Why take out supplementary health insurance?
Are you arriving in Luxembourg and wondering whether you need supplementary health insurance? How does the Luxembourg healthcare system work, particularly in terms of reimbursement?
In this article, we address all these questions to answer your queries. To do so, we interviewed Fabio Secci, CEO of CMCM, a mutual health insurance company established in Luxembourg since 1956.
Is health coverage sufficient in Luxembourg?
A high-quality healthcare system in Luxembourg
First of all, the Luxembourg healthcare system can be described as high quality. Access to care is easy thanks to a large number of general practitioners and specialists. In addition, the level of reimbursement for medical services is generally quite good for most types of medical care.
It is important to note that the Luxembourg healthcare system is governed by the Centre Commun de la Sécurité Sociale (CNS) for the public sector and the CNS for the private sector. Social security contributions to the healthcare system are mandatory for all employees and self-employed persons in Luxembourg.
As a result, the CNS medical expense reimbursement system is very efficient. For example, it covers 80 to 90% of the cost of seeing a general practitioner. This is also the case for medical expense reimbursements for certain specialists, especially if you have a medical prescription. What's more, medical expenses for minors under the age of 16 are reimbursed at 100%!
Some healthcare expenses remain the responsibility of patients
However, although the Luxembourg healthcare system is effective because it encourages personal responsibility, it is not entirely sufficient. Despite compulsory contributions to the healthcare system, certain medical expenses are not covered by the CNS. These remain the responsibility of patients, and it should be noted that the cost of medical services is high in Luxembourg.
A Luxembourg healthcare system that encourages responsibility
Insufficient healthcare coverage by the CNS
Although medical services are generally covered, at least in part, the CNS reimburses very little, if anything, for certain medical expenses. This is particularly the case for dental and vision-related expenses.
Furthermore, hospitalisation costs are not covered in full by the CNS. If the patient is hospitalized in a shared room, hospital costs can be reimbursed up to 90%. However, this is not the case for private rooms.
Empowering patients to take responsibility for their health
The decision not to reimburse healthcare expenses in full is based on the desire to make patients more responsible for their own health. In some cases, the need for medical care may be the result of a certain degree of negligence in our approach to health.
Furthermore, in the Luxembourg mindset, it is important to understand that nothing is free. In Luxembourg, unlike in some countries such as France, patients must pay their medical expenses up front. Healthcare is a cost or expense borne by the community. Receiving care is the result of collective effort and solidarity. Everyone must therefore be aware of this and contribute to maintaining the healthcare system.
In practical terms, how does this work in Luxembourg's healthcare system?
Hospital care coverage needs to be improved
First-class hospital room and reimbursement of care
In Luxembourg, if you are hospitalized, you are entitled to a single room. This is referred to as a first-class room.
In the case of first-class hospitalization, the final hospital bill can be up to 70% higher than the general rate prescribed by the CNS. This is because the cost of a single room is higher than the cost of a shared room. In addition, medical expenses related to the hospital stay are also affected by the first-class surcharge.
However, the CNS does not cover the difference in price between first and second class hospitalization, nor the additional medical costs incurred by this choice. These costs remain the responsibility of the patient.
Development of "first-class" hospital services
There are currently few single rooms in Luxembourg. Hospitals often reserve them for long-term hospitalizations. And as a general rule, there are more requests than can be met.
"However, hospital and clinic development projects will be very much geared towards creating single rooms. The long-term goal is to offer 80% single rooms," says Mr. Secci, director of the CMCM mutual health insurance company. Legislation will take this development into account. Not all single rooms can be treated as first-class rooms. The quota has not yet been set, but the current report could be respected.
In addition, additional paid services such as à la carte meals and pay TV are also expected to be introduced for this type of service. These costs will also be borne by the patient.
Coverage of first-class hospital rate differences
Furthermore, on the day of your hospitalization, if no shared room is available, you may be admitted to a single room, known as a first-class room. In addition, your illness may be contagious, requiring you to be isolated in a single room . In either case, it can be difficult to pay a supplement on top of the general hospital rate.
