Choosing a hospital
The standard of medical care is very high in Belgium, and the services, facilities and infrastructure are comparable in all types of hospital, whether you choose a public, private or university hospital.
In Brussels and the surrounding areas of Flemish Brabant and Walloon Brabant, there are 17 hospitals where you can give birth. So how do you choose?
In this section, we look at:
While in Belgium you are free to choose your care provider / hospital (e.g. it is not dependent on where you live), the two are closely linked. Where you can have your baby may depend on whether or not you have already chosen a care provider.
You have already chosen a care provider?
- If your gynaecologist delivers babies, then he/she will already be affiliated with a certain hospital (or in some cases, more than one hospital), and can only deliver babies in that hospital.
- If your gynaecologist does not deliver babies (e.g. could be the case if you see a gynaecologist at a family planning centre), he/she may still be affiliated with a hospital, and you would be under the care of the on-duty gynaecologist for the birth. Alternatively, you might prefer to change care provider.
- If your independent midwife performs hospital deliveries, then she will probably already be affiliated with a hospital.
You haven't chosen a care provider yet?
Then you are free to choose any hospital, irrespective of where you live. Perhaps you would like to choose a hospital that:
In this case, you might find a gynaecologist or independent midwife by asking your chosen hospital for a list of care providers who deliver there, and/or by asking for recommendations from people you know.
The one factor that can have the biggest impact on your final hospital bill is the kind of room you choose on the maternity ward.
Most hospitals offer a choice between a single room and a 'shared' room, which usually only has 2 beds (sometimes 3). If you choose a single room, not only do you pay a supplement for having a single room (this may be around €140 extra per day), but ALL the care that you receive during your time in hospital can be up to 200% to 300% more expensive. Note: if you are given a single room even though you did not request one, you will not have to pay a single-room supplement.
In the table below (published by the Union Nationale des Mutualités Libres (national union of liberal mutuelles) using data from 2010), you can see the impact of room type on the total cost, on the amount reimbursed by the 'mutuelle' / 'ziekenfonds', and on the final 'supplement' that will be partly /fully reimbursed by your hospitalisation insurance, or that you will have to pay yourself if you do not have this level of cover:
|type of birth||type of room||total cost||reimbursed by mutuelle||you pay||supplement*|
* the supplement is payable either by you or your hospitalisation insurance if you have such coverage
Single rooms usually have their own bathroom and area to wash and change your baby. It is also usually possible for the partner to stay overnight.
Many hospitalisation insurance policies cover all birth-related costs, irrespective of the room type you choose, but it's worth checking this with your insurer before making a decision.
Hospitals fall under the broad categories of 'public' and 'private', and some private hospitals are also university/teaching hospitals. The impact this has on how much the birth and hospital stay will cost you may depend on your personal insurance situation.
Some hospitalisation insurance policies cover all costs related to giving birth, irrespective of where you give birth or what kind of room you choose, so price need not be a factor in your choice of hospital. However, if you do not have such comprehensive coverage (e.g. if you will not benefit from reimbursement from the mutuelle), it might be worth keeping in mind that:
- private hospitals are generally more expensive than public hospitals
private hospitals that are also university hospitals are more expensive than non-university hospitals. For women who are covered by a 'mutuelle' / 'ziekenfonds', this difference is more than compensated by the fact that mutuelle/ziekenfonds reimburse a larger proportion of the costs related to the hospital stay and medical care in university hospitals than in non-university hospitals (1).
All hospitals should be able to provide you with a fee schedule, so that you can see how the costs are broken down - you will probably have to explicitly ask for this. Some mutuelles also provide hospitalisation cost simulators (this one is in French), which lets you compare hospital costs, and can give you a general idea of the difference between hospitals.
Private hospitals - non-university
Private hospitals - university
Private hospitals - non-university
Private hospitals - university
Irrespective of how you choose your hospital, it is a good idea to go on a hospital tour to find out more about their services and see if you like the atmosphere and philosophy of birth. Some hospitals take you on a tour of the actual labour and maternity wards, while others simply show a slideshow and offer a question and answer session in a conference room. Either way, you should have a chance to ask any questions you have.
Most hospitals offers tours in English, but even if they don’t (or you can't make to an English session), it may be worth joining a French/Dutch tour as most staff speak some English and should be able to answer your questions (or find someone who can). You usually have to register for a tour as places are often limited.
Some hospitals have websites where they give details of tours - otherwise you may have to phone the main reception for details.
Hospitals will typically require some kind of pre-admission, but the exact timing depends from one hospital to another. For example, Edith Cavell hospital requires mothers to 'reserve their room' around the third month of pregnancy. For other hospitals, pre-admission can be done much closer to the birth.
Ask your hospital what their procedure is, and which documents you will need to complete and submit. It may also be worth checking with your hospitalisation insurance provider, as sometimes your insurer will first need to send confirmation of your insurance coverage to the hospital.
One big advantage of the Belgian system is that, once you have chosen your care provider/hospital, you are not obliged to stick with that choice. If, for whatever reason, you are no longer happy with your choice, you can change care provider right until the moment you give birth - subject of course to agreement from your new care provider.
For list of hospitals in Brussels: http://www.health.belgium.be/filestore/19087231/D1-Brussel.pdf