Long-term care financing in Belgium

Abstract

Long-term care (LTC) in Belgium consists of a wide range of benefits in cash and in kind, organized at the federal, regional and municipal levels, and is related to health and social service provision.1 The bulk of LTC services are provided as part of the federal public compulsory health insurance system, which is financed by social security contributions and general taxes. The main actors in the management of the system are the federal parliament (issuing the main laws governing the system), the Ministries of Health and Social Affairs, the National Institute for Health and Disability Insurance (NIHDI) and the sickness funds, which serve as intermediaries between the administration, the providers and the patients. Since public health insurance covers practically the whole population, LTC coverage is also nearly universal. However, since LTC services provided through the health insurance system cover only nursing care (as well as paramedical and rehabilitation care) and part of personal care to dependent persons, a whole range of services is organized and provided at the regional and local level. Indeed, while there is no specific LTC legislation at the federal level, the regional governments have issued decrees that regulate a wide range of issues related to LTC services: certification of facilities such as nursing homes and day care centres, integration and coordination of services at the local level, quality monitoring systems and so on.