For a short stay and minor surgery, opting for a private room is not "essential." However, for a long stay and/or surgery requiring a lot of rest, this first-class option is not a luxury.
As such, the CMCM mutual health insurance company, and even some supplementary health insurance companies, cover this difference in hospital rates through various insurance offers.
A somewhat rigid healthcare system with regard to treatment abroad
There are two types of medical care abroad.
Lack of specialists in Luxembourg who can treat the problem
If the patient seeks treatment abroad, they must first request approval from the CNS for coverage of care not offered in Luxembourg. To do so, they must complete the S2 form. However, these medical expenses incurred abroad will not be covered in full by the CNS. On the other hand, the CMCM and certain supplementary insurance policies may reimburse the difference depending on their coverage.
Existing healthcare options in Luxembourg, but less comfortable
In cases where medical care is available in Luxembourg but the practices are less comfortable than those offered abroad, the CNS will only provide partial reimbursement. The CNS will cover 80% of the cost of an operation in Luxembourg. Therefore, if the cost of the operation abroad is higher than the cost of the operation in Luxembourg, you will be responsible for the difference.
It is therefore important to carefully compare the offers of supplementary insurance providers, including CMCM, to find out the maximum reimbursement limits for healthcare abroad.
Insufficient coverage for dental and vision care
In addition, dental and vision care can represent a significant expense. These costs are not covered, or only partially covered, by the CNS. It is therefore important to take out supplementary mutual insurance.
Inadequate reimbursement for dental care
In Luxembourg, dentistry is facing a problem that stems from the past. The general CNS system is no longer adequate.
The Luxembourg nomenclature applied to dental procedures is very old. As a result, many current services are not mentioned in it. And more and more services are not covered by the CNS.
This is the case with implants, for example. This practice, which is now very common, involves screwing a crown into place in place of a tooth that has had to be removed. Prices are now completely unregulated. As a result, there can be significant differences between different dentists. It is therefore important to have good supplementary health insurance.
Reimbursement for vision care
The Luxembourg CNS general scheme reimburses very little for vision care. For example , eyeglass frames can only be reimbursed every three years. Lenses can be covered every year, under certain conditions.
In addition, the CNS only accepts relatively thin lenses for very strong prescriptions (above 7). In this case only, these thin lenses will be reimbursed at a rate of 80%. On the other hand, below this level of correction, you will have to opt for "fairly thick" lenses, which are not very attractive, in order to receive partial reimbursement. But nowadays, aesthetics are important. You should therefore be able to choose relatively thin lenses, even if they are not reimbursed by the CNS.
Similarly, the CNS will not cover the cost of eye surgery to eliminate the need for glasses.
However, thanks to its "Denta&Optiplus" option, the CMCM will reimburse part of these costs. For example, in the case of refractive surgery, the CMCM reimburses up to €1,000 per eye and the third-party payment system applies.
In conclusion, our advice for good health coverage
The Luxembourg healthcare system is a good healthcare system. However, it has remained very conservative in some ways. More and more services are not reimbursed.
For good health coverage, we recommend:
- For dental care, compare two or three dentists when it comes to expensive treatments (braces, implants, etc.).
- Take out supplementary health insurance if you consider healthcare to be a significant expense for your household.
- Ask your employer if you already have health insurance through a group plan.
- Carefully compare the offers available from supplementary health insurance providers to identify the best value for money.
- Discover what CMCM has to offer . It covers the healthcare needs of more than 280,000 members and offers very attractive rates.
CMCM does not require any medical records and accepts everyone. Whether you are healthy, sick, old, or young, everyone is welcome at CMCM.
The premium is family-based. The whole family is automatically covered, unlike with other insurance companies.
Assistance abroad worldwide is already included in the basic CMCM package. CMCM covers all repatriation costs, as well as hospitalization costs abroad up to €100,000. In addition, a travel cancellation option due to illness is included up to €1,500 per member.
Furthermore, CMCM offers a 10% discount to young singles under the age of 30.
Find out more about healthcare reimbursements in Luxembourg
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