Special Solidarity Fund
Do you need a treatment that is not reimbursed by the statutory health insurance? In exceptional cases, you may receive financial support from the Special Solidarity Fund for a very serious condition.
When can you make use of it?
The Special Solidarity Fund can provide support in exceptional situations.
- For treatments or medicines that have proven their therapeutic value, are recognised here or abroad, but for which no equivalent alternative reimbursed by the health insurance system exists yet.
- For treatments or medicines that are included in the Belgian insurance package, but where the patient does not meet the medical conditions to receive reimbursement.
- For the treatment and the travel and accommodation costs, after approval by the advising physician or the board of medical directors, and prior to treatment abroad.
Have you already opened a global medical record with your general practitioner? Check it right away in your file, because it allows you to pay a lower co-payment for your visits to the GP.
How do you submit an application
You can submit your application up to a maximum of 3 years after the service was provided. While awaiting medical approval, you must first pay your medical invoices yourself.
Please note! You must always apply in advance for reimbursement of medical expenses abroad.
Send a registered letter to the advising physician of your health insurance fund: Helan Health Insurance Fund – Medical Service – Boomsesteenweg 5 in 2610 Wilrijk.
Include the following documents with your application:
- a medical prescription from your specialist
- a medical report that is as complete as possible
- a cost estimate (or an invoice of the costs)
- a sworn statement declaring that you cannot obtain reimbursement for these services in any other way
- informed consent (you will receive this from your health insurance fund)
The advising physician of your health insurance fund reviews your file and submits your application to the College of Medical Directors of the RIZIV or to the expert committee.
The College of Medical Directors or the expert committee decides whether you will receive financial support and determines the amount of the reimbursement.
Good to know
For a chronically ill child, an intermediary (e.g. your health insurance fund or the social service of the hospital where your child is being treated) can submit the application to the Special Solidarity Fund on your behalf. You will still need to sign the sworn statement.
What are the conditions?
Your medical treatment must meet a whole series of conditions. Here is an overview of the most important criteria:
- The condition is rare and affects vital functions.
- The costs of the treatment are high and are not reimbursed.
- The treatment has recognised scientific value and effectiveness, has passed the experimental stage, and is absolutely necessary from a medical‑social perspective.
- An alternative treatment that is eligible for reimbursement is not possible in your case.
- The treatment is prescribed by a specialist physician who is specialised in your specific condition.
On the website of the RIZIV you can find detailed lists of all legal criteria. Or ask your doctor for more information.
