Frequently asked questions

Don't worry, we cover day-case admissions as well as inpatient stays with one or more overnights.

Did the hospital charge you for a day-case admission?

AG will cover the costs associated with a day-case admission. As a rule, the hospital will bill a stay as a day-case admission if your procedure is performed under general anaesthesia or if you are assigned a hospital room.  

Did the hospital charge you for a consultation (outpatient care at the hospital)?

Certain examinations or a trip to the emergency room to get fitted for a plaster cast, for example, are not billed as a day-case admission but as a consultation (outpatient care at the hospital). You will generally have to cover these costs out of pocket. 

However, if this admission is within the coverage period for medical expenses related to another hospital stay for the same condition, then these expenses may be covered.

Want to find out if the hospital will charge you for an inpatient stay or a consultation?

You can ask your doctor or hospital directly how your services and treatment will be billed.

In what circumstances will my admission to the emergency room be covered?

It depends on how the hospital charges you for the services and treatment.

Did the hospital bill your admission to the emergency room as a day-case admission?

AG will cover the medical expenses associated with a day-case admission.

Did the hospital charge your admission to the emergency room as a consultation (outpatient care at the hospital)?

Then you will have to cover these costs out of pocket.

If you believe that your hospital bill specifies "day-case admission", send us a copy for us to review. If it is indeed a day-case admission, the costs are eligible for a refund.

Was your admission to the emergency room before or after a hospital stay?

If your admission to the emergency room is within the coverage period for medical expenses related to another hospital stay for the same condition, then you can claim back the medical expenses from us.

You can report your hospital admission as soon as the date has been set and at the earliest two months in advance (three months for childbirth). In the event of an unplanned hospital admission, you have up to 30 days from the admission date to report the stay online. Feel free to contact us to open up a new claim fro you.

How do I report a hospital admission? It couldn't be easier! The FAQ "How do I report a hospital admission?" will walk you through the process.

Medi-Assistance, AG's third-party payment system, will generally set up direct payment facilities with the hospital. With this arrangement, there is no need for you to pay anything upfront. The deductible and any non-covered expenses can then be recovered later. To activate the third-party payer system, you will need to report your hospital stay to us, ideally up to two months in advance and at the latest 30 days after the admission date.

Does your plan include the Medi-Assistance option? 

If so, you will generally be able to activate the third-party payer system.

We may, however, contact you for additional information in order to set up third-party payer arrangements. In some cases, we may first need your hospitalisation report, confirmation of coverage from your Sickness Fund, information about the liable third party responsible in the event of an accident, etc.

What if your plan does not include the Medi-Assistance option? 

You will always have to settle the bill with the hospital yourself first. We will then reimburse you in accordance with the terms and conditions of your healthcare plan (agreement). You will only need to send us a copy of the detailed invoices.

For more information, read the FAQ "How do I report a hospital admission?" and the FAQ "How do I send in medical expenses?".

When you have a baby, there are a number of costs and administrative procedures to deal with. For your convenience, we have put together the most frequently asked questions for expectant parents.

Will my hospitalisation insurance cover the costs associated with having a baby?

Don't worry, the costs associated with childbirth are generally covered. However, certain restrictive conditions, such as a waiting period after a new enrolment, may apply in rare cases.

Please also note that if you purchase nappies, baby lotions, a thermometer, infant formula, etc. via the hospital, these costs will not covered and will be billed to you.

You can find all the information you need about the reimbursement of hospital expenses in the FAQ "What medical expenses are eligible for a refund?" and in the FAQ "When do I need to report my hospital admission?".

When do I need to report my hospital admission?

Whether you will be giving birth in a hospital or at home, you must inform AG.

You can report your hospital admission no earlier than three months before your expected delivery date and up to 30 days afterwards. 

We will then give the hospital our approval valid for several months. This way, there is no need for you to tell us the exact delivery date afterwards. You will then have peace of mind on the big day.

For more information on reporting a hospital admission, check the FAQ "How do I report a hospital admission?".

Can my spouse/partner also stay with me in my hospital room?

If the hospital allows it, your spouse/partner can also stay with you in the maternity ward. Note, however, that we do not cover these costs. This means that you will have to pay for the supplements and meals/drinks charged for your support person out of pocket.

