The health of cross-border workers

Cross-border commuters and health in Luxembourg

Cross-border commuters work in Luxembourg, but reside in another country, such as France, Belgium or Germany. Given their hybrid status, they are entitled to benefits and financial coverage for their healthcare expenses. To do so, however, cross-border commuters must comply with a number of specific administrative formalities.

Specificities of cross-border workers in Luxembourg

A person working in Luxembourg, but living at least one day a week in another country - be it France, Belgium or Germany - is considered a "frontier worker".

Affiliation of cross-border commuters with the health insurance funds of both countries

Through their employer in Luxembourg, cross-border workers are affiliated to the Caisse Nationale de Santé in Luxembourg. However, they must also register with the health insurance fund in their place of residence in order to benefit from health care reimbursements.

The Caisse Nationale de Santé (CNS ) issues an entitlement document, known as the " S1 form ". This document is called the "BL1 form" for Belgian cross-border commuters.

General framework for cross-border workers

Frontier workers receive the S1 document at their home address. They must then return it to the CPAM in their place of residence.

If the insured has not received the document within 15 days of receiving the declaration of entry from the Centre commun de la sécurité sociale luxembourgeoise (CCSS), he/she must order the document himself/herself.

Please note! This procedure is not automatic if you work for a temporary employment agency. They must submit a written request.

Specific case of French border workers

Legal documents for French cross-border commuters living in the Meurthe-et-Moselle and Moselle départements are sent directly to the primary health insurance funds. This document is called the S072. Once registration has been validated, the policyholder receives confirmation of registration from the relevant Caisse Primaire d'Assurance Maladie (CPAM). No further action is generally required.

The principle of co-insurance for cross-border commuters

Insured cross-border commuters and their family members are entitled to Luxembourg benefits under the same conditions as Luxembourg residents. To do this, the health insurance fund in the country of residence sends the Luxembourg CNS (Caisse Nationale de Santé) a certificate proving that the family members are dependent on the insured person.

The legislation of the country of residence is decisive with regard to the status of family members entitled to benefits. If the spouse is employed in the country of residence, family members are generally dependent on the spouse.

Work incapacity and sick leave for cross-border commuters

Work stoppage procedure for cross-border workers

As soon as the employee is aware that he or she will not be able to go to work, he or she must inform the employer as soon as possible.

A medical certificate is not required for absences of less than one or two working days. The insured therefore has nothing to send to the CNS. However, you must notify your employer as soon as possible.

Find out more about sick leave in Luxembourg.

The sick frontier worker must go to the doctor to obtain a work stoppage certificate. The insured must then send the original certificate to the CNS before the end of the third working day of incapacity. The second copy must be sent to the employer within the same timeframe.

Please note! To facilitate processing, we advise you to indicate the Luxembourg national identification number (the 13-digit number on the insured's card) on the sickness certificate, and not the national number of the insured's country of residence.

Depending on the country of residence, however, it is not always possible to obtain certificates of incapacity for work in the form stipulated by the CNS. This is particularly the case in Belgium, where most work stoppage certificates have only one section. It is therefore preferable to request a duplicate from the doctor, in order to give it to the Luxembourg employer.

Penalties for non-compliance with the sick leave procedure

In Luxembourg, there are penalties for failure to declare incapacity for work. If the insured fails to submit one or more medical certificates to the CNS, the latter sends a written reminder. But if the employee repeats this omission, the CNS is able to penalize him/her, in accordance with article 447 of the Social Security Code. The employee is liable to a fine of up to €750.

Authorized exits in case of work stoppage for cross-border commuters

If you are off work, you can visit your GP, a social security medical check-up or any other healthcare provider. It should be noted that no other outings are authorized during the first five days of work stoppage, despite any indication to the contrary that may appear on the certificate.

From the 6th day of work stoppage, the patient is authorized to go out, if the doctor has noted no contraindications. Outings can then take place between 10 a.m. and 12 p.m. and between 2 p.m. and 6 p.m.

Please note! All these outputs must be documented in the event of an inspection by the Caisse Nationale de Santé .

Controls at the border patient's place of residence

As with Luxembourg residents, the CNS can carry out administrative checks at the frontier worker's place of residence. Checks are carried out between 8 a.m. and 9 p.m., from the first day of stopover.

The patient is therefore required to provide the exact address of the place where he or she will be staying during his or her stay. Otherwise, the person must be reachable by telephone or e-mail.

In the event of absence, the inspector leaves a notice at the inspection site. The patient must then justify his or her absence within three working days of the inspection date.

Coverage of healthcare costs for cross-border commuters

CNS covers the reimbursement of healthcare costs provided they are provided in Luxembourg or in any country other than the country of residence.

In the country of residence, treatment is paid for by the local health insurance fund.

Health care coverage in country of residence

Of course, insured cross-border commuters are entitled to reimbursement of their healthcare costs. Benefits in the country of residence are reimbursed exclusively on the spot, in accordance with local rates and conditions.

To be reimbursed for their healthcare costs, cross-border commuters must therefore contact the health insurance fund in their country of residence.

Reimbursement for treatment in another country

The CNS reimburses healthcare costs incurred in countries other than Luxembourg or the country of residence. A distinction is made between two cases:

Care received in an EU, EEA or Swiss country

If treatment is required during a temporary stay, the insured person is invited to use his or her European Health Insurance Card. Treatment is then reimbursed at the rates applicable in the country in question.

Care received in a country with which Luxembourg has an agreement

Outside the EU, the EEA or Switzerland, Luxembourg will pay for treatment in accordance with the legislation of the country concerned, provided that Luxembourg has signed a social security agreement with that country.

More information on healthcare in Luxembourg

Silver partner

INFPC Luxembourg Vocational training

INFPC and portal


Our events Employment - vocational training

Our latest articles Employment - vocational training

Largest employers in Luxembourg

Overview of employment in Luxembourg Luxembourg employed over 49,000 people in Q4 2022, residents and cross-border commuters...

Apply for a summer job in Luxembourg

Summer is already well underway in Luxembourg, much to everyone's delight. School vacations are fast approaching...

Apply for a summer job Luxembourg

Are you aged between 15 and 27, studying in Luxembourg or abroad? In Luxembourg, you can apply...

They trust us

AXA assurances Luxembourg
Raiffeisen Luxembourg
Child king