In the federal state of Belgium, healthcare is managed by the federal level. The Flemish Government introduced an additional insurance for non-medical care (Dutch: zorgverzekering) in 2001, which proved to be controversial and has a relatively long legal history.
Healthcare and social security in Belgium is a federal matter, but the special laws of Belgium grants the three communities several competences, such as "assistance to persons". The Flemish Government made use of this to provide an additional insurance for non-medical help and services, mainly targeted at elderly people. The insurance is mandatory for all people aged 25 and above and living in the Flemish Region, and optional for inhabitants of the Brussels-Capital Region (as Brussels is covered by both the Flemish and French Community).
Controversy and legal issues
The French Community, however, feared this was a first step towards splitting the Belgian social security and found this service to be discriminatory. They fought this at the Constitutional Court, and tried to come up with legal arguments to repeal the decree (as laws by communities and regions are called), but to no avail. The system was however slightly adapted several times to suit their justified complaints.
The Constitutional Court sent a prejudicial question to the European Court of Justice, who inspected the decree. They do consider this insurance to be social security, as opposed to Belgian terms, and they judged that the "place of residence criteria" as used in the decree (i.e. the insurance is for those living in Flanders or Brussels) violates the "work place criteria" that EU law dictates for social security for EU citizens who made use of their right of freedom of movement. People working in a country where they do not live must enjoy the same social rights as citizens of that state. Consequently, the Flemish decree was adapted to provide this insurance also for people working in Flanders or Brussels but not living there, as long as they made use of their right of free movement. Since EU law only recognizes "Belgium" and not the various entities within it, this does not include Walloons working in Flanders. As a result, anyone living or working in Flanders or Brussels enjoy this insurance, except Walloons unless they made use of their right of free movement.