Can I choose a deluxe single room for my inpatient stay?

We will cover room surcharges and supplemental doctors' fees for a stay in a deluxe single room, provided that it is not billed as a studio, suite or apartment. Otherwise, we will not be able to cover the room surcharges. It's a good idea to check with the hospital's billing department first. 

Can I give birth at home?

In most plans, a lump-sum is provided for home births, including pre-admission and post-discharge medical expenses. For more information, check the terms and conditions of your healthcare insurance.

Am I entitled to postnatal care?

In many cases, your policy covers postnatal care. To be sure, check the terms and conditions of your healthcare insurance.

Is my baby automatically covered by my hospitalisation insurance?

Your baby will not be enrolled in your hospital plan automatically.

You will need to request to have your child added to your plan within three months of the birth so that s/he can join without any waiting period or medical formalities. 

How to report a hospital admission? It couldn't be easier!

You can report your hospital admission in different ways. If you have a My Healthcare Card, you can report your hospital admission directly by logging in to MyAG Employee Benefits (app or computer).

You can report your hospital admission up to two months in advance (or three months in the case of childbirth) and as soon as possible for unplanned admissions. See the FAQ "When do I need to report my hospital admission?"  for more information.

Sometimes the hospital will change the date of a previously scheduled hospital admission. If you have already reported your hospital admission, there are several possibilities.

Has your hospital admission been accepted with third-party payer arrangements?

You should then check the acceptance letter or e-mail to see exactly when we have agreed to settle the bill with the hospital directly. You will find this information in the "Information about the hospital stay" - "Possible admission between" section. If the new admission date is between the specified dates, you do not need to do anything as our agreement with the hospital remains applicable.

If the new admission date is outside the dates listed under "Possible admission between", you must inform AG of the new date. You can communicate this information to us via the e-mail address or telephone number indicated on your hospital acceptance letter or e-mail.

Has your hospital admission been accepted without third-party payer arrangements or is further information required?

You will need to inform AG of the new date. You can communicate this information to us via the e-mail address or telephone number indicated on your hospital acceptance letter or e-mail.

AG applies a policy of hospital segmentation. We therefore cover all medical expenses in the vast majority of hospitals, regardless of the type of room selected. 

However, if you opt for a single room in an expensive hospital (e.g. a university hospital or a hospital in Brussels), you will have to pay half of the hospital bill yourself. To obtain a full refund, you can request to add the "university option" and "SL option" to your plan. 

For more information about hospital segmentation, check your plan or the "What is hospital segmentation?" section. 

Do you have coverage through your employer?

If so, then you will generally be covered if you opt to stay in a single room. Note, however, that a deductible is often applicable to stays in a single room. The deductible is also often higher than if you choose a shared room.

For more details on this subject, check the terms and conditions of your healthcare insurance or contact your HR department.

Depending on your plan, the coverage period is one or two months pre-admission and three or six months post-discharge.

Sample case: your plan includes coverage for medical expenses one month prior to admission and three months post-discharge. You were in the hospital from 10 to 15 June. The costs associated with this hospitalisation incurred between 10 May and 15 September will be eligible for coverage.
Check your policy or the covers included in your hospital plan on MyAG Employee Benefits for the exact terms and conditions applicable to refunds.

Scan the medical expenses or take a clear photo and send them (preferably in PDF format) via MyAG Employee Benefits (app or computer) or via www.ag.be/hospi.

Note that prior registration is required in order to send in medical expenses via MyAG Employee Benefits (app or computer). You will be prompted to check your personal details and provide a bank account number.
You will find more information on registering on MyAG Employee Benefits​​ on this page or on the app.

 
What if you don't want to send in medical expenses online?

Don't worry, you can always send us the documents by ordinary mail. Fill out the "Request to claim back medical expenses".

Are your expenses associated with a hospital stay or a claim? Then fill out the"Report a hospital admission" form to declare your expenses.

Send the completed form with copies of invoices or proof of payment to:

• AG Insurance
  Medical Dept - Health Care
  53 boulevard Emile Jacqmain 53
  1000 Brussels

Note: if sending by ordinary mail, send us a copy of these medical expenses and always keep the original documents.

