Before you start

Commune registration and a national register number
A Belgian bank account for reimbursements
S1 or E104 form from your previous EU health insurer, if you have one
Employment or self-employment status, which determines how contributions are collected

Step-by-step

1
Choose a mutuelle and join it yourself
Solidaris and the Mutualité chrétienne are the largest in Wallonia, alongside the liberal, neutral and independent funds, and the free public fund CAAMI/HZIV. Statutory cover is identical everywhere; they differ on complementary benefits, service and the small monthly contribution. Nobody enrols you — not your employer, not the commune.
In personWho: YouWeek 1–3
2
Hand over your S1 or E104 if you were insured in the EU
These forms carry prior cover across and prevent a fund applying a waiting period before entitlement begins. Ask your old insurer for the form before you leave — obtaining it afterwards is much slower and occasionally impossible.
In personWho: You
3
Register a dossier médical global (DMG) with one GP
Nominating a single GP to hold your DMG raises the reimbursement on GP consultations substantially and gives you a doctor holding your whole record. It costs you nothing — the fund pays the GP an annual fee for keeping it — and it is the highest-return few minutes in the Belgian system.
In personWho: YouFirst GP visit
4
Check whether a doctor is conventionné
Doctors who have signed the national fee agreement charge the official tariff; those who have not may add supplements your reimbursement does not cover, because the refund is calculated on the official rate regardless. It is published information and it is a question to ask when booking rather than at the desk afterwards.
OnlineWho: You
5
Take hospitalisation insurance before you need it
Statutory cover handles most hospital costs, but a private single room can carry very large room and fee supplements. Hospitalisation insurance via your mutuelle, an insurer or your employer is the standard Belgian answer and is far cheaper taken in advance.
OnlineWho: You
6
Use 1733 out of hours, and 1722 when the water rises
Evenings, weekends and public holidays, 1733 routes you to the on-call GP service — free, intended, and quicker than an emergency department for anything a GP can handle. 1722 is the separate non-urgent fire brigade line, which in a river city that flooded badly in July 2021 is a number worth having in your phone before you need it.
OnlineWho: You

Documents you’ll need

eID and national register number
Belgian bank account details
S1 or E104 from a previous EU insurer
Employment contract or self-employed social insurance affiliation
Vaccination records for children entering school

Things most newcomers don’t know

Compulsory does not mean automatic — you have to join a fund yourself.

Your employer registers you for social security, which funds the system, but the mutuelle that actually reimburses you is a separate membership you take out. Until you have, you carry the full cost of treatment. Newcomers from countries with a national health service, or where the employer arranges cover, routinely spend their first weeks in Belgium uninsured without realising it.

Source: RIZIV/INAMI

The dossier médical global is free and raises your GP reimbursement immediately.

Nominating one GP to hold your DMG increases the refund rate on GP consultations, improves continuity because that doctor holds your full record, and costs you nothing because the fund pays the GP for maintaining it. It also makes out-of-hours cover and specialist referrals smoother. It is the cheapest optimisation in the Belgian system and a large share of foreign residents never hear of it.

Source: RIZIV/INAMI

Wallonia runs long-term care and disability support through AVIQ, not through the Flemish scheme.

Health insurance is federal, but the care and support layer around it is a Community and Regional matter. In Wallonia that is AVIQ, which handles disability support, home care and residential care policy; Flanders has its own scheme with its own annual care contribution, and Brussels a third arrangement. Anyone with a family member needing long-term care, or with a disability, needs the Walloon answer rather than a Belgium-wide one — and the entitlements do not simply travel with you if you move region.

Source: AVIQ; Walloon Region

The whole system runs in French here, including out of hours.

112 is answered in French, Dutch and English, and hospital emergency departments will find someone. Routine care is different: GP surgeries, the 1733 on-call service, pharmacy advice and mutuelle counters all work in French, and the paperwork that decides what you get reimbursed is in French. If your French is limited, choosing a GP who speaks your language is worth more than choosing the nearest one — and the university hospital, with an international faculty, is the likeliest place to find one.

Source: community-reported

Common mistakes to avoid

Assuming your employer or the commune enrols you in a health fund.
Leaving the S1 or E104 behind and being told a waiting period applies.
Never registering a dossier médical global and overpaying on every GP visit for years.
Booking a non-agreement specialist without asking about supplements.
Looking up Flemish long-term care entitlements and assuming they apply in Wallonia.

Some of this may be out of date. Spotted something inaccurate? Help us keep it right for the next newcomer.