Luxembourg - Healthcare

This chapter details what you need to know about claiming healthcare.

In what situation can I claim?

Compulsory health insurance covers, amongst others, salaried employees, the self-employed, apprentices, mariners, young volunteers, young au pairs, as well as people receiving pensions, invalidity pension, unemployment benefits, parental leave or the guaranteed minimum wage.

As somebody covered by this insurance, you have the right to benefits to both yourself and members of your family (joint insured persons), including: spouses, partners, children under your legal guardianship under 30 years old, parents or direct relatives or relatives by marriage to the third degree where they take care of the household of the insured person instead of a spouse.

Students pursuing their studies in Luxembourg are subject to health insurance if they are not covered by social protection in their capacity as a family member.

Anybody not covered or no longer covered by compulsory insurance or joint insurance may voluntarily receive coverage:

by continuing to pay contributions following a loss of insurance, on the condition that they were insured for at least 6 continuous months immediately before their disaffiliation (excluding a break of less than 8 days), and to submit the application within three months to the Social Security Centre (Centre commun de la sécurité sociale - CCSS);
otherwise, by taking out optional insurance. In this case, contributions are to be paid from the date of first request, but benefits may only be claimed after a period of 3 months.

What conditions do I need to meet?

To enable benefits such as consultations, visits, treatments and medical services and healthcare to be covered by health insurance, they must be:

provided by service providers which have signed an agreement with the National Health Fund (Caisse Nationale de Santé - CNS);
be included in the statutes of the CNS;
be listed in a breakdown of treatments or a list of tariffs.

What am I entitled to and how can I claim?

You are free to choose your own general practitioner and are free to consult a specialist doctor.

The healthcare you may receive is as follows:

Medical treatment
Dental treatment
Visual aids (spectacles, contact lenses etc.)
Treatment performed by healthcare professionals
Medical biology analyses
Orthoses, prostheses, epistheses and dental implants
Medicines
Medical devices
Hospital treatments and stays
Therapeutic cures
Physical rehabilitation and post-oncological care
General and occupational rehabilitation
Transport expenses incurred in connection with health care
Palliative care
Blood products and plasma derivatives
Organ transplants
Psychotherapies treating a mental disorder.

How is healthcare accessed?

Non-inpatient medical appointments are covered up to 80% of the listed official tariff. Consultations are covered up to 88% of this tariff. Amongst other things, full coverage is provided for chemotherapy, radiotherapy, haemodialysis, procedures provided as part of preventive medicine schemes (children's vaccinations, mammograms, etc.), and physiotherapy (in case of serious pathology, post-surgery rehabilitation and treatments for children under 18, otherwise 70% coverage).

100% of the costs are covered for children and youngsters under 18.

Above the annual amount of EUR 69.86 fully paid by health insurance, dental procedures and services are covered up to 88% of the tariffs. Dental prosthetics costs are covered up to 80% of the tariffs, except for restorative maxillo-facial prostheses, for which the coverage amounts to 100% of these tariffs. Coverage is 100% for children and young people who are under the age of 18.

Further details about coverage for other services is available on the dedicated web page of the Caisse nationale de santé.

Medicines are only covered upon presentation of the original medical prescriptions. For medicines appearing on the official list, there are 3 classes and for each class there is a rate of coverage:

the standard rate of 80% applies to all medicines not included in a specific provision;
the preferential rate of 100% applies to medicines for specific therapies which contain a single active ingredient and which are intended to combat particularly serious or chronic illnesses;
the reduced rate of 40% applies to non-essential pharmaceutical products of more limited therapeutic use.

Persons covered contribute to hospitalisation costs, excluding medical fees, at the rate of EUR 23.68 per day of hospitalisation in a second class room, up to the limit of 30 days per calendar year. Hospitalisation in a 1st class room is fully payable by the patient. Coverage is possible through the use of additional insurance.

Healthcare services are granted:

either in the form of reimbursement through the CNS (or through public sector health insurance) if you have paid your fees. In this system, it is your responsibility to pay the fees to the service provider for the treatment received;
or in the form of direct coverage by the CNS (3rd party payer system). In the event that you benefit from the 3rd party payer system, it is your responsibility to pay the service provider (doctor, dentist, pharmacist, etc.) solely the portion of the costs personally payable by you.

What is the duration of the coverage?

Healthcare services are provided to you from the date of your inclusion in social security, except in the event of optional insurance, where a waiting period of three months is applied.

In the event that you cease your inclusion in the social security system, your right to healthcare services is upheld for the current month in question and for the subsequent three months, on condition that you had previously been included in the system for a continuous period of 6 months immediately prior to your disaffiliation. Insurance periods completed in another country are taken into account.

Jargon busters

Caisse nationale de santé (CNS): Health insurance fund for all private sector workers, salaried employees and self-employed persons.
Centre commun de la sécurité sociale (CCSS): Body which governs affiliation and the collection of contributions for all branches of social security.
Service providers: doctors, dentists, pharmacists, nurses, midwives, physiotherapists, opticians, speech therapists, orthopaedists, rehabilitation specialists, laboratories, spas, convalescence centres, patient transportation services. All service providers are linked to the CNS by agreement and must respect the tariffs.
Tariffs: prices for treatment and services negotiated between the representative associations of the service providers and the CNS, entered into the official lists and descriptions.

Know your rights

The link below provides a legal definition of your rights. This website is not a European Commission website and it does not represent the views of the Commission: