatient care expenses during these periods will be reimbursed in accordance with the above-mentioned conditions, provided that our medical department has already received advance notice of the admission (e.g. via Medi-Assistance).
Sample case: Imagine your inpatient stay scheduled for 1 April 2020 has been postponed by the hospital to 15 May 2020 due to coronavirus measures. If your hospital plan includes pre-admission coverage for up to one month prior to the scheduled inpatient stay, the plan will refund outpatient care expenses associated with the admission from 1 March 2020 until the new admission date (15 May 2020) set by the hospital.
We do, however, request that you notify us as soon as possible of the new admission date set by the hospital.
What if you are on long-term sick leave due to coronavirus? Will you be entitled to coverage through your corporate-sponsored income protection plan?
If you are ill and/or on extended sick leave as a result of being infected by coronavirus, then it will be considered a case of occupational incapacity.
- During the first month of incapacity, the employer will pay your salary as usual.
- Afterwards, you are entitled to state benefits through the Belgian National Social Security system.
- If your employer has had the foresight to take out an income protection plan for you, you will collect a replacement income (on top of your state benefits).