Frequently asked questions about not being entitled to reimbursements
Not up to date with your social security contributions
Are you self-employed or receiving an allowance? If so, don’t forget to pay your social security contributions. Otherwise, you won’t receive any reimbursements from the statutory health insurance scheme.
At Helan, we review all files annually. For this, we always look back two years.
To determine eligibility for reimbursements from the statutory health insurance in 2026, we need to look at the social contributions you paid in 2024.
This means that you may currently be up to date with your social contributions, but if you were not two years ago, you still will not be entitled to reimbursement for that period.
Yes. If you are not in good standing with statutory health insurance, you cannot benefit from the third-party payment system. This is the system that allows patients to pay only their personal contribution, also known as the co-payment.
During a visit to a doctor or hospital, you will be informed that your insurance status is not in order. As a result, you will be charged the full rate.
When your statutory health insurance file is not in order because you did not pay social contributions, you are not entitled to reimbursement of your medical expenses at that time.
But there is good news! If you later bring your file back in order, you may still receive reimbursement afterwards.
- So make sure you keep all doctors’ notes and other proof of payment.
- If you are later informed that your file is back in order, submit your medical certificates to us.
- This can be done via a Helan mailbox or by post to Helan Onafhankelijk ziekenfonds, Boomsesteenweg 5, 2610 Wilrijk.
When you are not in order with statutory health insurance, this has an impact on the reimbursement of medical care for anyone who is dependent on you.
- If your partner has their own health insurance file, they will not be affected.
- If you have children who are dependent on you and you are unable to bring your file in order, schedule an advice appointment.
If you are registered on your parents’ or partner’s file, you are granted the same rights as that person. When that person’s rights are not in order, you therefore also have no rights. It is the responsibility of the policyholder to take the necessary steps.
Yes, even if you are not in good standing with statutory health insurance, we still recommend paying your health insurance contributions. This way, you can still receive reimbursements from the supplementary benefits.
Both for statutory health insurance and for supplementary benefits, we are required to close your file if it has not been in order for more than 2 years.
Not up to date with your health insurance contributions
Anyone who does not pay their health insurance contributions will not receive any reimbursements under the supplementary benefits scheme.
You are confusing supplementary benefits with statutory health insurance.
- Paying your health insurance contribution ensures that you are entitled to reimbursement from the supplementary benefits.
- Reimbursement from statutory health insurance depends on whether or not you paid social contributions on your income.
- Employees usually do not need to think about this. Social contributions are automatically deducted from their salary.
- Self-employed people must arrange this themselves every quarter through their social insurance fund.
- People who received a minimum number of days of benefits due to retirement, unemployment, incapacity for work, or parental leave must also pay social contributions.
If you are registered on your parents’ or partner’s file, you are granted the same rights as that person. When that person’s rights are not in order, you therefore also have no rights. It is the responsibility of the policyholder to take the necessary steps.
Yes, even if you are not in good standing with statutory health insurance, we still recommend paying your health insurance contributions. This way, you can still receive reimbursements from the supplementary benefits.
Both for statutory health insurance and for supplementary benefits, we are required to close your file if it has not been in order for more than 2 years.
Not up to date for other reasons
You’re working abroad, so you no longer pay social security contributions here. Consequently, you’re required to take out insurance abroad.
Depending on the country where you worked, it may still be possible to bring your insurance status in order retroactively. Unfortunately, this is not possible for all countries. The Netherlands is an example of this. Schedule an advice appointment with us so we can help you get started.
Do you work for an institution such as the European Union, NATO, SHAPE or UNESCO? If so, they provide health insurance (for example JSIS). Please provide us with a certificate clearly stating the start date of this insurance.
