A hospital stay

Before admission 

In many cases you will know a few weeks or days in advance that you will have to spend time in hospital, e.g. for surgery. In this case you choose in advance the hospital and the type of room.

• Selecting a hospital
  
  The choice of a hospital is free, but often depends on a number of factors. Regardless of the location, each hospital has its specialisations. It can also be that your attending physician or specialist is attached to a particular hospital. 
   
• Selecting a room type
  
  The choice of a room type seems simple, but there are a few important points to bear in mind. You are well advised to check in advance whether your hospitalisation insurance covers the room and fee supplements for a single room.
  Also note the possible deductible (own portion), i.e. the amount that is not reimbursed by the hospitalisation insurance.

Once you have chosen your hospital and room type, it's time to report your admission to your insurer.

If you have to go into hospital, it can be that you have already received treatments prior to the admission. These so-called 'outpatient' or 'ambulatory costs' are usually reimbursed by your hospitalisation insurance.

While in hospital 

Once in the hospital, you must sign the declaration of admission. This document contains, among other things, the room choice and other information on the subsequent billing of your hospital stay. After signing the admission form, the hospital will sometimes ask for an advance.

After the hospital stay 

• The bill
  
  The hospital will send the hospital bill only 2 to 3 months after the end of your stay. This will tell you the share that has already been paid by your health insurance and the portion that you have to pay yourself. Your personal contribution consists of the co-payment (patient contribution) and any supplements. These depend on your choice of room.  
  
  If your insurance provides a third party payer agreement, your insurer will receive the hospital bill and pay directly to the hospital. You will then receive a settlement statement, with any non-reimbursed costs deducted from the repayment of your medical care before and after your hospital stay. 
  In other cases, the bill is sent to your home.

• Medical care after admission
  
  It often happens that you need to take medication in the weeks following your hospital stay, receive treatment (e.g. physiotherapy) or return to the hospital for checks. This is so-called outpatient (or ambulatory) care. Your hospitalisation insurance will reimburse these costs if incurred within a certain period before or after your hospital stay, if the INAMI/RIZIV recognizes the costs, and if they are directly linked to the reason for admission.

Are outpatient operations also covered?

Outpatient operations ('one-day hospitalisation') are today more the rule than the exception for keyhole surgery and minor surgical interventions such as arthroscopy, extraction of wisdom teeth, and treatment of varicose veins. You stay one day in the hospital and are allowed home the same day. Where the hospital invoices your hospital stay as one-day hospitalisation, your hospitalisation insurance refunds your costs. 

To be quite sure, you can best check in advance with your treating physician or the hospital. You should not confuse one-day hospitalisation with urgent care received in a hospital, such as placing a plaster cast on a broken foot or an emergency admission. These are settled through an 'outpatient bill' and your hospitalisation insurance reimburses only if the care relates to a recent hospitalisation.

What happens in the case of an accident? 

If you land in hospital after an accident, the same conditions apply as for a planned hospitalisation. Obviously you cannot inform your insurer of this admission in advance.

The information provided about hospital stays is for general information purposes only. For more details and information about how to claim a refund from AG Employee Benefits for your hospital expenses, go to the "I'm admitted to hospital"  page.