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Think you could benefit from supplementary insurance coverage?​

No doubt you’ve already noticed medical expenses outside of a hospital stay (doctors’ appointments, orthodontics, etc.) can quickly add up.

In addition, the Belgian National Institute for Illness-Disability Insurance puts a maximum cap o​n the refunds you can claim. For example, did you know that:


 

You still have to pay 20% of your outpatient care expenses out-of-pocket.


For prescription medication, appointments with your GP or consultations with a specialist, you end up paying roughly 20% of the costs yourself. But this doesn’t have to be the case anymore if you take out outpatient care coverage.

 

Speech therapy sessions are not reimbursed by the Belgian Institute for Illness


30 speech therapy sessions will cost you up to €1,402.50 and this amount will not be refunded.

 

The average cost of an orthodontic treatment is €3.092


The cost of orthodontic treatment – including fitting and placement of the device – can easily add up to an average of €3.092 and the Belgian National Institute for Illness-Disability Insurance will refund only €710.

 

A unique fringe benefit available via the federal government departments

Through your employer, as active worker, you’re entitled to supplementary coverage.

Select the option that best meets your needs.

 
 

Dental Flex

€8.91 / adult

€6.18 / child

Per month

 

Ambucare Flexible

€21.91 / adult

€7.22 / child

Per month

Dental costs

Dental and orthodontic treatments * dental protsthetics*, dental x-rays, checkups and tooth extractions

Dental and orthodontic treatments * dental protsthetics*, dental x-rays, checkups and tooth extractions

Outpatient medical treatment

///

doctors’ appointments, house calls, technical medical services and minor surgery

nurse-administered treatment, kinesitherapy and physiotherapy

radiology, medical imaging and laboratory analyis

Pharmaceutical products, orthopedic devices and eyewear

///

licenced medication and bandages sold in pharmacies

Optical and hearing devices

///

eyeglass frames* (up to €85), eyeglasses*, contact lenses* and hearing aids*

orthopedic devices

///

bandages and splints

paramedical treatments​

///​

partial coverage (50%) can be claimed for :

consultations with a psychologist, nutritionist, podiatrist or speech pathologist

consultations with an osteopath, chiropractor, homeopath or acupuncturist

homeopathic remedies

Refund

Exemption

None

Deductible

No deductible

Maximum cap

1250 ​€ per year and per insured*

Reimbursement rate

80%

Practical example

Exemption

None

Deductible

75 € per year and​ per insured person

Maximum cap

1250 € per year and per insured*

Reimbursement rate

80%

Practical example

Affiliation

Waiting period

None

Exclusion, refusal

None

Waiting period

None

Exclusion, refusal

None

*An intermediate cap of €250 for Year one, €500 for Year Two and €1250 for Year Three will apply to all costs combined

What isn’t covered?


No coverage will be provided for medical expenses that are the result of "serious misconduct" (for example, reckless behaviour, heavy alcohol consumption or narcotic use). Non-medically necessary treatments such as cosmetic treatments, contraception and preventive check-ups and examinations will also be excluded from coverage. In addition, maximum caps and reimbursement rates will apply.

Your hospitalisation insurance covers the costs associated with your inpatient stay, such as your hospital bill and additional doctors' fees before and after your hospital admission. These costs are only covered for a limited period of time (two months pre-admission and six months post-discharge).if you incur other medical expenses outside this period, you can claim back the costs via your outpatient care plan or dental insurance.

Let’s say that you or one of your children has an accident and needs dental treatment to repair the damage. You will get absolutely nothing back from the national Illness-Disability insurance (INAMI/RIZIV), regardless of how much you have had to pay out of pocket. Fortunately, if you have an outpatient care plan or dental insurance to fall back on, you can claim back the costs of ​this treatment up to maximum of € 1,250*.

​Warning: for certain covers such as eyewear and orthopaedic devices, orthodontics and prosthetics (including dental bridges and implants), an intermediate cap of €250 for Year one, €500 for Year Two and €1250 for Year Three will apply to all covers combined​

You will have three months to decide whether or not you want to sign up for a Dental or Ambucare plan from the day you receive your second letter from AG Insurance at your home address. The first letter contains information about the outpatient care plan options (Dental Flex and Ambucare Flexible). A few days later, a second letter will be sent to you containing all the details you need to register on My Global Benefits. Once you have successfully ​completed your registration, you simply go online to select your desired option. Note: The timing for the letters will vary depending on the institution you work for. Click here for an overview of the dates. Haven’t yet received your letter by the scheduled date? We may not have your correct address. Check this with your HR department.

