Belgium - Long-term care

This chapter tells you what you need to know in order to benefit from long-term care benefits in Belgium.

In what situation can I claim?

While there is no specific insurance for long-term care in Belgium, federal and federated regulations however provide for benefits aimed at dependent, disabled or elderly persons, who require specific equipment or long-term care. In particular:

the integration allowance (AI); federal social assistance due to offset the additional costs associated with a loss or reduction of autonomy; the benefits in kind provided by the federal compulsory healthcare and sickness benefit insurance for persons unable to perform on their own the basic activities of daily living (nursing care at home and assistance of a third party, for example);the allowance for assistance to the elderly (APA) in the Walloon Region, in the Brussels-Capital Region and in the German-speaking Community: allowance for disabled persons designed to offset the additional costs associated with a loss or reduction of autonomy; the allowances provided by the Flemish Social Protection (Vlaamse Sociale Bescherming):
- care budget for the severely dependent persons: aid and assistance of a non-medical nature supplied by third parties to persons with reduced autonomy in a residential, semi-residential or out-patient setting;
- care budget for persons with disabilities: allowance granted to persons with a recognized disability and with a limited need for assistance. The budget can be used freely for assistance needs: nursing care at home, day care, accompaniment, purchase of service vouchers, community care, etc.;
- care budget for elderly persons requiring care: allowance designed to offset the additional costs associated with a loss or reduction of autonomy. This budget replaced the APA for persons residing in the Flemish region;
personal assistance budget provided by the Walloon social protection for disabled persons;
benefits in kind provided by the social protection of each of the federated entities for elderly persons as well as persons with a mental or physical disability (reception and accommodation in rest homes, in day care centres as well as stays in psychiatric nursing homes and assisted-homes initiatives, for example).

What conditions do I need to meet?

Federal compulsory healthcare and benefit insurance

To benefit from the federal compulsory insurance:

you have to be affiliated to a health insurance body which is itself affiliated to a certified national union of mutual insurance funds, or register with the Auxiliary Fund for Sickness & Invalidity Insurance (CAAMI);
your contributions have to reach at least a given minimum amount. If such is not the case, an additional contribution has to be paid to maintain the entitlement to healthcare;
your affiliation to the health insurance body expires at the latest at the end of the second year following the last year for which you were insured;
you suffer from a lack or reduction of autonomy.

Integration allowance

To provide assistance with the additional costs which you will meet as a disabled person in arranging your day-to-day living space (motorised wheelchair, special equipment for the bathroom or the kitchen, etc.), an integration allowance (AI) may be awarded to you if:

your disability is certified by an approved medical doctor;
your income does not exceed certain limits;
you are at least 18 years of age and under 65;
you are included in the population register;
you are domiciled in Belgium and actually reside there.

More information about the integration allowance is available on https://www.socialsecurity.be

Allowance for assistance to the elderly

If you are aged 65 or over and you have difficulty in carrying out your day-to-day activities, you may be entitled to an allowance for assistance to the elderly (APA). This allowance is identical to the integration allowance, but is aimed at persons aged 65 or over. The earliest you can claim this allowance is the day of your 65th birthday. In addition to this age condition, the following criteria also have to be satisfied:

you are domiciled in Wallonia, in Brussels or in the German-speaking Community and actually reside there;
your disability has been recognized by a medical officer (doctor from insurance companies in Wallonia, doctor or multidisciplinary team appointed by the administration in Brussels);
your earnings and those of your partner do not exceed certain limits, except for the German-speaking Community where income is not taken into account;
you are listed on the population register.

More information about APA is available on https://www.socialsecurity.be/

https://www.vlaamsesocialebescherming.be and https://www.iriscare.brussels.

Flemish Social Protection (Vlaamse sociale bescherming) in the Flemish region.

Flemish Social Protection is a set of interventions and funding systems for long-term care within the Flemish Community.

Membership is compulsory in Flanders and voluntary in the bilingual Brussels-Capital Region. A contribution of €29 or €58 is requested (in 2023) from each insured person, which finances the healthcare budgets.

To be eligible for a care budget for the severely dependent persons or for a care budget for elderly persons requiring care, the insured person must have resided 10 years (of which 5 years continuously) five years in the Flemish region or in the Brussels-Capital region and be member of an agreed insurance fund. To be eligible for a care budget for the severely dependent persons, persons subject to the obligation of completing the integration path need an integration certificate (from 18 to 65 years of age). The beneficiary must also, depending on the intervention, either have a reduced self-sufficiency capacity within a residential, semi-residential or outpatient framework or have a recognised disability or be at least 65 years of age with a disability or a reduction in self-sufficiency (7 points or more on the autonomy scale). Medical examinations for the care budget for elderly needing assistance are still conducted at the federal level.

More information available on https://www.vlaamsesocialebescherming.be.

