Increased Benefit (BIM/VT), Maximum Bill (MAF) and health aids in Belgium 2026: who qualifies

2.5 million Belgians benefit from Increased Benefit (BIM/VT) status, around 21% of the population. Many others would be entitled to it without knowing. Increased Benefit (BIM/VT) status, the Maximum Bill and the additional aids can reduce your health bill by several hundred to several thousand euros per year. Here is how to find out whether you qualify.

This article complements our guide to health insurance funds in Belgium. If you are not familiar with the INAMI system, the co-payment or the GMD, first go read the basic guide — what follows refers to it constantly.

The stakes are simple: everyone pays the same health contributions in Belgium, but not everyone pays the same costs. For those with modest incomes or significant health costs, two major schemes exist: Increased Benefit (BIM/VT) status, which reduces co-payments and gives access to additional benefits, and the Maximum Bill (MAF), which caps annual health spending. Plus a few specific aids that few people know about. To check your reference income, use our net salary calculator or our guide understanding your payslip.

Increased Benefit (BIM/VT) status — for whom and why

The BIM (Bénéficiaire de l'Intervention Majorée, Increased Benefit recipient) is a status that entitles you to a higher reimbursement of your health care. Concretely:

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Reduced co-payments A consultation with your GP with a GMD drops from ~€4 to ~€1. A consultation with a contracted specialist drops from ~€12 to ~€3. On medicines, the percentage you pay decreases (from 25% to 15% in category B, for example).
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Cheaper hospitalization Reduced daily hospital flat fee, capped medicine co-payment in hospital, certain surcharges prohibited.
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Additional social benefits 50% discount on SNCB tickets in 2nd class, preferential fares on STIB/TEC/De Lijn, access to the social energy tariff (under conditions), telephony discounts, some municipalities add further aids.
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Automatic third-party payment You can ask your GP to apply third-party payment: you only pay the co-payment, the rest is billed directly to the health insurance fund. No more need to advance the full amount.
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Easier access to the social MAF If you are a BIM/VT holder, you automatically benefit from the social MAF — protection beyond €548.55 of co-payments over the year (2026 amount). Details below.

Who is granted the BIM/VT automatically?

For certain categories of people, the status is granted automatically by the health insurance fund, without any application. You are automatically a BIM/VT holder if you receive:

Situation giving entitlement to automatic BIM/VT Source
Social Integration Income (RIS) or equivalent CPAS aid for at least 3 consecutive months CPAS
Income Guarantee for the Elderly (GRAPA) SFP — Federal Pensions Service
Allowance for persons with disabilities (income replacement allowance, integration allowance) DG Persons with Disabilities
Allowance for assistance to the elderly (APA in Wallonia/Brussels, Flemish equivalent) AVIQ / Iriscare / Vlaamse sociale bescherming
Minor orphaned of father and mother FAMIRIS / FAMIWAL / Opgroeien
Child with a disability of at least 66% Family allowance fund
Unaccompanied foreign minor (MENA) MENA guardianship

If you are in one of these situations, your health insurance fund contacts you or applies the status without any action. You have nothing to do.

The "income" BIM/VT — for everyone else

If you are not in an automatic category, you can still obtain BIM/VT status if your household income does not exceed a certain ceiling. This is the declaration on honour, the most frequent way of being granted the status (1.3 million Belgians in 2025). If you are a tenant on a modest income, also look at our guides tenant rights and reducing your tenant charges.

Official ceilings in 2026 (amounts verified on the health insurance funds' websites):

Reference period Annual gross taxable ceiling (single person) Increase per dependent person
One-year period (2025 income for an application in 2026) €28,054.93 + €5,193.74
One-month period (with indicator) — as of 1 March 2026 €28,662.69 + €5,306.25

Concretely, a couple without children can obtain the BIM/VT if their 2025 income did not exceed €33,248.67 (28,054.93 + 5,193.74). A household with two dependent children can reach €43,636.15 (28,054.93 + 3 × 5,193.74). Always check with your health insurance fund's simulator for your specific case.

