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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.
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…). |
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
The world's reference Auto-CPAP. Connected, quiet, with integrated heated humidifier.
View productPhilips DreamStation 2
Compact and quiet Auto-CPAP. Colour screen, Bluetooth and Wi-Fi connectivity.
View productLöwenstein Prisma SMART Auto
German precision technology. Advanced adaptive algorithm, ultra-quiet.
View productBrowse our full Auto-CPAP range
Complete selection of brand-new Auto-CPAP devices, delivered quickly to Belgium - with personalised buying advice.
See all Auto-CPAP devicesRIZIV 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 |
Frequently asked questions about CPAP reimbursement in Belgium
INAMI (RIZIV in Dutch) is the federal body that sets the rules and funds the CPAP convention. Your mutuelle (health insurance fund, ziekenfonds, Krankenkasse) is the body that registers you, verifies your eligibility and pays the daily allowance to the sleep centre. The two work together: INAMI sets the legal framework, the fund manages your individual file. Belgian CPAP coverage is not a purchase reimbursement but device provision on loan.
The main threshold is an AHI (apnea-hypopnea index) greater than or equal to 15 obstructive apneas per hour, measured by polysomnography or polygraphy. If you have an AHI between 5 and 14 with severe daytime symptoms (sleepiness, hypertension, cardiovascular), your doctor can justify an application. Below 15 without comorbidities, you are not eligible for the convention but can buy your CPAP directly. See our page AHI explained.
The moderator ticket is €0.25/day, about €7.50/month or €91/year. BIM (increased intervention) status beneficiaries pay nothing at all. This cost covers the device, mask, accessories, maintenance, repairs and medical follow-up: everything is included. The condition is to use your CPAP at least 4 hours per night on average, otherwise coverage may be suspended after an adaptation period.
Under the INAMI convention, the accredited sleep centre provides the device on loan. You do not buy it and it never belongs to you. The fund pays the centre directly. Conversely, by buying at VivaRespire outside the convention, you become the owner of your CPAP, freely choose the model and start immediately. Many patients combine both: convention for follow-up, direct purchase for a second travel device.
Yes. The device provided by the sleep centre remains its property. If you stop treatment, move abroad, fail to meet minimum compliance (4 h/night) or choose to leave the convention, you must return the equipment to the centre. This lack of ownership is precisely why some patients prefer to buy directly at VivaRespire and keep their equipment for life.
No. The Belgian system does not provide reimbursement for direct CPAP purchase. INAMI coverage operates exclusively via provision by an accredited centre. This rule is clear and identical for all CPAP retailers in Belgium. VivaRespire is an online shop outside the convention: you pay your CPAP in full and immediately become the owner. No Belgian health fund reimburses this purchase, regardless of the retailer.
Some hospitalisation insurance or private supplementary plans include medical equipment allowances that may partially cover CPAP purchase, notably DKV, AG Insurance or Ethias depending on your contract. Check with your insurer mentioning the reimbursement code on your prescription. Conditions vary widely between policies. VivaRespire provides a detailed invoice you can submit to your insurer for possible partial coverage.