Walloon Social protection in the Walloon Region

To be eligible for the Walloon social protection (benefits in kind), you have to reside on the territory of the French-speaking Walloon Region. To be entitled to the personal assistance budget for persons with disabilities, several criteria must be satisfied by the applicants:

they have to be Belgian citizens or be assimilated to a person having the Belgian nationality, or have 5 years of continuous residence in Belgium;
they have to be domiciled on the territory of the French-speaking Walloon Region (i.e. in one of the Walloon communes except for the 9 communes forming the German-speaking Community);
they have to be under 65 years of age when submitting their first application for an intervention;
they have to have a disability.

More information available on https://www.aviq.be

Brussels social protection in the bilingual Brussels-Capital Region

To be eligible for the Brussels social protection, you have to reside on the territory of the bilingual Brussels-Capital Region.

More information available on https://www.iriscare.brussels

Social protection in the German-speaking Community

To be entitled to the personal assistance budget for persons with disabilities, several criteria must be satisfied by the applicants:

they have to be domiciled on the territory of the German-speaking Community; and be insured primarily in Belgium
they have to be under 65 years of age when submitting their first application for an intervention;
they have to require assistance.

The average allowance granted amounts to €266.71 per month if you have BIM status.

More information available on http://www.ostbelgienlive.be

What am I entitled to and how can I claim?

Federal compulsory healthcare and benefit insurance

Nursing care at home: assessment is made on the basis of the Katz evaluation scale (bathing, dressing, transfers and locomotion, toileting, continence, feeding).

Assistance of a third party: the level of need of assistance of a third party is assessed on the basis of the total number of points assigned within the framework of the degree of autonomy evaluation.

To submit an application: www.socialsecurity.belgium.be.

Integration allowance

The degree of autonomy is generally established by a medical expertise: it serves as a basis for calculating the amount of the allowance payable. The latter can be cumulated with the income replacement allowance. The earnings of the person concerned as well as those of the partner with whom he/she forms a household are taken into account when calculating the allowance.

To submit an application: https://handicap.belgium.be/fr/nos-services/allocation-integration.htm

Allowance for assistance to the elderly

The German-speaking Community

It resumes the full competence in 2023 (see: Ostbelgien Live - Pflegegeld ).

The Joint Community Commission of Brussels-Capital is competent for the assistance to the elderly (APA) since 1st July 2014 but the Federal public service for social security kept managing this allowance during a transition period. This management is ensured since 1st January 2021 by the bi-Community Office for health, aid to individuals and family benefits (Iriscare), except for determining the level of autonomy decrease (task progressively transferred from the Federal public service for social security).

To submit an application: https://www.iriscare.brussels/nl/burgers/ouderen/tegemoetkoming-voor-hulp-aan-bejaarden-met-een-handicap/Flemish social protection

The care budget for the severely dependent recognized as heavily relying on nursing at home amounts to €135 per month.
Elderly persons living in a rest home, a retirement and nursing home or a psychiatric nursing home can also be entitled to an allowance of the same amount.

To submit an application: https://www.vlaamsesocialebescherming.be/zorgbudget-voor-zwaar-zorgbehoevenden

The care budget for persons with disabilities, also called basic assistance budget (BOB), is an allowance granted to persons with a recognized disability and with a limited need for assistance. It is a fixed amount of €300 per month which can be used freely for assistance needs: nursing care at home, day care, accompaniment, purchase of service vouchers, community care, This budget is automatically granted (no application possible).

More information available on: https://www.vlaamsesocialebescherming.be/zorgbudget-voor-mensen-met-een-handicap

The care budget for elderly persons (65 years and over) requiring care can reach a maximum amount of €683 per month according to the income and the importance of care needed.

To submit an application: https://www.vlaamsesocialebescherming.be/zorgbudget-voor-ouderen-met-een-zorgnood

The Walloon social protection

More information concerning benefits related to long-term care in the French-speaking Walloon Region and concerning the relevant application procedures available on https://www.aviq.be/

The Brussels social protection

More information concerning benefits related to long-term care in the bilingual Brussels-Capital Region and concerning the relevant application procedures available on http://www.iriscare.brussels/fr/citoyens/

The German-speaking Community social protection

More information concerning benefits related to long-term care in the German-speaking Community and concerning the relevant application procedures available on https://ostbelgienlive.be/desktopdefault.aspx/tabid-3132/5785_read-35691/

Jargon busters

AI: integration allowance
APA: allowance for assistance to the elderly
BOB: basic assistance service
CAAMI: Auxiliary Fund for Sickness & Invalidity Insurance
SPF Social Security: Federal public service responsible for social security.

Forms you may need to fill in

To submit an application, see

Know your rights

The links below allow you to find out more about your rights. These sites are not dependent upon the European Commission and so do not represent the viewpoints of the latter.

For more information about the Federal compulsory healthcare and benefit insurance: