Belgium

Belgium is aging inside one of Europe's stronger welfare states. At the start of 2023 about 2.3 million people, close to one in five Belgians, were 65 or older, and the Federal Planning Bureau expects that share to pass 25% by 2050, with most of the rise arriving before 2030 (For a Healthy Belgium). Unlike much of the world, Belgium has genuinely built for this, which makes it a useful study in what a well-financed system does well, and where it still leaves families exposed.

The care model is a mixed one. A large amount of formal care is publicly financed: home nursing is reimbursed nationally through the federal health insurer, and the country keeps a dense network of residential homes (woonzorgcentra in Flanders, maisons de repos in Wallonia and Brussels). In 2021 around 7.6% of Belgians 65 and over received home nursing care, with wide regional variation (KCE / HSPA 2024). Alongside all that formal provision sits significant informal care, still carried mainly by families (Eurocarers).

The piece most worth borrowing is the Flemish care insurance, the zorgbudget within the Vlaamse sociale bescherming. It is a mandatory, solidarity-funded long-term-care insurance: adults pay a small flat annual contribution, on the order of EUR 60, and heavily dependent people receive a cash care budget they can put toward the support they need (Settling in Belgium). A dedicated social-insurance pool specifically for dependency, paid out as flexible cash, is precisely the mechanism most countries, the United States included, have never managed to create.

Technology is the quiet gap. Belgium's strength is financing and well-organized human care, not automation: there is no national eldercare-AI initiative and no robotics story, and while telecare and home-care digitalization exist, coordination is still largely institutional and administrative. Software built for the family doing the navigating, rather than for the institution delivering the service, is the layer with room to grow.

The honest reality check is fragmentation and cost. The 2014 sixth state reform handed most eldercare to the regions and language communities, so what you are entitled to depends heavily on whether you live in Flanders, Wallonia, Brussels, or the German-speaking Community (Healthy Belgium). And even here, the non-medical cost of a residential home, the room, the meals, the daily personal care, falls largely on the resident, so a care-home stay can still eat into a family's savings despite the strong welfare state (KCE). Belgium earns its place in this atlas as proof that even a rich, well-designed system leaves a real navigation-and-cost problem for families to solve.