What is "the indicator"?

If a household member is in a situation marking a stable drop in income (unemployment or work incapacity for at least 3 uninterrupted months, bridging right for self-employed…), you can request an accelerated assessment based on the previous month's income (multiplied by 12). The ceiling is then higher. Very useful in the event of a recent setback.

✅ How to submit a BIM/VT application

Contact your health insurance fund (in branch or online). You will fill in a declaration on honour and provide proof of income (tax assessment notice for each adult household member, account statements or pension/allowance/RIS certificates, proof of any supplementary pensions). The health insurance fund processes the file — then you either receive the status or not. It is free and without commitment.

⚠️ BIM/VT reform underway in 2026

Federal Health Minister Frank Vandenbroucke announced at the end of April 2026 his intention to tighten the access criteria for the BIM/VT, notably by including assets in the calculation (proposal of a threshold of €60,000 of dormant capital). The debate is underway in Parliament. If you meet the current criteria, do not delay submitting your application — the new rules are not yet applied, and the status, once acquired, is retained as long as the conditions are met.

The Maximum Bill (MAF) — universal protection

While the BIM/VT targets modest incomes, the MAF applies to all Belgian households, BIM/VT holders or not. It is automatic protection that caps your health costs over the year.

The principle is simple: you accumulate co-payments over the course of the year. As soon as your household reaches a certain ceiling, your health insurance fund fully reimburses any additional costs. You have nothing to do — it is automatic, calculated by the health insurance fund based on INAMI and tax data.

There are 4 types of MAF, whose 2026 ceilings are as follows:

Type of MAF 2026 ceiling For whom
Social MAF €548.55 / household BIM/VT status holders and dependents
Income MAF (net income < €13,402.43 in 2024) €270.55 Households with very low incomes (automatic calculation)
Income MAF (other brackets) Variable — between ~€450 and ~€1,800 All households, progressive ceiling depending on 2024 income
Child MAF (under 19) €792.35 / child individually Any child under 19, regardless of household income

The chronic MAF — bonus for regular spending

If a member of your household has individually borne at least €527.27 of co-payments in 2025 (or holds the "chronic condition" status), your MAF ceiling is reduced by €121.90 in 2026. You therefore reach full reimbursement more quickly. Combinable with the social MAF or income MAF.

✅ The MAF is automatic — really

You have nothing to do to benefit from the MAF. Your health insurance fund automatically adds up your co-payments linked to INAMI and the tax administration. As soon as the ceiling is reached, you receive a letter and your pharmacy is notified — you no longer pay anything at the pharmacy for reimbursable medicines until the end of the year. Other excess amounts are reimbursed to you monthly.

Concrete case: a BIM/VT couple with a chronic child. The household benefits from the social MAF (€548.55 - €121.90 chronic = €426.65 of co-payments before full reimbursement). The child benefits in parallel from their child MAF at €792.35. The protection is cumulative.

The social energy tariff — bonus of BIM/VT status

The social tariff for electricity and natural gas is a substantial reduction (often 30 to 50% compared to the market tariff) granted to certain recipients of social aid — including BIM/VT holders, under conditions. On the housing side, also look at the energy grants in Belgium which reduce the annual bill.

The grant is automatic: the FPS Economy communicates with your supplier, who applies the social tariff directly on your bill without any action on your part. You receive a letter as soon as the social tariff is activated.

Conditions of the social tariff Hold an electricity and/or gas purchase contract for private use, AND be in an eligible category: RIS, GRAPA, disability allowance, or BIM/VT (under conditions currently limited in time). Check on the FPS Economy website.
Important for BIM/VT holders The extension of the social tariff to BIM/VT holders was initially temporary and has been renewed several times. Always check the current conditions on economie.fgov.be — the status may change politically.

Transport discounts for BIM/VT holders

BIM/VT status opens up discounts on all Belgian public transport. You need a BIM/VT certificate issued by your health insurance fund to activate the discount.

Operator Discount
SNCB (Belgian railways) 50% on tickets in 2nd class everywhere in Belgium
STIB (Brussels) Reduced fare on subscriptions and single tickets
TEC (Wallonia) Preferential fares depending on zone and subscription
De Lijn (Flanders) Discounts depending on the chosen formula

SNCB procedure: present the BIM/VT certificate at the counter to buy a personal discount card. For the other operators, the certificate is requested when subscribing.

The Special Solidarity Fund — lesser known but essential

The INAMI's Special Solidarity Fund steps in for exceptional medical costs not reimbursed by the classic system: very expensive medicines not yet listed in the nomenclature, innovative medical devices, care abroad not covered by agreements, etc.

General conditions:

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Rare disease or severe chronic condition Medical diagnosis establishing the rarity or severity, generally certified by a hospital specialist.
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Costs not covered by the compulsory insurance The care must be medically indispensable and not available via the classic INAMI reimbursements or via other coverage.
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Complete medical and social file Application submitted by your specialist doctor and your health insurance fund, with a detailed medical report and financial justification. Case-by-case examination by the College of Medical Directors.

For the citizen, it is rarely automatic — it is rather a last-resort scheme, to be activated with your doctor and your health insurance fund when the costs become unbearable.

Practical strategy — how to activate what concerns you

1
Check whether you are eligible for the BIM/VT If your household's 2025 income is below €28,055 (single person) or €33,250 (couple), you can probably obtain the BIM/VT. If you have been unemployed, incapacitated or on a bridging right for > 3 months, you can apply using the indicator. First reflex: contact your health insurance fund.
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Open a GMD with your GP Free, immediate, and combined with the BIM/VT, it reduces your co-payment to ~€1 per consultation. It is the most profitable combo in the system.
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Ask for third-party payment from your doctor if you are a BIM/VT holder You only pay the co-payment — no more need to advance €30 then wait for the reimbursement.
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Request your BIM/VT certificate to activate transport discounts SNCB card, STIB/TEC/De Lijn subscription. To be renewed with each change of situation.
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Check the social energy tariff If you are a BIM/VT holder or in an eligible category, check on your energy bill whether the social tariff is applied. If not, contact your supplier or the FPS Economy.
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Let the MAF kick in automatically You have nothing to do — it is calculated by your health insurance fund. If you have significant health costs (chronic, hospitalization, heavy treatments), nevertheless keep an eye on the breakdown in your member area: you will gain access to full reimbursements as soon as the ceiling is reached.

Common pitfalls

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Believing the BIM/VT is reserved for people in extreme precarity False. With a ceiling of ~€28,000 for a single person, many modest pensioners, long-term unemployed, self-employed in difficulty, emancipated students, single parents can claim it without being in absolute poverty. INAMI estimates that around 20% of the population could be entitled to it.
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Not reporting a drop in income to your health insurance fund If you lose your job, become incapacitated, divorce or if your household changes: inform your health insurance fund within 3 months. You could unlock the BIM/VT via the "indicator" more quickly, or activate an income MAF with a lower ceiling.
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Forgetting the MAF for children The child MAF at €792.35 is automatic, but many parents do not keep an eye on it. For a child with orthodontics, regular physiotherapy or a chronic illness, the ceiling can be reached quickly.
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Thinking that fee surcharges count towards the MAF False. Fee surcharges (a non-contracted doctor in a single room, for example) are not counted in the MAF. Only INAMI co-payments are. To protect yourself from surcharges, it is hospitalization insurance that comes into play.
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Giving up because the procedure seems heavy The health insurance fund's income investigation generally takes a few weeks, and BIM/VT status is valid for several years once obtained. The return on investment (health + transport + energy savings) more than covers the time spent.