Belgium's healthcare system rewards those who understand it and penalises those who don't. For sexual health specifically, the two community services — Ex Aequo in Brussels and the ITM Help Center in Antwerp — are accessible without insurance or registration. For everything beyond them, a Mutuelle (health insurance fund) is the key that unlocks affordable care.
🛡️ Ex Aequo and ITM: Open to All
Ex Aequo (Brussels, exaequo.be) and the ITM Help Center (Antwerp, itg.be) do not require Belgian health insurance, a residence permit, or an eID to access their community testing and counselling services. A tourist, a recent arrival, or anyone without Belgian registration can attend either service for rapid HIV and syphilis testing, STI counselling, and navigation support.
You do not need insurance or Belgian ID to use Ex Aequo or the ITM Help Center community services. These are your entry point for testing and PrEP navigation regardless of your residency status.
For the full HRC clinical pathway — including PrEP via the Convention — you will eventually need a Mutuelle. But the community services are where you start.
🇪🇺 Tourists: Your EHIC at Belgian Hospitals
If you need hospital care — for PEP outside community service hours, for example — and you are visiting from the EU or EEA, your EHIC (European Health Insurance Card) entitles you to state-provided emergency and urgent care at the same terms as a Belgian insured patient.
Present your EHIC at the hospital Urgences / Spoedgevallen (emergency department). The ticket modérateur (co-payment) applies — typically €10–30. PEP is classified as urgent medical care and is covered. If you don't have your EHIC in an emergency, go anyway and sort the paperwork afterwards.
Non-EU visitors do not have EHIC coverage. Hospital care will be billed. Travel insurance covering emergency medical care should cover PEP treatment costs. Do not let cost concerns delay seeking PEP.
📋 New Residents: The Mutuelle Requirement
Anyone legally residing or working in Belgium should register with a Mutuelle (French) / Ziekenfonds (Dutch) promptly. This is not optional — it is the cornerstone of Belgian healthcare access.
Choosing a Mutuelle: All cover the same standard benefits package. Main providers:
- CM (Christelijke Mutualiteit) — Flemish, largest overall
- Solidaris — French-speaking
- Partenamut — French-speaking
- Liberale Mutualiteit / Mutualité Libérale — liberal-affiliated
- Neutraal Ziekenfonds / Mutualité Neutre — non-pillar-aligned
To register: Bring your eID (Belgian electronic identity card) and your Belgian National Register number (on your residence permit or commune registration). Most Mutuelles have local offices in every municipality.
How reimbursement works: Belgian healthcare is not free at point of use. You typically pay the full cost upfront and the Mutuelle reimburses its share afterwards. The portion you keep is the ticket modérateur / remgeld (co-payment). For PrEP via Convention: this is €8–12/month. For GP visits: typically €1–5.
🪪 Your eID Card
Your eID (elektronische identiteitskaart / carte d'identité électronique) is Belgium's electronic identity card. Present it at every healthcare encounter — it links to your Mutuelle registration and pharmacy reimbursement. EU citizens who are registering as residents receive an eID through their local commune (municipality) office after registering their address.
🩺 Registering with a GP
Your huisarts (Dutch) / médecin traitant (French) handles primary care and referrals. Register with a GP near your home — this links you to a single doctor's file for ongoing care. Your GP can refer you to specialist services including mental health, dermatovenerology, and — for PrEP — your nearest HRC.
Your GP cannot initiate PrEP Convention reimbursement. For sexual health testing and PrEP, Ex Aequo (Brussels) or the ITM Help Center (Antwerp) are better first contacts than your GP. You do not need a GP referral to access either community service or an HRC directly.
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