Reimbursement of medical expenses and drugs

To date, and pending the generalization of third-party payment announced by the government for 2023, patients must advance their medical expenses before requesting reimbursement from the CNS or CMFEP.

Participation in health care benefits

Health care is reimbursed in part or in full by the Health Fund, CNS or CMFEP.

In order for this to be effective, you must first register with the Centre Commun de la Sécurité Sociale. This is normally done by the employer. Once registered, you can then obtain full or partial reimbursement of your medical and health care expenses with your health insurance company.

These medical expenses can be related to a consultation with a general practitioner or specialist, dental fees charged by the dentist, hospital fees, purchases of drugs and other products delivered in pharmacies on medical prescription, …
In order to be reimbursed, the services must be provided by a service provider who meets all the professional legal obligations required in Luxembourg.

Third-party payment system

Certain types of medical care, hospital fees, physical therapy, laboratory fees, etc., and medications are settled directly between the provider and the NHA. This is the third-party payment system.

The recipient of the care does not have to advance these medical expenses. All they have to do is present their insurance card to benefit from the part covered by the third-party payment system. He just has to pay the part that is not taken care of.

Since 2013, social third-party payment has been in place for the most disadvantaged households. The third-party payment system will be generalized in 2023.

Reimbursement of medical expenses and drugs

The National Health Fund (CNS) is the health body for private employees. The CMFEP is the insurance body for people working in the Luxembourg public sector.
Both allow the insured person and his/her dependents to benefit from the reimbursement of medical expenses, drugs, hospitalizations, analyses and medical care, ….

This reimbursement is made in part or in full, according to a nomenclature of procedures and a list of reimbursement rates published by these organizations.

Procedures for the reimbursement of medical expenses by the NHA

As a private sector employee or beneficiary/co-insured, you can be reimbursed in part or in full for your medical expenses by the NHA.

To do so, you must, at the time of the first request and after registration with the CCSS, communicate to your health insurance fund your bank account number.

Depending on the nature of the services, doctors’ fees, medical care and medication costs are reimbursed by the health insurance according to the nomenclature established by the CNS.

Please note that some medical or paramedical procedures are not covered by the National Health Fund.

What documents and information are required for a refund?

  1. The original fee statement
  2. Proof of payment
  3. The indication of the bank account (only if it has not been filled in before)
  4. The 13-digit registration number

For the cost of medication: on presentation of your health insurance card at the pharmacist, you will be charged only for the part not covered by the health insurance fund.

The originals of the bills of fees or other medical expenses, paid, must be sent to the National Health Fund. If you pay by Internet, don’t forget to attach your debit notice or you won’t be refunded!

What do I need to know if I’m off sick?

What is the mailing address to send medical claims to the NHA?

For all your claims for reimbursement of doctors, specialists, dentists, …. you must send the above documents to the National Health Fund.

CNS Caisse nationale de santé – Service Remboursements, 125 Route d’Esch L-1471 Luxembourg

Cross-border commuters who are affiliated to a health insurance fund in their country of residence are of course entitled to receive medical treatment in their country. However, the reimbursement of cross-border health care will be done by the health insurance of the country of residence. If the patient is treated in Luxembourg, the CNS will reimburse the cost of the treatment.

Physician fees and drug reimbursements in plain language

On the website of the CNS (National Health Fund), you will find a tool that allows you to search for the associated tariff according to which the doctor is entitled to bill, based on the wording of the codes present on the medical fee memoranda.

To find out the percentage of reimbursement of drugs, you can consult the list of drugs and the corresponding amount (in percentage) of reimbursement by clicking on this link.

  • Dental expenses: in addition to dental expenses, 2 scaling procedures have been reimbursed per year since 2017, as well as anesthesia for fillings
  • Expenses for organic glasses and contact lenses: improved coverage
  • Work stoppages: maximum duration of compensation of 78 weeks instead of 52 previously,
  • 100% reimbursement of medical expenses for children for speech therapy, psychomotor therapyand nursing care and/or administered by physicians.
  • Lymphatic drainage: 24 prescribed sessions, possibility of purchasing compression stockings in 2 pairs every 12months

Urgent care abroad

In case of urgent care abroad, a distinction must be made between European Union countries and Switzerland and other destinations.

In the European Union and Switzerland, urgent care is theoretically reimbursed on the basis of the European Health Insurance Card. In other countries, you will be obliged to advance all the costs and to check with your health insurance fund on your return to see what the possible reimbursement is.

In any case, remember to ask for detailed and receipted invoices, written if possible in one of the common European languages (French, German, English).
To facilitate reimbursement, also make sure the physician you consult or provider is licensed and contracted (as opposed to a private practitioner).

In any case, we advise you to contact your health insurance company to find out about possible reimbursement terms before your departure.

Reimbursement of medical expenses (CNS)

Supplementary health insurance

The CNS and the CMFEP do not reimburse health care costs, health care expenses and medication in full.

To improve your reimbursements, consider taking out a mutual health insurance policy. For a monthly fee, it will cover the difference and improve your reimbursement rate.

Supplementary health insurance is not mandatory in Luxembourg. On the other hand, it can be a very good investment against life’s accidents. Don’t hesitate to ask for quotes from several companies.