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Coronavirus (COVID-19): FAQ
If you get vaccinated against COVID-19, can you claim coverage via your hospital plan, outpatient care plan and/or income protection plan?
HOSPITALISATION - Vaccination (for all vaccines, including for COVID-19) isn't covered by your outpatient care insurance or hospitalisation insurance. If, however, you are admitted to the hospital due to COVID-19 vaccine-related complications, coverage can be claimed for this inpatient stay through your hospital plan.
INCOME PROTECTION - If you get vaccinated against COVID-19 and, as a result of this injection, end up having to take incapacity leave due to an incident referred to in your income protection plan, you will be able to claim coverage through your income protection plan.
If, after being vaccinated against COVID-19, you end up dying as a result of this injection, will your beneficiary(ies) be entitled to your death benefit coverage?
If, after being vaccinated against COVID-19, you should die as a result of your injection, your beneficiaries will be able to claim your death benefit proceeds.
What happens to coverage abroad in the various zones (green, orange, red)?
If you have a staff member travelling abroad, s/he will be entitled to coverage in the event of an illness, accident or repatriation.
It is very important, however, that your staff member strictly complies with all instructions given by the local and Belgian authorities (see https://diplomatie.belgium.be/en), in red zone destinations as well as elsewhere.
The Belgian federal government further wishes to sensitise travellers to the fact that new COVID-19 outbreaks abroad can significantly impact their travel plans, and that repatriation cannot be guaranteed if commercial flights are cancelled or borders closed.
At the current time, code red means that travel to a country with this colour code is strongly discouraged by the Belgian federal government, or that the authorities of the country in question prohibit non-essential travel from Belgium or impose restrictions (testing, quarantine, etc.).
What happens to your insurance covers if you take coronavirus parental leave?
Due to the coronavirus outbreak and the resulting school closures,
parents with a child under the age of 12 or a disabled child under the age of 21 are
now entitled to take coronavirus parental leave until 30 September 2020. This measure has not been extended.
AG considers coronavirus parental leave
to be the equivalent of ordinary parental leave. This means that
the rules for ordinary parental leave also apply to coronavirus parental leave.
Your employer needs
to inform you of the consequences this leave may have on your insurance covers (retirement, death, hospitalisation, guaranteed income protection and waiver of premiums).
Does your hospitalisation insurance cover medical expenses related to epidemics or pandemics such as coronavirus (COVID-19)?
All medical expenses associated with coronavirus are refundable. This includes treatment in Belgium or abroad, but only if in connection with a hospital admission.
The treatment must be
curative, administered by an
accredited physician and eligible for statutory compensation under the Belgian Social Security system.
If you have
outpatient care insurance through your employer, then any medical expenses that you incur outside of a hospital setting will also be covered, provided that they fulfil the above-mentioned criteria.
Is the cost of screening and testing for coronavirus also covered?
If your employer has taken out
hospitalisation insurance with AG for you and/or your family, then the cost of such tests
will be refundable if they are an essential part of a curative treatment, carried out an
accredited physician and
eligible for statutory compensation under the Belgian Social Security system.
The government has given instructions not to charge for COVID-19 diagnostic tests. These costs will be covered in full by the INAMI/RIZIV.
AG's hospital plans do not refund the cost of testing carried out on an outpatient basis.
The National Institute for Health and Disability Insurance (INAMI/RIZIV) will cover the cost of COVID-19 testing according to certain criteria.
Below are the refunds provided by the INAMI/RIZIV for COVID-19 testing:
- For a molecular diagnostic test (RT-PCR test): a refund of EUR 46.81
- For an antibody test (blood test): a refund of EUR 9.60.
- For an antigen test (rapid diagnostic test): a refund of EUR 16.72.
These amounts include all test-related costs: test materials, equipment, reagents, investment costs, quality control, payroll, supervision, protective equipment, transport costs, etc.
Preventive screening tests for coronavirus do not fulfil these criteria and are therefore
not covered under our policies.
What if you are quarantined due to COVID-19? Can you claim coverage under your hospital plan in that case?
If you need to be
quarantined for some time due to COVID-19
even if you are not actually
sick, these expenses are
not covered by your hospitalisation insurance. A quarantine is a preventive measure and does not require a hospital stay. In principle, the cost will be covered by the local or Belgian federal authorities.
If you are sick and need to be hospitalised, regardless of whether you have been quarantined or not,your hospital plan will refund the hospital expenses.
Given the extraordinary circumstances, many medical professionals may now diagnose patients with symptoms of coronavirus infection by telephone. Will these teleconsultations be refunded?
Teleconsultations will temporarily be recognised by the INAMI/RIZIV as a specific type of doctor's appointment. The cost for consultations with a general practitioner will be
directly billed to the patient’s Sickness Fund. As the patient will not be charged any co-payment or additional out-of-pocket expenses, there are no costs to claim back from AG.
For other consultations, the usual terms for claiming a refund will apply. The services or treatment must be prescribed by a doctor and recognised by the INAMI/RIZIV as curative therapy. Any entitlement to a refund and the amount that may be claimed will depend on the type of plan (hospitalisation or outpatient care coverage).
Hospitals are postponing admissions for non-life-threatening conditions and operations in order to prioritise care for coronavirus patients. How does this affect refunds for pre-admission outpatient care expenses that you incur in connection with these hospitalisations?
If your scheduled admission has been postponed due to the coronavirus outbreak,
AG will temporarily refund outpatient care expenses incurred in the pre-admission period applicable to the initially scheduled inpatient stay. Outpatient care expenses incurred between the initially scheduled admission and the new admission date will also temporarily be covered. Outpatient care expenses during these periods will be reimbursed in accordance with the above-mentioned conditions, provided that our medical department has already received advance notice of the admission (e.g. via Medi-Assistance).
Sample case: Imagine your inpatient stay scheduled for 15 December 2020 has been postponed by the hospital to 15 January 2021 due to coronavirus measures. If your hospital plan includes pre-admission coverage for up to one month prior to the scheduled inpatient stay, the plan will refund outpatient care expenses associated with the admission from 15 November 2020 until the new admission date (15 January 2021) set by the hospital.
We do, however, request that you
notify us as soon as possible of the new admission date set by the hospital.
What if you are on long-term sick leave due to coronavirus? Will you be entitled to coverage through your corporate-sponsored income protection plan?
If you are ill and/or on extended sick leave as a result of being infected by coronavirus, then it will be considered a case of
- During the first month of incapacity, the employer will pay your salary as usual.
- Afterwards, you are entitled to state benefits through the Belgian National Social Security system.
- If your employer has had the foresight to take out an
income protection plan for you, you will collect a replacement income (on top of your state benefits).