WRITTEN QUESTION E-2355/02

by Ieke van den Burg (PSE) to the Commission

(31 July 2002)

Subject: Exclusion from health insurance in Belgium resident system

1. Is the Commission aware that Dutch pensioners living in Belgium are denied access to the Belgian medical insurance scheme as persons entered in the national register of natural persons (hereafter referred to as the resident system) if they are or may be entitled to health care under a foreign scheme?

2. Is the Commission aware that the exclusion from the Belgian resident system also applies if the persons concerned can opt for admission to a voluntary insurance scheme, such as the voluntary insurance cover provided for by the Exceptional Medical Expenses Act (AWZB) in the Netherlands?

3. Does the Commission not consider it unacceptable that because the AWZB in the Netherlands provides only partial cover for medical expenses and the health insurance system in the country of residence, Belgium, does not provide for a complementary package, which firstly makes joining the AWZB voluntary scheme virtually compulsory and secondly means that the persons concerned are denied the possibility of insuring themselves in their country of residence exclusively against the risk of medical expenses not covered by the AWZB voluntary scheme, those concerned have to insure themselves twice, or if they are unable to obtain cover on the private health insurance market are denied adequate protection against the risks of medical expenses? How should application of the Belgian regulations be seen in relation to Article 13, paragraph 2, point (f) of Regulation (EEC) No 1408/71?

4. If the Belgian resident system is to be classified as voluntary or optional continued insurance, how does application of the relevant legislation by Belgium accord with Article 15, paragraph 2, of Regulation (EEC) No 1408/71, under which the persons concerned are free to opt for the scheme of their choice if application of the legislations of two or more Member States entails overlapping of two or more systems of voluntary or optional continued insurance?

Response given by Mrs Diamantopoulou on behalf of the Commission

(7 October 2002)

In accordance with Belgian legislation regarding compulsory health insurance, different categories of people are entitled to healthcare. In the main these people are in employment or in receipt of a replacement income. Furthermore, in order to include all persons resident in Belgium, those on the national register are also entitled to cover. However, any person who is or may be entitled to healthcare under another Belgian or foreign scheme does not qualify for this option.

This would appear to be the case with Dutch pensioners who can voluntarily join the Dutch insurance scheme established under the Exceptional Medical Expenses Act. As a result they are excluded from the Belgian scheme for persons on the national register because they may be entitled to healthcare under a foreign health insurance scheme.

Therefore, under Article 15(2) of Regulation (EEC) No 1408/71(1), where application of legislations of two Member States entails overlapping insurance:

- under a compulsory insurance scheme and one or more voluntary or optional continued insurance schemes, the person concerned shall be subject exclusively to the compulsory insurance schemes;

- under two or more voluntary or optional continued insurance schemes, the person concerned may join only the voluntary or optional continued insurance scheme for which he has opted.

As a result, if the Belgian scheme for persons on the national register is a compulsory insurance scheme, the retired Dutch national in the situation referred to by the honourable Member of Parliament should be subject exclusively to the compulsory Belgian scheme, under the terms of Article 15(2).

If the Belgian scheme is voluntary, under the terms of the above-mentioned Article 15(2), the pensioner should be able to choose between the Belgian voluntary insurance scheme and the Dutch voluntary insurance scheme.

The Commission will ask the Belgian authorities for further details regarding the voluntary or compulsory nature of the scheme provided for persons on the national register as well as their opinion as regards the Commission's analysis. The honourable Member of Parliament will be informed of the results of the Commission's investigation into this matter.

(1) Regulation (EEC) No 1408/71 of the Council of 14 June 1971 on the application of social security schemes to employed and self-employed persons and their families moving within the Community, OJ L 149, 5.7.1971.