Please include your bank account number and specify your reference, contract and/or card number on one of the enclosed documents or the cover letter.

Can I send in medical expenses for my family members?

You can send in medical expenses for all members of your family covered under the same plan, provided that they have activated their card: they need to be registered and to have verified their personal details and bank account number.

How do I send in medical expenses for a family member?

Scan the medical expenses or take a clear photo and send in them online (preferably in PDF format) via MyAG Employee Benefits (app or computer) or via www.ag.be/hospi.

Note: medical expenses can only be sent in via MyAG Employee Benefits (app or computer) if the family members are already registered on MyAG Employee Benefits.

For your minor-age children, this is done automatically when you finalise your own registration. Your partner and adult children will need to register on MyAG Employee Benefits.

You will find more information on registering on MyAG Employee Benefits on this page.

 
What if you don't want to send in medical expenses online?

Don't worry, you can always send us the documents by ordinary mail. Fill out the "Request to claim back medical expenses."

Are your expenses associated with a hospital stay or a claim? Then fill out the "Insurance claim" form to declare your expenses.

Send the completed form with copies of invoices or proof of payment to:

• AG Insurance
  Medical Dept - Health Care
  53 boulevard Emile Jacqmain 53
  1000 Brussels

Note: if sending by ordinary mail, send us a copy of these medical expenses and always keep the original documents.
Please include your bank account number and specify the reference, contract and/or card number for the family member in question on one of the enclosed documents or the cover letter.

When do I need to send in my medical expenses?

Depending on your plan, the coverage period is one or two months pre-admission and three or six months post-discharge. This means that the outpatient care and treatment must be provided or purchased during this period.

However, the statutory time limit for sending in medical expenses associated with your hospital stay is three years.

Of course, we recommend not waiting until the last minute to send in your expenses.

If you have outpatient care insurance, the three-year period also applies and you can send in your expenses throughout the year.

How do I send in my medical expenses after an appointment with my GP, dentist or physiotherapist?

How does it work in practice?

There are two options:

1. After an appointment with a GP, physiotherapist or dentist, if you already use the "Helena" portal (in a few months' time, this will also be possible via the "OxiCity" portal), you can immediately forward your invoices to your insurer in one single click, and you'll get your money back shortly afterwards. To make use of this option, your consent will be required. You can give it on the patient portal or on the Assurmed website (if you do not have access to a patient platform).
2. With the barcode on the invoice or proof of purchase you send in via MyAG Employee Benefits, AG can immediately retrieve your data in digital form and issue the refund. You then give your consent (one time only) via www.assurmed.be.

With AssurMed, you get more streamlined handling of your expenses with GPs, dentists and physiotherapists, which means you get your money back even faster. This only applies if you have outpatient care coverage or if the expenses were incurred during the pre-admission/post-discharge period if you have hospitalisation coverage.

To treat a critical illness such as cancer, diabetes, Crohn's disease, etc., a hospital stay is not always required. Your doctor, physiotherapist, etc. can also provide you with quality care. This type of outpatient care is added to your hospital bill and can add up to quite a hefty sum if you need long-term treatment.

Fortunately, we have you covered. Despite the term "hospitalisation", your AG hospital plan will refund the cost of treating a critical illness year-round, even outside of any hospital stay.

How does critical illness coverage work?

• Request to activate the coverage
  To activate the "critical illness" coverage, you'll need to send us a medical report from your attending physician with the name of your illness, the date of diagnosis and the planned treatment.
  
  
• Evolution of your "critical illness"
  After a certain amount of time, we may request a new medical report to see how your situation is evolving.
  
  
• End of critical illness
   Coverage will end when we receive a medical report stating that you have recovered and show no more signs of the illness. However, we'll continue to refund the costs of your annual critical illness-related check-ups.
  
  
• Relapse
  If, after some time, you have a relapse and the illness returns, your critical illness coverage can be reactivated. In that case, you simply repeat the procedure outlined above.
  To find out which conditions qualify for "critical illness" coverage, check the covers in your hospital plan or contract.