Why is it a good idea to take out supplementary health insurance?

Fabia Secci CMCM

Are you moving to Luxembourg and wondering whether you should take out supplementary health insurance? How does the Luxembourg healthcare system work, particularly in terms of reimbursement?

In this article, we'd like to take a closer look at all these issues, and answer any questions you may have. To do so, we interviewed Fabio Secci, General Manager of CMCM, a health mutual established in Luxembourg since 1956.

Good health cover in Luxembourg - but enough?

A quality healthcare system in Luxembourg

First and foremost, Luxembourg's healthcare system can be described as a quality system. Access to care is easy, thanks to a large number of general practitioners and specialists. What's more, the level of reimbursement for medical services is generally quite reasonable for most medical treatments.

Luxembourg's healthcare system is governed by the Centre Commun de la Sécurité Sociale and the CNS for the private sector. Social contributions to the healthcare system are compulsory for all employees and self-employed workers in Luxembourg.

As a result, the CNS medical expenses reimbursement system is highly efficient. For example, it covers 80-90% of expenses incurred by a general practitioner. This is also the case for reimbursements of medical expenses to certain specialist doctors, all the more so if you have a medical prescription. What's more, medical expenses for minors under the age of 16 are reimbursed at 100%!

Certain healthcare expenses remain payable by patients

But while Luxembourg's health care system is effective because it encourages responsibility, it is not entirely adequate. In fact, despite compulsory contributions to the healthcare system, certain medical expenses are not covered by the CNS. These are borne by the patient, and it should be noted that the cost of medical services in Luxembourg is high.

An empowering healthcare system in Luxembourg

Insufficient health care coverage by the CNS

While medical services are generally covered, at least in part, the CNS reimburses some medical expenses very little, if at all. This is particularly true of dental and vision-related expenses.

When it comes to hospitalization costs, the CNS does not cover all expenses. If the patient is hospitalized in a multiple room, hospital expenses may be reimbursed up to 90%. But this is not the case for a single room.

Patient empowerment

The reason for not reimbursing the full cost of medical care is to make patients more responsible. Indeed, the need for medical care can, in some cases, be the result of a certain carelessness in our relationship with health.

And when it comes to the Luxembourg mentality, it's important to understand that nothing is free. In Luxembourg, unlike certain countries such as France, patients must pay their medical expenses upfront. Indeed, providing care is a charge or expense borne by the community. Receiving care is the fruit of a collective effort and solidarity. Everyone must be aware of this and contribute to maintaining the healthcare system.

In concrete terms, how is the healthcare system working in Luxembourg?

A less-than-optimal general hospital care system

Hospitalization in a first-class room and reimbursement of medical expenses

In Luxembourg, in the event of hospitalization, you can benefit from a single room. This is known as a first-class room.

In the case of first-class hospitalization, the final hospital rate 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 expenses incurred by this choice. These costs are borne by the patient.

Expansion of "First Class" hospital services

Single rooms are still in short supply in Luxembourg. Hospitals often reserve them for longer hospital stays. And as a rule, there are more requests than requests met.

"But the development projects of hospitals and clinics will be very much oriented towards the creation of single rooms. The long-term objective is to offer 80% single rooms," asserts Mr. Secci, head of the mutual health insurance company CMCM. Legislation will be attentive to this development. Not all single rooms can be treated as first-class rooms. No quota has yet been set, but the current ratio could be respected.

Additional fee-based services, such as à la carte meals and pay TV, are also planned for this type of service. These costs will also be borne by the patient.

Coverage of first-class hospital tariff differentials

In addition, on the day of your hospitalization, in the absence of a shared room, you may be hospitalized in a single room, known as first class. Or your illness may be contagious, requiring you to be isolated in a single room. In either case, it may be difficult to pay a supplement to the general hospital rate.

For a short stay and a minor operation, opting for a single room is not "imperative". But for longer stays and/or operations requiring a lot of rest, this first-class option is not a luxury.

The CMCM mutual health insurance plan, and even some complementary health insurance plans, cover this difference in hospital rates, through various insurance offers.

A somewhat rigid healthcare system for treatment abroad

There are two types of medical care abroad.

Lack of specialists in Luxembourg to deal with the problem

If the patient seeks treatment abroad, he or she must first request the CNS's agreement to cover the cost of treatment not offered in Luxembourg. To do so, they must complete form S2. However, these medical expenses incurred abroad will not be fully covered by the CNS. On the other hand, the CMCM and certain complementary insurances may reimburse the difference, depending on their offers.

Existing care services in Luxembourg, but less comfortable

In cases where medical care is available in Luxembourg, but practices are less comfortable than those offered abroad, CNS reimbursement is partial. The CNS covers 80% of the cost of an operation in Luxembourg. As a result, if the cost of the operation abroad is higher than the cost of the operation in Luxembourg, you will have to pay the difference.

That's why it's important to compare the offers of supplementary insurers, including CMCM, to find out the maximum reimbursements for treatment abroad.

Insufficient dental and vision care coverage

In addition, dental and vision care can represent a significant budget. These expenses are not, or only to a limited extent, covered by the CNS. So it's important to opt for a complementary mutual insurance plan.

Inadequate reimbursement of dental care by the CNS

Dentistry in Luxembourg is facing a problem from the past. The general CNS system is no longer appropriate.

Luxembourg's nomenclature for dental procedures is very old. As a result, many current services are not mentioned. And more and more services are not covered by the CNS.

One example is implants. This practice, now very common, consists of screwing on a crown in place of an original tooth that has had to be removed. Today, prices are completely free. In fact, there are considerable differences between dentists. That's why it's important to have the right supplementary health insurance.

Reimbursement of eye care by supplementary health insurance plans

Luxembourg's general CNS scheme reimburses very little for eye care. For example, spectacle frames may be reimbursed only every 3 years. Lenses may be reimbursed every year, under certain conditions.

What's more, the CNS only accepts relatively thin lenses for very high corrections (above 7). In this case only, these thin lenses will be reimbursed up to 80%. On the other hand, below this level of correction, you will have to opt for "fairly thick" and therefore unattractive lenses to hope for partial reimbursement. But these days, 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 an eye operation to do without glasses.

On the other hand, thanks to its "Denta&Optiplus" option, CMCM will reimburse part of these costs in addition. For example, in the case of refractive surgery, the CMCM reimburses up to €1,000 per eye, with third-party payment.

In conclusion, our advice for good health coverage

Luxembourg's healthcare system is a good one. But in some ways, it has remained very conservative. More and more services are not reimbursed.

For good healthcare coverage, we recommend :

CMCM requires no medical records and accepts everyone. Whether healthy, ill, old or young, everyone is welcome at the CMCM.

The premium is family-based. The whole family is systematically covered, unlike other insurance companies.

Worldwide assistance abroad is already included in the basic CMCM package. CMCM covers all repatriation costs, as well as hospitalization costs abroad up to 100,000 euros. In addition, a trip cancellation due to illness option is included up to 1,500 euros per member.

In addition, the CMCM offers a 10% discount to single young people under 30.

Find out more about healthcare reimbursements in Luxembourg

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