social security - FOD Sociale Zekerheid

- Persons entitled to one of the benefits for disabled persons in accordance with the lawof 27 February 1987- The non-accompanied foreigners younger than 18- Disabled children with a physical or mental incapacity of at least 66%.Second way : on the basis of a personal situation and an income screening performed by theinsurance institutions (also RVV/BIM status):- Orphans, invalids, pensioners and widows (former WIGW/VIPO status)- Persons who have been unemployed for at least 1 year- Residents of at least 65 years old- Recognised disa bled persons (who do not receive benefits)- Permanent civil servants who are granted leave of absence for sickness or infirmity sinceone year and military who are discharged from office due to health reasons since one year- Single-parent families- Persons entitled to a heating allowanceThe family that is taken into account consists of the entitled person, his spouse or life partner andtheir dependants.The taxable gross family income of the family of the entitled person must be under 15,364.99 EUR,increased by 2,844.47 EUR per dependant (maximum amounts on 1 July 2011).Third way : on the basis of an income screening performed by the insurance institutions (OMNIOstatus). For families with modest incomes.The family that is taken into account for the OMNIO status is the "National Register family", asit is composed on 1 January of the year for which the right to the OMNIO status is examined.The family income must be under 15,163.96 EUR, increased by 2,807.26 EUR per extra person(application 2011, taxable family income of the preceding year).The persons entitled to higher reimbursements receive e.g. higher reimbursements for medicalcare and medicines and a more favourable scheme for the advance payments and the personalfee (patient fee) in case of hospitalisation.C.2. Pharmaceutical costsIf you have a prescription of an acknowledged practitioner, you do not have to pay the full amountat the chemist's, but the reimbursement rates are applied directly (third payer's scheme). Thishowever only applies on the condition that you are insurable and that the prescribed medicineis covered by the insurance for medical care. Beneficiaries of the preferential category are alsoentitled to higher reimbursement rates.Pharmaceutical dispensations include pharmaceutical specialities and magistral preparations, i.e.drugs prepared by the chemist himself. On the basis of their social and pharmaceutical utility,reimbursable pharmaceutical specialities are divided into five reimbursement categories.The reimbursement category that is granted indicates to which extent the compulsory insurancecontributes towards the expenses. Since 1 April 2010, the patient fee of the (not-hospitalised)patient is calculated on the basis of the reimbursement rate of the medicine ex-factory.43