Coverage of healthcare expenses
Are you arriving in Luxembourg and wondering how your healthcare expenses will be covered? Find useful information here.
Principle of reimbursement for medical care
Advance payment of healthcare costs to practitioners
Currently, most patients must pay the full cost of medical care to their healthcare providers upon presentation of an invoice.
Once the bill has been paid, they can then claim reimbursement from the national health insurance funds by presenting the paid invoices.
In Luxembourg, the process for obtaining reimbursement for healthcare may also include procedures related to obtaining a CNS certificate for sick leave, which comes with specific rights and obligations for employees.
The national health insurance funds cover all or part of the costs according to a number of criteria. Any supplementary health insurance funds to which the patient may have subscribed may then cover the remainder of the bill.
Mandatory registration with the CCSS
In order for the national health funds to cover your healthcare costs, you must first register with the Joint Social Security Center (CCSS).
Only once you are registered will you be able to obtain full or partial reimbursement of your medical and healthcare expenses. The health insurance fund to which you are affiliated will only reimburse you upon presentation of proof of payment.
The National Health Fund (Caisse Nationale de Santé, CNS) is the health insurance provider for private sector employees. The CMFEP is the insurance provider for people working in the Luxembourg public sector.
These two health insurance funds enable the insured person and their dependents to receive full or partial reimbursement of medical expenses, medication, hospitalizations, tests, and medical care, etc.
Reimbursement of healthcare costs and professional fees
To be eligible for full or partial reimbursement, medical expenses and professional fees must be related to a doctor's appointment, dental expenses, hospital expenses, etc. Purchases of medicines and other products dispensed by pharmacies are also covered in full or in part by the health insurance funds on medical prescription. This is also the case for vaccinations, which are free for those under 18 years of age.
Health insurance funds reimburse these medical expenses on the basis of fee statements and invoices issued by healthcare providers. However,these providers must fulfill all the legal professional obligations required in Luxembourg.
Medical expenses are reimbursed in part or in full, according to a list of procedures and reimbursement rates published by the Luxembourg National Health Fund (Caisse Nationale de Santé, CNS) and supplementary health insurance funds.
Third-party payment system in Luxembourg
Since 2013, third-party payment has been in effect for the most disadvantaged households. Under the third-party payment system, the CNS pays healthcare costs directly to the provider concerned. This means that the beneficiary of the care does not have to pay these medical expenses up front.
To benefit from this system, the insured person must present their social security card to the healthcare provider. They will then be able to benefit from the portion covered by the third-party payment system. They will only have to pay the portion not covered by the CNS.
The third-party payment system is expected to be rolled out across the board in the near future, most likely in 2024.
How can you get your healthcare costs reimbursed?
Coverage by the National Health Fund in Luxembourg
As an employee in the private sector or a beneficiary/co-insured person, you can be reimbursed for part or all of your medical expenses and medication by the CNS or Caisse Nationale de Santé. Your employer mustfirst register you with the CCSS.
Then, whenever you have to pay healthcare costs to a doctor or healthcare specialist, simply send your health insurance fund (CNS or CMFEP) the invoices for the fees you have paid to obtain a refund.
The health insurance fund reimburses doctors' fees, medical care, and medication costs in full or in part. The CNS sets the exact amount of these reimbursements for each medical procedure, healthcare service, and medication.
Vaccinations are also covered, provided they are included in the vaccination schedule.
Please note that certain medical and paramedical procedures are not covered by the National Health Fund. This is particularly the case for osteopaths, naturopaths, acupuncturists, etc.
What documents must be submitted to the CNS for reimbursement?
Medical expenses incurred with a doctor or healthcare provider
The originals of invoices or other medical expenses paid must be sent to the National Health Fund, accompanied by proof of payment to the healthcare provider.
When submitting your claim for reimbursement to the health insurance funds, you must enclose the following documents with your claim:
- The original invoice for fees paid
- Proof of payment (copy of the bank transfer) if the invoice was not paid directly by the provider through immediate payment on site
- Your bank account number for reimbursement by bank transfer (only if it has not been provided previously, particularly when submitting your first reimbursement claim)
- The patient's 13-digit registration number.
Please note that you must attach the doctors' prescriptions for reimbursement, particularly for tests such as blood tests, X-rays, MRIs, physiotherapy, etc. Prescriptions must be less than two months old at the time of the specialist appointment.
Coverage of medication costs
The cost of medication purchased from a pharmacist is covered directly by the CNS, based on a medical prescription less than two months old. You will not need to pay the reimbursable portion up front. You will only have to pay the portion not covered.
This coverage is provided upon presentation of your health insurance card at the pharmacy. The total or partial reimbursement of medication costs is based on a specific nomenclature. You will onlyhave to pay the pharmacist the portion not covered by the health insurance fund.
Where should you send your reimbursement claims to the CNS?
For all your requests for reimbursement of medical, specialist, dental, etc. expenses, you must send the above documents to the National Health Fund.
CNS Caisse nationale de santé – Service Remboursements
4 Rue Mercier L-2980 Luxembourg
Cross-border workers who are members of a health insurance fund in their country of residence are, of course, entitled to receive medical treatment in their country. Healthcare costs will then be reimbursed by the health insurance fund in their country of residence. If the patient receives treatment in Luxembourg, healthcare costs will be reimbursed by the CNS. See our page on healthcare for cross-border workers.
Amount of healthcare reimbursements
On the CNS (National Health Fund) website, you will find the legal rates charged by doctors, according to the codes listed on medical fee statements. The CNS will reimburse your medical expenses up to these legal rates, but not beyond.
To find out the reimbursement percentage for medicines, you can consult the list of medicines and the percentage of coverage by clicking on this link.
- Dental expenses: in addition to dentalexpenses , two teeth cleanings per year are reimbursed, as well as anesthesia for fillings.
- Costs of prescription glasses and contact lenses: partial coverage, currently being improved
- Sick leave: maximum compensation period of 78 weeks.
- 100% reimbursement of medical expenses for children for speechtherapy , psychomotortherapy , and nursing care and/or care administered by doctors.
- Lymphatic drainage: 24 prescribedsessions , option to purchase two pairs of compression stockings every 12 months
Want to reduce your healthcare costs? Choose a healthy diet, as recommended by the Slow Food Grand Duchy convivium.
Reimbursement for medical care abroad
In the event of emergency treatment abroad, a distinction must be made between European Union countries and Switzerland on the one hand, and other destinations on the other.
In the European Union and Switzerland, emergency care is theoretically reimbursed on the basis of the European Health Insurance Card.
In other countries, you will be required to pay all costs up front and then contact your health insurance provider upon your return to find out about possible reimbursement.
In any case, remember to ask for detailed, paid invoices, written in one of the common European languages (French, German, English) if possible.
To facilitate reimbursement, also make sure that the doctor or provider you consult is approved and contracted (as opposed to a private practitioner).
In any case, we advise you to contact your health insurance provider before you leave to find out about any reimbursement arrangements.
Improving the reimbursement of medical expenses
It is important to note that the CNS and CMFEP do not reimburse all healthcare costs, medical expenses, and medications.
To improve your medical reimbursements, consider taking out supplementary health insurance. For a monthly premium, this will cover the difference and optimize your reimbursement rate for medical expenses.
Supplementary health insurance is not compulsory in Luxembourg. However , it can be a very good investment against life's accidents. Don't hesitate to request quotes from several companies.
Find out more about health insurance services.
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