Ordering certificates and forms

  1. Certificate of co-insurance
  2. Certificate of affiliation for those living on social inclusion income and those living on pensions
  3. Provisional certificate replacing the European Health Insurance Card (EHIC)
  4. Form applicable during a stay in a country linked to Luxembourg by bilateral agreement
  5. S1/BL1 form

Certificate of co-insurance

The certificate of co-insurance can be requested and obtained via MyGuichet.

MyGuichet - Certificate of co-insurance

Note

1) A certificate of co-insurance for Luxemburg residents is always issued by the competent Luxembourg health fund (CNS, CMFEP, CMFEC, EMCFL).

2) As a general rule, a certificate of co-insurance for non-residents is issued by the competent social security institution of the place of residence.  

Exception : if the institution requesting the certificate of co-insurance (e.g. university, embassy etc.) is not situated within the country of residence, the CNS is responsible for issuing the requested certificate.

CCSS- Certificate of affiliation

Affiliation certificate for those living on social inclusion income and those living on pensions

The affiliation certificate for those benefiting from a social inclusion income or those living on pensions can be requested from the Joint Center of Social Security (Centre commun de la sécurité sociale-CCSS) by following the link opposite.

Provisional certificate replacing the European Health Insurance Card (EHIC)

MyGuichet - Certificate of replacement

The provisional certificate replacing the EHIC (valid for three months as of the issue date) can be issued on request via MyGuichet.

Form applicable during a stay in a country linked to Luxembourg by bilateral agreement

MyGuichet - Certificate of entitlement to health benefits during a stay in Cape Verde, Morocco, Bosnia and Herzegovina, Tunisia or Turkey

For a stay in a country linked to Luxembourg by bilateral agreement, the insured person is required to present a specific form to the social security institution of their place of stay, certifying that the holder has the right to benefits in kind during their stay. This institution covers the provided healthcare at the same rates and tariffs, and under the same conditions as they normally apply.

The countries are Bosnia-Herzegovina, Cap Verde, Morocco, Tunisia and Turkey (the European Health Insurance Card is valid in Macedonia, Montenegro and Serbia).

These forms can now be requested via MyGuichet.

S1/BL1 form

Ordering an S1/S072 form

Ordering a BL1 form

A cross-border worker insured in Luxembourg must register with the health insurance fund of their country of residence in order to benefit from health care reimbursements in that country. The CNS issues a document of entitlement for this purpose:

  • S1 (except Belgium)
  • S072, the document of entitlement intended for French cross-border workers living in the departments of the Great East (Grand-Est), which are ARDENNES (08), AUBE (10), MARNE (51), HAUTE-MARNE (52),  MEURTHE-ET-MOSELLE (54), MEUSE (55), MOSELLE (57), BAS-RHIN (67), HAUT-RHIN (68) and VOSGES (88), is sent directly to the respective CPAM (Caisse Primaire d'Assurance Maladie). A confirmation of registration will be sent to the cross-border worker by the CPAM.
  • BL1 for Belgian cross-border workers.
 

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