Health insurance in Luxembourg
All residents living in Luxembourg have access to the free public Luxembourg healthcare system, although private insurance may be necessary in certain situations.
Luxembourg's healthcare system is one of the best in Europe. It has a high standard of state-funded healthcare covering each citizen with basic medical coverage. Private healthcare is also available, and all citizens have the right to choose their doctor, specialist and hospital. Plus, Luxembourg’s Union of Sickness Funds oversees the health service in Luxembourg. Here is an overview of public and private healthcare in Luxembourg, along with other medical care essentials to know.
Healthcare in Luxembourg: The state system
The state provides free basic health coverage to all citizens, and all employed citizens and employees contribute to this system. All dependent family members are covered by family members who pay into the insurance system. Children are covered under their parents, and students are covered until age 27. Coverage includes most treatment by your general practitioner or specialists, any laboratory tests, prescriptions and hospitalisation.
Who is covered?
All employees and self-employed workers in Luxembourg are required to make social security contributions, which in turn entitles them to Luxembourg healthcare. The spouse and children of employers living in Luxembourg are also entitled to healthcare.
EU, EEA and Swiss nationals who have reached retirement age in their home country are entitled to free healthcare in Luxembourg as long as their pensions are in order to receive it. In order to qualify, they must obtain a Form E121 from the previous EU country of residence. Acquiring this form prior to departure is advisable and will help simplify the registration process.
European Health Insurance Card
EU residents staying in Luxembourg on a temporary basis can use their European Health Insurance Card (EHIC) which entitles them to receive medical treatment at the same cost as a Luxembourg national. This is a great temporary option for Luxembourg residents, or for expats living in Luxembourg but often traveling around Europe throughout the year.
Non-working foreigners and Third country nationals
Non-EU/EEA nationals may have to provide proof of private health cover before being granted a visa.
Foreigners coming to live in Luxembourg without working must produce proof of health insurance in order to obtain a residence permit. If you qualify for ‘non-resident’ tax status, you may not be required to contribute to national social security, in which case you will probably be covered by your employer’s health care plan.
EU nationals studying in Luxembourg will also be covered by their EHIC throughout their period of study. Non-EU students, however, may be required to take out a private health insurance plan prior to arrival, although their university can provide more detail. Students and unemployed adults under 30 years may apply for continued health insurance at the University of Luxembourg website.
Luxembourg state healthcare: What you pay
Healthcare taxes are taken out of wages that employees and employers divide to pay half of each. The amount goes into the Luxembourg Health Offices of the Caisse Nationale de Santé (CNS), or the Caisse de Maladie which literally means ‘disease fund’ (www.cns.lu). The normal contribution amounts to about 2.8 percent of gross income from each side, up to a maximum contribution of EUR 6,225. If you are starting work in Luxembourg, your employer must register you within eight days of starting work. Once your employer registers you a form is sent to them from the ‘Centre Commune de la Sécurité Sociale’ (CCSS) asking for family details of all members so they can be included on your health plan. Return the form to the CCSS and they will mail you a social security card (Carte de Sécurité Sociale).
Manual work, self-employed, or pensions
Manual workers in certain trades pay a higher rate (almost 10 percent), split between employee and employer, and those on public assistance usually pay a reduced rate of 5.2 percent. If you are self-employed you have to pay the entire tax percentage, but fortunately the amount varies based on your profession and income. Those on unemployment benefits or retirement or disability pensions have health insurance contributions deducted from their benefit payments.
‘Dépendence’ is a long-term insurance financed through a one-percent tax withholding for employees that provides benefits toward costs of long-term care in nursing homes or other extended care.
How to register for Luxembourg healthcare
To register for healthcare in Luxembourg you must have a social security card that acts as your health insurance card given to you by the state, or the Centre Commune de la Sécurité Sociale.
Social security card
Applying for a social security card in Luxembourg is easy and mandatory to be considered eligible for healthcare in the country. After registering for a residence permit at the ‘Centre Commune de la Sécurité Sociale’ (CCSS) you will receive an application form asking about your personal details, your family members and dependents. Fill out this form and send it back to the commune by post. The form will want information or a copy of a valid identification like a passport, proof of employment and residency, and a certificate of entitlement. The CCSS will look over your application form, and eventually send a social security card to the residential address in about three weeks.
Your Luxembourg social security card (Carte de Sécurité Sociale) should be with you at all times, and it is required to show for first doctor visits, medical and pharmacy visits and prescriptions. The card, with your name and unique social security ID number, shows that you are eligible for all medical treatment and prescriptions. If you have a European Health Insurance Card then it is valid for medical assistance in any European Union country.
In Luxembourg, the health care system works on a reimbursement basis with visits and fees. Patients pay upfront and then submit receipts for consultations, treatment and medicines for reimbursement. The process will take about three weeks before receiving a reimbursement put directly into your bank account, along with a notification by post. Your healthcare provider will reply with the appropriate reimbursement rate, which varies from 80 to 100 percent.
All medical fees in the country are decided by the Caisse de Maladie state healthcare fund department. Most doctor visits are reimbursed at 100 percent, but the reimbursement rates vary for other services. For prescription medicine there is a 78 percent refund, though this can also vary from zero to full coverage percent. Levels of reimbursement on dentistry depends on if your dentist has a contract with the Caisse de Maladie.
Emergency treatment in a neighbouring country like Germany, Belgium or France may also qualify for reimbursement at the same rates as in Luxembourg. Examples of what the Luxembourg healthcare state will cover:
- Bandages, Accessories, etc.
- Dental and Orthodontic Appointments and Treatment
- Emergency and Accidents
- Emergency Ambulance Transport
- Eye care and Visual Aids (Spectacles, Contact Lenses)
- General Practitioner and Specialist appointments
- Hospitalisation, Treatment and Surgeries
- Laboratory Appointments and Blood Tests
- Pregnancy and Child Birth
- Medicine Prescriptions
- Medical and Treatment Therapy
- Recovery Costs
Private health insurance
Many people in Luxembourg take out private health insurance with a non-profit health insurance agency or a mutual association (mutuelles) affiliated with the Ministry of Social Security. While 99 percent of the population is covered by the state healthcare system, about 75 percent have some extra private healthcare purchase to help for coverage on things that might be considered non-essential to the state. The big plus of having an additional insurance is to cover unforeseen medical costs in a foreign country or unexpected hospitalisation.
Lastly, many employers offer supplementary cover as a benefit of employment. A mutuelle pays the portion of your medical fees that isn’t covered by your caisse and may offer extended coverage for such things as hospitalisation, eye care, dental treatment and medical services outside Luxembourg. This system is managed by Le Foyer, CGP, or Caisse Médico Chirurgicale Mutualiste (CMCM) for example.
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