CPAP health fund reimbursement Belgium - RIZIV 2025

CPAP health fund reimbursement in Belgium - complete RIZIV/INAMI guide

Do you have sleep apnea and want to know how your Belgian health fund covers your CPAP treatment? You may have heard about the "RIZIV convention" or the "Krankenkasse" and want to understand how the system works. This guide explains everything: the exact mechanism of Belgian CPAP coverage, the conditions to qualify, the real costs, the steps to follow, and the alternatives available if you don't meet the criteria.

Note: In Belgium, "Krankenkasse" is the German-language term used in the German-speaking Community (Deutschsprachige Gemeinschaft) for the health fund - equivalent to "mutualité" in French. The CPAP coverage system is exactly the same for all Belgian residents: RIZIV (Dutch), INAMI (French) or Landesinstitut für Kranken- und Invalidenversicherung (German) all refer to the same institution.

How Belgian CPAP coverage actually works

Belgian CPAP coverage is often described as a "reimbursement", but this term is misleading. It is not a purchase reimbursement. You do not buy a device first and then claim the cost back. The system works as follows:

What the coverage is NOT

You do not buy a CPAP device
You do not choose the model
The device never belongs to you
Your health fund does not reimburse a purchase

What the coverage IS

An accredited sleep centre provides the device on loan
Your health fund pays the centre directly
You pay only a small patient co-payment
Device + mask + medical follow-up: all included

The accredited sleep centre handles everything: the CPAP or Auto-CPAP device, mask, headgear, tubing, filters, heated humidifier if needed, regular medical follow-up, maintenance, repairs and replacement in case of breakdown. Your health fund pays a daily rate directly to the centre. You pay only a patient co-payment of €0.25/day, i.e. €7.50/month - or nothing at all if you have BIM/OMNIO status (increased intervention).

Eligibility conditions for the RIZIV/INAMI convention

To benefit from Belgian CPAP coverage, you must meet three cumulative conditions:

Condition	Explanation
1. Diagnosis by polysomnography (PSG)	Full overnight study at an accredited sleep centre. Required result: OAHI ≥ 15 events per hour (Obstructive Apnea-Hypopnea Index). This criterion has been in force since the 2017 amendment 5.
2. Proven CPAP efficacy	A second examination (home or in-centre titration) must confirm that CPAP effectively improves your nocturnal breathing.
3. No more appropriate treatment	The sleep centre physician verifies that no better alternative is available (surgery, significant weight loss, mandibular advancement device…).

The 4-hour rule: Once on the convention, you must use your CPAP for an average of at least 4 hours per night to maintain coverage. This is an average over the entire reference period (minimum 2 months) - not a nightly obligation. Falling below this average triggers a 3-month "joker" agreement. If compliance remains insufficient after those 3 months, the convention is suspended for 1 year.

CPAP coverage costs

Status	Per day	Per month	Per year
BIM / OMNIO / Increased intervention	€0.00	€0.00	€0.00
Standard beneficiary	€0.25	€7.50	€91.25

This rate covers everything: the CPAP or Auto-CPAP device, mask, headgear, tubing, filters, humidifier if prescribed, professional maintenance, repairs, replacement in case of breakdown, and complete medical follow-up.

What if you don't qualify for the convention?

The convention does not apply to all patients. VivaRespire exists for those who want to own their own CPAP device, outside the conventional circuit:

OAHI < 15/hour: you don't reach the RIZIV/INAMI threshold, but your doctor still recommends therapy.
Immediate start: you don't want to wait 4 to 8 weeks for the conventional pathway.
Freedom of choice: you want to select your own device and mask from the latest models available.
Ownership: you want to own your CPAP - take it everywhere, access it without an intermediary, never have to return it.
Second device: you're on the convention for your main CPAP and want a compact device for travel.
Data access: modern connected devices give you full direct access to your therapy statistics.

Our most popular CPAP devices

ResMed AirSense 11 AutoSet

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Philips DreamStation 2

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Löwenstein Prisma SMART Auto

German precision technology. Advanced adaptive algorithm, ultra-quiet.

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Browse our full Auto-CPAP range

Complete selection of brand-new Auto-CPAP devices, delivered quickly to Belgium - with personalised buying advice.

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RIZIV convention vs purchase: comparison

Criterion	RIZIV/INAMI Convention	Purchase at VivaRespire
Monthly cost	€7.50/month (or €0 if BIM)	One-time purchase - €0/month thereafter
Device ownership	Never - loan only	Yours for life
Choice of model	Limited by the sleep centre	Free choice - latest connected models
Time to start therapy	4 to 8 weeks	Fast delivery - immediate start
Usage constraint	≥ 4h/night average mandatory	No constraint
Access to your data	Via the centre - limited access	Full direct access via app
Eligibility condition	OAHI ≥ 15/hour mandatory	No AHI condition