Beginning November 1, 2026, independent contracted midwives in Belgium will be authorized to charge patients an out-of-pocket financial contribution—known as a ticket modérateur—for specific prenatal and postnatal care services. Reported by rtl.be, the measure is designed to boost professional revenues within the primary healthcare sector, though it has drawn mixed reactions from practitioners who object to funding sector revalorization through patient fees.
In Plain English: The Clinical Takeaway
- Out-of-Pocket Contribution: Patients will pay a small, regulated fee (up to €4.25 depending on the service) for certain prenatal and postnatal visits starting November 1.
- Exemptions: Labor management, childbirth assistance, and injections remain entirely exempt from this new patient contribution.
- Maximum Billing Protection: According to telesambre.be, the amounts paid by patients will count toward the calculation of the maximum out-of-pocket healthcare ceiling (MàF).
Fee Structures and Patient Financial Caps
Under the regulatory update, the newly permitted personal contributions vary based on the specific type of clinical consultation and the patient’s insurance standing. For standard prenatal and postnatal care—excluding the critical initial five days following delivery—midwives may invoice up to €4.25 per service, as detailed by rtl.be. For postnatal home visits conducted during those first five days postpartum, the charge is set at €2.50.
Patients who qualify for increased reimbursement status, known as beneficiaries of increased intervention (BIM), face significantly reduced contributions. Lalibre.be noted that individual practitioners retain the legal freedom to demand these personal quotas in full, collect them partially, or waive them entirely.
Sector Revalorization Versus Practitioner Critique
The National Institute for Health and Disability Insurance (Inami) explained via telesambre.be that the policy aims to increase midwife compensation in a budget-neutral manner. Funds generated through these patient contributions will be directly reinvested into the profession, raising standard consultation fees by 9.13% and immediate postnatal care fees by 7.13%.
Despite these adjustments, professional bodies remain critical of the mechanism. Murielle Conradt, president of the Professional Union of Midwives, stated to rtl.be that the measure falls short of resolving systemic remuneration issues. Citing Inami data indicating that independent midwives gross approximately €23,000 to €25,000 annually, Conradt argued that relying on patient pockets rather than government funding is an inadequate solution for frontline healthcare providers.
Contraindications & When to Consult a Doctor
Independent midwives remain available for urgent clinical triage during the vulnerable postnatal window.
References
- RTL Info: Sages-femmes : une facturation supplémentaire dès novembre
- La Libre: Nouveau le 1er novembre – Les sages-femmes pourront facturer une partie de leurs soins à leurs patientes
- Télésambre: Dès le 1er novembre, les sages-femmes pourront facturer une participation financière à leurs patientes
- Institut national d’assurance maladie-invalidité (Inami): Official Sector Guidelines and Tariff Structures
