At the start of the year, mutuals traditionally communicate new advantages they offer as part of their supplementary insurance. Financial interventions that may vary from region to region, within the same mutual. These benefits are not granted automatically. A request must be made, via an ad hoc form, and their granting is subject to compliance with conditions (recognized service provider, authorization from the medical adviser, etc.) and ceilings (number of sessions and maximum amount per year).
The complementary insurance for which, let us remember, the contribution is compulsory, covers a series of costs related to health care, which are little or not at all reimbursed by the compulsory health insurance. We therefore find a core core benefits in the offer of all mutuals which, to distinguish themselves from one another, offer also interventions of a often more commercial nature.
Among the 2021 novelties, many services are related to pathologies or specific (increased) needs related to the coronavirus crisis. Here are the ones we have identified.
Christian mutuality
“If there is little new in appearance this year, we have carried out a harmonization full of benefits and services for all MC members affiliated in Wallonia and Brussels. This means that there are some novelties for members of this or that region and not for others. For example, in eastern Hainaut, the “sport” advantage is granted without age limit, whereas it was previously reserved for children “, explains Joëlle Delvaux, spokesperson.
“The MC has carried out a complete harmonization of the advantages and services for all its affiliates in Brussels and Wallonia.”
Birth and adoption grant
350 euros when registering a child for the MC.
Care 0-18 years
Up to 18 years (22 years for orthodontics), reimbursement of the user fee for treatment with contracted providers if the treatment is covered by compulsory insurance (in certain cases with the agreement of the medical adviser).
Speech therapy
Refund of 100% of the user fee up to 18 years old.
Psychology (up to 240 € / year)
Intervention up to € 15 / session with recognized providers (max. € 240 / year), intervention for sexological, neuropsychological and eating disorders consultations, and intervention for each member in the event of group sessions.
Contraception (up to € 50 / calendar year)
For everyone and for all types of male and female contraceptives, up to € 150/3 years for the contraceptive IUD or implant.
Non-urgent transport (reimbursement of km)
Intervention in the cost of transport from or to a hospital of 1.50 € / km by ambulance, 0.50 € / km by adapted transport vehicle, 0.15 € / km by private car, taxi, public transport, or accompanied by an Alteo volunteer.
Hygiene care at home (5 € / treatment)
Reimbursement of up to € 5 / treatment for family help or partner home care (max. 2 toilets / week);
Home nursing care (user fees 100% reimbursed)
Automatic reimbursement if you use Home Help & Care services.
Free mutual funds (Partena)
In the context related to Covid, “we intend to draw more particularly attention to the new services in terms of Mental Health and of sport“, says Véronique De Keyser, PR Manager at Partenamut.
Psychology (320 € / year)
For all, reimbursement of up to 320 € / person (instead of 240 €), 16 sessions / year (against 12) and 20 € / session (against 15 €) + 5 sessions on the counseling and psych support line by phone or now also by video.
Sport (90 € / year)
The 50 € / year for registration in a sports club are supplemented by:
30 € for registration to an event or challenge (3 x10 €)
10 € / year for sports fitness medical examination.
“We intend to draw attention to new mental health and sport benefits.”
Coronavirus (100% of the co-payment)
User ticket covered at 100% for 6 months for post-hospitalization care (general practitioner, specialist, physiotherapist, radiology, clinical biology) of Covid patients who have stayed in intensive care.
Non-urgent transport
For beneficiaries of the increased intervention (BIM): reimbursement at 75% (instead of 50%) of non-urgent transport costs to a hospital, a rehabilitation center, a convalescent institution or a rest home.
For all: third-party payment for contracted transport.
Prevention and innovation
Test for sleep apnea (€ 10 / screening) + the Sunise sleep app (€ 20 / year)
Syndo (counseling program for those suffering from hypertension or heart disease): 50% of the coaching costs during the first 3 months.
Contraception (40 € / year)
Condoms bought in pharmacies.
Dietetic/nutritionist
Reimbursement of € 15 / session (against € 10), max. 4 sessions / year.
Heavy or chronic pathology: up to € 180 / year (€ 15 / session, max. 12 sessions)
Socialist mutual funds (Solidaris)
“This year, the big news concerns the offer linked to optics”, explains Bruno Deblander, communications director of Solidaris.
-18 years old: € 75 / year for purchases made from partners.
+18 years: € 75/3 years for purchases made with partners.
This benefit can be combined with the 30% granted to under-18s and the 20% granted to over 18s by the partner network “Optique Point de Mire”, excluding Inami reimbursement.
Psychology (240 € / year)
Consultations are better reimbursed: 240 € / year, instead of 150 €.
“This year, the big news at Solidaris concerns the optical offer.”
Other
An adjustment of the related advantages:
– televigilance;
– the loan of medical equipment;
– sports activities, courses, plains and holiday centers for under 18s (up to € 125 / year).
Heavy pathology in children (serious illness, disability): enhanced support and support. Support for costs beyond a deductible of 650 €.
Neutral mutual funds
“We do not have no major changes nor new services in any of our mutualities, ”indicates Philippe Mayné, CEO of Neutral Mutualities.
In a 2021 brochure, however, some services are marked with a small logo “better than in 2020”. The interventions concerned are those relating to:
– to the baby diapers;
– to the tests and check-ups (including € 10 / coronavirus screening test, maximum 2 / year);
– with the purchase of soles;
– to the prostheses (dental, capillary, orthopedic, acoustic, etc.);
– reimbursement of co-payments for outpatient consultations and care for under-18s.
Liberal mutuality (Hainaut- Namur)
The Liberal Mutual has also made some changes. Here are the 2021 improvements and changes for Hainaut-Namur affiliates.
Orthodontics (improvement)
Up to 400 € for a classic treatment (800 € on dispensation from the Dental Technical Council).
+ Reimbursement of legal co-payments for the duration of the treatment.
Dental care not reimbursed by the INAMI (improvement)
Up to 100 euros per year
Hospitalization (new)
Intervention in the emergency department bill when the emergency room immediately leads to hospitalization. On presentation of the original hospital invoice.
Treatment with implantable contact lenses (new)
Up to 100 euros per eye treated as a single intervention.