CM-MediKo Plan in detail

CM-MediKo Plan is an insurance for medical expenses that are not related to hospitalisation.

Join CM-MediKo Plan Calculate your premium

Are you going to the dentist, ophthalmologist or physiotherapist? You don't think about it, but the costs for these visits can quickly add up to hundreds and even thousands of euros. Not to mention the costs for braces, glasses or hearing aids, for example. With the CM-MediKo Plan, you will also be reimbursed for a large part of these costs.

I am not yet affiliated with CM-MediKo Plan

The biggest advantages of this insurance for medical costs are the premiums that start from 12.57 euros per month, the short waiting time, the very favorable membership conditions for newborns and the easy application for reimbursements. Moreover, everyone is really welcome!

What is insured within CM-MediKo Plan?

CM-MediKo Plan provides extensive coverage for:

Co-payment: a reimbursement of 75% up to 1,500 euros per year for services provided by doctors, specialists, dentists, physiotherapists, speech therapists, nurses and other healthcare providers. Please note that supplements that the healthcare provider may request in addition are not eligible. A deductible of 30 euros per insured person is applied to the total reimbursement for the statutory co-payments for all services from the same calendar year.
Orthodontics: up to 600 euros for all treatment plans started before the 18th birthday and up to 600 euros for all treatment plans started after the 18th birthday.
Dental prostheses and implants: up to 600 euros per year
Periodontics: up to 600 euros per year
Monophonic hearing aids: up to 600 euros per device
Stereophonic hearing aids: up to 1200 euros per device
Corrective lenses: up to 120 euros per year
Lens implants: up to 250 euros per year
Surgical correction of your vision outside the hospital: up to 250 euros per year
Travel vaccines against yellow fever, hepatitis A, typhoid fever, Japanese encephalitis, tick-borne encephalitis, polio and meningococcal ACWY up to 25 euros per year
Childbirth allowance of 250 euros per birth
Nutrition and diet advice: up to 40 euros per year

What is not insured within CM-MediKo Plan?

CM-MediKo Plan does not reimburse costs:

with the co-payment guarantee and hearing aids for which there is no right to reimbursement from the statutory health insurance
that occur within an admission period or during a day admission
for services that are not prescribed in Belgium and are not provided in Belgium
for services that have not been performed or not prescribed by a doctor.

How much does my CM-MediKo Plan cost?

Premiums start from 12.57 euros per month and depend on your age. In the calendar year of membership, your premium depends on your age on the date of membership. Afterwards, your premium depends on your age on December 31 of the calendar year preceding the premium period. From the 4th connected dependent, the premium is limited to a maximum of 8.90 euros.

You can calculate your premium yourself here . The table below provides an overview of the premiums per month in euros:

If joining before the 60th birthday
0-9 years	12.57
10-19 years	16.84
20-34 years	17.69
35-49 years	21.80
50-64 years	23.41
65-74 years	26.62
From 75 years	29.24
When joining after the 60th birthday
60-64 years	28.08
65-74 years	31.95
From 75 years	35.09
When joining after the 66th birthday
66-74 years	34.61
From 75 years	38.01
When joining after the 70th birthday
70-74 years	39.93
From 75 years	43.87

What are the limitations on the reimbursements of this insurance?

The right to a refund starts after the following waiting periods starting from the connection date:

three months for the guarantees: statutory co-payment, travel vaccines and nutritional and dietary advice
six months for the eye care guarantee
twelve months for the guarantees: periodontics, dental prostheses and implants, orthodontics, hearing aids and the maternity allowance

Reimbursements are calculated exclusively on the basis of the statutory rates included in the nomenclature of the compulsory insurance for medical care and on the basis of the rate applied for those who have a global medical file with their GP.

Am I insured abroad?

The insurance only applies to services prescribed in Belgium and provided in Belgium.

What are my obligations?

As an insured person, you must be and remain affiliated with CM Vlaanderen for the services and benefits offered and be in compliance with the CM contribution payment.
You must sign the required insurance documents and pay the insurance premium.
If you want to join the insurance, you must join the insurance not only yourself, but also all your dependents for statutory health insurance.
If you wish to report a claim, you must provide all relevant documents about the claim to the insurer as described in the general terms and conditions.

How do I pay my insurance premium?

The premium can be paid by transfer per year or by direct debit. With direct debit you can choose between: annually, quarterly or monthly. The dates for direct debit are determined in advance and always occur before the start of the insured period.

When does the insurance start and end?

The agreement is concluded upon signature by the policy holder of the insurance application and the first premium payment.

The insurance commences on the commencement date and is valid for life, except in the event of cancellation by the policy holder, failure to pay the premium and in the event of fraud.

How do I cancel my insurance contract?

You can cancel the insurance by registered letter, by bailiff's writ or by issuing the cancellation letter against acknowledgment of receipt.

Do you have another question about CM-MediKo Plan?

Please review the frequently asked questions page. Is your question not listed? Then contact CM.

Frequently asked questions

I am affiliated with a hospitalization insurance through my employer. But it does not reimburse my medical expenses outside the hospital. I contacted CM, and they told me that I can combine CM-MediKo Plan with any hospitalization insurance. I immediately affiliated.

Karim, 37

I am affiliated with CM-MediKo Plan

Thanks to the CM-MediKo Plan, you will also be reimbursed for a large part of these costs:

Deductible

Deliver the certificate of provided assistance to CM. This is the note that you receive after your consultation with your doctor or healthcare provider. You deliver it to us via one of the CM mailboxes. An envelope is not necessary.

You will receive the refund directly into your bank account. This happens automatically four times a year:

Costs from January 1 to March 31 will be refunded in mid-June .
Costs from April 1 to June 30 will be refunded at the end of August .
Costs from July 1 to September 30 will be refunded at the end of November .
Costs from October 1 to December 31 will be reimbursed at the end of February of the following year.

Orthodontics

Have your dentist fill out the ' harmonization document ' or 'evidence for performed treatment(s)'. You can find this on the RIZIV website.

Deliver the completed proof via the My CM app or a CM mailbox. An envelope is not necessary.

For orthodontic treatments that are not reimbursed by health insurance, a treatment plan is required. This plan includes:

The diagnosis
The description of the treatment plan
The equipment to be installed
The date of creation

Have the orthodontist draw up a treatment plan and submit it. Do this at the latest with the first application for a refund by CM-MediKo Plan.