Insurance

Any person engaged in a paid professional occupation in Luxembourg is mandatory affiliated with the Luxembourg social security institutions. Indeed, the Human Resources manager has the obligation to inform the Common Social Security Center (CCSS) of the hiring of each new collaborator through an entry declaration. Once this declaration has been registered by the CCSS, the civil servant/public employee is automatically affiliated with the Health Insurance Fund for Civil Servants and Public Employees (CMFEP). The same applies to family members who are already co-insured and residing in the Grand Duchy.

Any person affiliated with the CMFEP by the CCSS is entitled to health-maternity insurance benefits from the first day of their affiliation.

You can check your affiliation status and that of your co-insured family members online on the myguichet.lu portal (Personal Data/Health and Social/Health Insurance)

In case of the termination of professional activity or the termination of the employment contract, your employer or the State Personnel Management and Guidance Center (CGPO) informs the CCSS by sending an exit declaration. The common center then proceeds with your disaffiliation and that of your co-insured family members.

However, if you have been continuously affiliated for a period of 6 months, you continue to benefit from healthcare services provided by CMFEP during the current month and the following 3 months. An interruption of less than 8 days is not taken into account for the calculation of the continuity of affiliation condition.

This period can also be extended by an additional 3 months for illnesses undergoing treatment at the time of the cessation of affiliation.

Important: The extension of affiliation does not apply when the beneficiary has legal coverage for the same risks during this period.

In case of loss of affiliation, a resident insured in Luxembourg has the option to purchase voluntary health insurance through the affiliation center, CCSS.

To be eligible for continued voluntary health insurance, the applicant must:

• be at least 18 years old
• reside in the Grand Duchy of Luxembourg
• have lost the status of mandatory insured or family member protection after having benefited from it for a continuous period of six months immediately preceding the loss of this status. The continuity requirement is not disrupted by an interruption of less than eight days
• not have access to legal coverage for the same risks (e.g., the possibility of co-insurance with a parent or spouse/partner)
• submit an admission request to the Common Social Security Center within three months of losing affiliation, or risk forfeiture

Contributions are calculated based on the minimum social wage, with a current contribution rate of 5.60% for health insurance.

For any additional information, please contact the relevant authority, namely the Common Social Security Center.(Centre commun de la sécurité sociale)

Family members dependent on the primary insured person and residing in Luxembourg benefit from the protection associated with health insurance through co-insured affiliation, provided that they are not personally affiliated. The coverage of mandatory and voluntary insurance extends to:

• the spouse or partner
• parents and relatives in the direct or collateral line up to the third degree, who, in the absence of a spouse or partner, maintain the household of the primary insured person
• legitimate, legitimized, natural, and adopted children of the primary insured person for whom tax relief is obtained
• children taken in on a lasting basis in the household of the insured person, whom they provide with education and maintenance
• beneficiaries referred to in 3) and 4) under the age of thirty and for whom child tax relief is no longer granted, if they have resources below the Minimum Social Inclusion Income (REVIS) for a single person

The benefit of this article is subject to the condition that the individual is not personally affiliated and, except in the case of studies or professional training, that they reside in the Grand Duchy of Luxembourg.

Insured individuals are advised to verify the affiliation of their children at the age of 18. The same applies if they have been employed. Insured individuals do not need to send a certificate of studies to the CMFEP.

At the age of 30, co-insured children who are either studying or have resources below the Minimum Social Inclusion Income (REVIS) for a single person can apply to the CNS to remain co-insured. They will be notified of this in writing.

If the spouse to be co-insured was insured in a country other than Luxembourg, they must provide the CMFEP with an affiliation certificate (S041 or co-insurance certificate) issued by the last social security organisation with which they were insured. If such a certificate cannot be provided because they have not resided in Europe, they must send a sworn declaration to the CMFEP, signed by themselves. In this declaration, the spouse must swear not to have health insurance in another country and commit to promptly report any changes in their situation after the submission of this declaration.

The insured individual is considered a cross-border worker if they work (and are insured) in a different EU country than the one in which they reside, provided that they return to their country of residence every day or at least once a week. In this case, the country where they work is the competent country for healthcare. The health insurance fund of the competent country issues an S1 form, with which the cross-border worker must register with the health insurance fund in their country of residence.

Therefore, the S1 form is a document that allows the insured person and/or their family members residing in a Member State other than Luxembourg to register with the health insurance institution in their country of residence to benefit from healthcare benefits (medical care, hospitalization) provided by the maternity health insurance as stipulated by the legislation of the country of residence, similar to an insured person from that country.

Our insured individuals can obtain the S1 form from our affiliation service. It must be submitted promptly to the institution in the place of residence, which registers the individuals and informs CMFEP. The health insurance fund of the country of residence then decides on any possible co-insurance of family members in accordance with the legislation of the country of residence by issuing the S071 form.

The cross-border worker, working in the Grand Duchy of Luxembourg and residing in Belgium, must submit a request to CMFEP to obtain a BL1 form. This form should be promptly handed over to the relevant mutual insurance company in Belgium, which then proceeds with the registration of the dependent.

The mutual insurance company in Belgium also decides on any possible co-insurance of family members in accordance with Belgian legislation and informs CMFEP by issuing a BL6 form.

The coverage of expenses for healthcare services provided in your country of residence is exclusively handled by the country of residence, following the rates and tariffs applicable to social insurance beneficiaries in that country.

The coverage of expenses for healthcare services provided in Luxembourg is managed by CMFEP upon presentation of original and paid invoices (please refer to the "remboursement" section).

Regarding the coverage of healthcare received in a country other than Luxembourg or the country of residence, emergency care is directly covered by the competent institution at the place of stay upon presentation of your European Health Insurance Card or the replacement certificate.

For planned inpatient hospital care in a country other than Luxembourg or the country of residence, prior authorization is required from CNS, based on a favorable opinion from the Social Security Medical Control (in the case of a directive agreement).

Additional information for Belgian cross-border workers: Belgian cross-border workers are entitled to additional reimbursement from the Grand Duchy of Luxembourg for healthcare services performed in Belgium. The reimbursement of the Belgian supplement is either processed through your mutual insurance company or directly by yourself, by submitting invoices or fee statements to CNS.