When you sign up for Ambucare Flexible, you get the total package. With Dental Flex, you get the covers listed in item 3. below:

  1. Outpatient care (doctors’ appointments, physiotherapy, medical imaging, etc.)
  2. Pharmaceutical products, eyewear and orthopaedic devices (prescription medication, eyeglasses and frames, contact lenses, hearing aids, etc.)
  3. Dental care and dental prosthetics (dental treatment, dental bridges, crowns and implants, orthodontics, etc.). This coverage is also available as a stand-alone plan (Dental Flex).
  4. 4. Paramedical treatment (consultations with a psychologist, nutritionist, podiatrist, speech pathologist, chiropractor, homeopathy and acupuncture, homeopathic remedies, etc.)
Check the details of your covers via Ambucare Flexible and Dental Flex

No coverage will be provided for non-medically necessary treatment such as cosmetic procedures, contraceptive treatment, and preventive check-ups and examinations. Medical expenses that can be attributed to "gross negligence" (e.g. reckless behaviour or the use and abuse of alcohol or narcotics) are also excluded from coverage.

Have you decided to sign up for one of the outpatient care plans? ? If so, then your enrolment already started on the first day of the month your invitation letter was sent to you in the mail.

  

Let’s say that you received your invitation letter on 10 February, but only formally signed up on 5 March. Guess what? Your coverage already started on 1 February. This means that you can claim back medical expenses incurred as of this date from AG Insurance. All you have to do is send in your doctors’ fees, invoices, receipts, etc. to AG Insurance. This can be done by ordinary mail (completed form + receipts) or quickly and easily online via the web form where you can immediately attach your scanned expenses.

   Tip: Don’t remember what you did with your receipts? Ask your Sickness Fund for an overview.

Your options are to enrol just yourself or your entire family. For example, you cannot enrol just you and your children without also including your spouse/domestic partner. If you opt to sign your family up for the plan, everyone will be covered under the same plan.

For example, you cannot mix and match by selecting Dental Flex for yourself and Ambucare Flexible for your family.

Premiums may be paid quarterly or annually. You can also opt to pay by direct debit.

Your employer, the Federal Public Service, has arranged for you to sign up without having to comply with any medical formalities. This means that there is no medical questionnaire for you to fill out:

  • and therefore no additional premiums or exclusions
  • plus no exclusions for pre-existing conditions

Your coverage is effective immediately. There is no waiting period to serve.

Your coverage will be valid until you leave the Federal Public Service. You always have the option to take out continuation coverage on an individual basis. Just keep in mind that your premium will go up (the premium is linked to your age).  

Interested in applying for individual continuation coverage? E-mail us at continuation@aginsurance.be.

You can easily send in your doctors’ fees, invoices, receipts, etc. by filling out the form and sending it in by ordinary mail together with your receipts or, alternatively, via the web form where you can immediately attach your scanned expenses. Just click on this link and follow the instructions.

 Tip: Don’t remember what you did with your receipts? Ask your Sickness Fund for an overview.

Yes, you can claim back your outpatient care costs in Belgium and abroad. Good to know if ever you incur medical costs while on vacation.

Yes, in some cases.

  1. If you recently got married or have just welcomed a new kid into the family AND you previously opted to enrol your entire family in the plan, these new family members will be enrolled automatically.
  2. If you recently got married or have just welcomed a new kid into the family AND, as you were previously single, you only enrolled yourself in the plan, you will be given the option to enrol your new family members.
  3. However, if you previously enrolled just yourself (even though you also had a spouse/partner and/or children at this time), you will not be allowed to enrol any other family members.

My Global Benefits is a secure web-based platform where you can find out everything you need to know about your AG Insurance policies (if you have coverage through your employer). And precisely because the site is so secure (prior registration is required), is this the go-to place to select your desired outpatient care plan.

  Once you have successfully registered on My Global Benefits, you can also use your My Healthcare Card (which will also be sent to your home address) at the pharmacy. All you have to do is hand your card to the pharmacist who will scan the barcode printed on the back side, and your proof of purchase will be sent to AG Insurance automatically. To start with, you ​can use this card at the pharmacy for your pre-admission and post-discharge expenses or for critical illness-related medical expenses. If you also opt for an outpatient care plan, then you can use the card year-round.

Warning: Be sure to input your bank account number in My Global Benefits first so that we know which account to credit!

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