Joining a health insurance fund when arriving in Belgium: timing, choice, students and families

Information checked on 25 October 2026.

In Belgium, compulsory health insurance goes through a mutuality (health insurance fund): you choose a mutuality from one of the five national unions, or the CAAMI, a public fund with no complementary contribution. Join as soon as you are registered with the municipality, with your national register number. A student from outside the European Union pays a legal contribution of 78.93 euros per quarter in 2026 in the « student » category; registered as a « resident » without income, they generally pay no legal contribution. A spouse and children can be registered as dependants, with no contribution.

This article is part of the series on arriving in Belgium. For the overview by visa, read the central page arriving in Belgium with a D visa.

Why the mutuality is unavoidable

The Belgian system refunds nothing directly: INAMI organises health care insurance, and the mutualities pay it out. According to INAMI, to be entitled to refunds, you must join a mutuality. The University of Namur calls it a legal obligation for anyone living in Belgium.

Without membership, you pay everything yourself: a consultation, an X-ray, a night in hospital. And for a student, proof of health insurance determines the residence card.

The bodies to choose from

INAMI lists five national unions, plus two public funds:

The legal refund is the same everywhere. What changes is the complementary insurance. The mutualities of the five unions make it compulsory with membership, for a contribution (about 45 euros per quarter in 2026 according to UCLouvain), and in return offer extra benefits: glasses, psychologist, speech therapist, osteopath, sport, travel assistance. CAAMI only offers compulsory insurance: no complementary contribution, no extra benefits.

How to choose? Compare the benefits you will actually use (a baby on the way, glasses, a sport), how close an office is and the language spoken at the counter. You can change mutuality later.

When to join

There is no single deadline set in days, but any delay costs you: care received before membership is not covered. Do it as soon as you have proof of your registration with the municipality:

Ask the mutuality you choose from which date your care will be refunded, and keep your care certificates in the meantime.

Documents to bring

• your residence document (A card, registration certificate or annex 15 with D visa);
• a residence certificate and, if you have dependants, a household composition, issued by the municipality;
• depending on your status: enrolment certificate from the institution (student), contract or payslip (employee);
• the mutuality's membership form, often available online.

Your « status »: employee, student, resident, dependant

The mutuality registers you under a status that sets what you pay:

• Employee: you are the main member (titulaire). Social contributions are deducted from your salary; the complementary contribution of the chosen mutuality remains.
• Student: the « student » category costs a legal contribution of 78.93 euros per quarter in 2026 (UCLouvain figure). It is mainly for those whose legal domicile is not yet in Belgium.
• Resident: once registered with an address in Belgium, you can switch to « resident ». CAAMI states that without official income, you pay no contribution; with income, the contribution is proportional.
• Dependant: registered under a main member's account, pays nothing.

Students from outside the European Union: visa insurance or mutuality?

For the D visa, the Immigration Office asks for proof of health insurance. Many students arrive with travel insurance or insurance linked to their scholarship. Two paths, according to UCLouvain:

• You have insurance on arrival: the municipality directly issues the one-year residence permit, then you join a mutuality as a « resident ».
• You arrive without insurance: the municipality gives you a 4-month registration certificate. You join a mutuality, most often as a « student », and bring the proof to the municipality no later than 15 days before the 4 months end. You then receive the A card, and can switch to « resident », which is cheaper.

Private travel insurance often covers routine care poorly and has a limited duration: the mutuality remains the lasting solution. The details of the first month are in international student in Belgium: the steps of the first month. Comparing with France? The system there is different, see social security for international students in France.

Spouse and children: registering dependants

INAMI recognises as dependants the spouse, the cohabitant (only one), children under 25 and some ascendants. The main rules:

• the main member applies to their mutuality, with a statement of the dependant's income;
• the spouse or cohabitant must in principle live with the main member, and their income must stay under a ceiling;
• for a child under 25, there is no income condition; their main residence must be in Belgium;
• the dependant pays no contribution.

Arriving through family reunification? The main member already living there can prepare the registration as soon as you are registered with the municipality: see family reunification in Belgium: what happens after arrival.

General practitioner and global medical file (DMG)

In Belgium, choose a general practitioner and ask them to open your global medical file (DMG). According to INAMI, opening it is completely free for you. In return, what you pay yourself for a consultation with that GP (the patient's share) is capped at 4 euros, and at 1 euro if you are entitled to increased reimbursement. The DMG also gives access to certain care pathways.

Refunds in practice

At the doctor's, you pay the consultation or only your share, depending on the practice. The mutuality then refunds the legal part to your Belgian bank account. So give your account number to the mutuality when you join. Reimbursed medicines cost less at the pharmacy once your membership is active. In hospital, the mutuality pays a large part of the costs directly.

BIM status: increased reimbursement

On a low income, you can apply for increased reimbursement (intervention majorée, BIM status): your share goes down for consultations, medicines and hospital. For a 2026 application based on the previous year's income, the ceiling is 28,054.93 euros gross taxable per year for a one-person household, plus 5,193.74 euros per additional member. Some specific situations follow a different ceiling (29,236.66 euros since 1 September 2026). Ask your mutuality, which examines the file.

Summary table

The other arrival steps

The mutuality comes after the municipality and before most other steps. The entry page of the series sums up each country's deadlines: arriving in Europe with a long-stay visa.

Finding your compatriots

Which mutuality answers in French, English or Lingala? Which GP near you still takes new patients? Your compatriots who are already settled know. On Compatri, find every community present in Brussels, in Liège, in Charleroi and in the other cities of Belgium, or your country's diaspora: Senegalese in Belgium, Ivorians in Belgium, Congolese in Belgium.

Compatri is neither a mutuality nor an insurer, and does not sign you up anywhere. Only INAMI and your mutuality are authoritative.

Official sources

• INAMI: joining a mutuality
• INAMI: contacting the mutualities (list of national unions)
• INAMI: your right to refunds as a dependant
• INAMI: the global medical file (eDMG)
• INAMI: increased reimbursement, income ceilings
• CAAMI: health care insurance for students
• Immigration Office: first residence authorisation for studies
• UCLouvain: health insurance for students from outside the European Union
• University of Namur: administrative steps and mutualities 2026-2027