How does the healthcare system work in Luxembourg?
Getting to know another country’s healthcare system can be daunting for new expats. But if you are living and working in Luxembourg, you don’t have to worry too much because you are in safe hands. Luxembourg’s healthcare system is one of the best in Europe. The state-funded system, overseen by the National Health Fund (Caisse Nationale de Santé or CNS), adheres to high standards, provides basic medical coverage to all citizens and is based on three fundamental principles: compulsory health insurance, free choice of provider for patients and compulsory provider compliance with the fixed set of fees and services.
Who is covered?
In Luxembourg, all employees and self-employed workers are required to make social security contributions, which in turns entitles them and their dependent family members to healthcare. All minor and children under the age of 30, residing in Luxembourg and not personally insured, may be co-insured with a parent who is personally registered with health insurance. Coverage includes most of the treatments provided by general practitioners or specialists, any laboratory test, prescriptions and hospitalisation. When you start working in Luxembourg, your employer (or potentially you if you are self-employed) will declare your employment to the Joint Centre of Social Security (Centre Commun de la Sécurité Sociale or CCSS). The CCSS will send you a declaration of entry confirming your affiliation to the Luxembourg social security (for more information, visit www.ccss.lu). Once registered, you will receive a social security card bearing your national social security number. This card must be presented to healthcare providers.
If you want to reside in Luxembourg and are retired, you need to show evidence of health insurance in order to acquire resident’s permit. If you are eligible for non-resident tax status, you may not be required to make healthcare contributions and are likely to be covered by your employer’s healthcare insurance scheme.
Payment in advance or third-party payment system?
The healthcare system in Luxembourg works on the basis of reimbursement, which varies from 80 to 100%. You pay the medical fees upfront and then submit the reimbursement claims to the CNS (for more information, visit www.cns.lu). In this case, you have to send the original doctor’s invoice or other medical fees paid upfront, duly settled, to the CNS. Good to know: if you send your letter to the CNS from within Luxembourg, you don’t need to put a postage stamp on the envelope. The process will take about three weeks before receiving a reimbursement put directly into your bank account, along with a notification by post.
For certain types of healthcare, the costs are settled directly between the CNS and the provider/supplier. These include pharmaceutical costs, hospital costs, physiotherapist costs, laboratory costs, etc. In this case, you only pay the portion of the costs not covered by health insurance. Medications under medical prescription are usually covered by the CNS through the third-party payment system. They are organized in three categories: 40%, 80% and 100%. Pay attention to the fact that you will be charged full price for non-prescription medicines if you purchase them directly from the pharmacy. Hospital costs are directly paid for by health insurance, except for doctors’ fees.
Do I need private health insurance?
More than 90% of your healthcare needs are covered by the CNS. However, you can opt to take out an additional private health insurance. Many employers also offer supplementary health cover to their employees as an employment benefit. The private insurance covers the portion of your medical fees that isn’t covered by the CNS and offers extended coverage for such things as hospitalisation, eye care, dental treatment and medical services outside Luxembourg. The big plus of having an additional insurance is to cover unexpected hospitalization or unforeseen medical costs in a foreign country. So, check carefully the terms and conditions before buying any private insurance policy.
Some practical information
In Luxembourg, you can choose your own doctor but make sure that your doctor is contracted into the state health scheme to avoid extra fees. You can search for a doctor by discipline and town at www.collegemedical.lu (only in French). Also, www.doctena.lu lists doctors by discipline, town AND language and arrange medical visits so you can book online.
There are no private hospitals in Luxembourg. All hospitals are run by the CNS. You must have a referral from your doctor for an admission to a hospital if your case is not an emergency.
And, last but not least, the medical emergency phone number in Luxembourg is 112. Emergency care is provided by the emergency department at large hospitals. Not all hospitals in Luxembourg have emergency services. Within the Luxembourg area, emergency care outside of working hours is rotated among the two big hospitals (Hôpital Kirchberg and Centre Hospitalier de Luxembourg). You can have the list of clinics and hospitals on duty in 2017 (only in French) at http://www.sante.public.lu/fr/urgences-gardes/2017-garde-hopitaux-annuel.pdf.
Immigration has always played a decisive role in the Grand Duchy’s economic development and and this trend is not going to stop. In 1961, the number of inhabitants in Luxembourg amounted to 314,900 people with a proportion of 13.2% of foreigners.
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