Third-party payment scheme
With the third-party payment scheme, you only pay your share of the costs to your doctor, dentist, physiotherapist, pharmacist, or other healthcare provider.
What is the third-party payment scheme?
If your healthcare provider applies the third-party payment scheme, you only pay the co-payment. With a non-contracted healthcare provider, an additional fee may be charged.
You do not advance the reimbursement from the health insurance. Your health insurance fund pays that amount directly to the healthcare provider. You therefore do not need to send any treatment certificates to your health insurance fund afterwards to request reimbursement.
Do you already have a global medical record opened with your general practitioner? Check it right away in your file.
Who is entitled to the third-party payment scheme?
You are always entitled to the third-party payment scheme if you are admitted to the hospital, and in most cases at the pharmacy, provided your file is in order.
- Since 1 January 2022, the third-party payment scheme is available to everyone, including for outpatient services.
- The application of the third-party payment scheme is optional for both the patient and the healthcare provider, and therefore not mandatory for either party.
- The general practitioner is required to apply the third-party payment scheme for patients with an increased allowance, except during home visits.
Good to know
Fully reimbursed does not always mean completely free. If your doctor is not contracted and therefore does not adhere to the official tariffs, you may have to pay an additional fee out of pocket. Check whether your doctor is contracted.
