Reimbursement of costs
The tariffs for medical acts and services are set in a nomenclature concluded as part of the agreement between the Association of Doctors and Dentists (AMMD) and the CNS. Doctors are required to comply with these rates (exceptions: personal convenience and 1st class tariffs).
The insured paid the medical invoices
In general, the insured person pays the doctor's invoice directly and requests reimbursement from his competent health insurance fund.
In this case, the insured must send the original, duly paid and receipted invoices to his competent fund. The 13-digit national identification number must be indicated. If this is the first request for reimbursement, a bank account number (RIB) must be enclosed. For submissions to the CNS from Luxembourg, the insured does not need to apply a stamp to the envelope.
CNS – Service Remboursements nationaux
The third-party payment system
In the case of inpatient treatment in a hospital, if the stay exceeds three days or if the invoice for medical fees per doctor exceeds 100 euros, the doctor may send the invoices directly to the CNS (third party payer).
For consultations in doctors' practices and outpatient treatment in hospitals, the reimbursement rate is 88% of the fees set for adults and 100% for children and young people under 18 years of age.
In the case of inpatient or semi-stationary treatment (=ambulatory in place of supervision), invoices are covered at the rate of 100% of the fees in the nomenclature of acts and services of doctors (excluding the 66% increase in the case of first-class treatment).
Abroad (EU, EEA or Switzerland)
In the event of scheduled outpatient treatment without prior authorisation: Treatment is reimbursed by Luxembourg according to Luxembourg conditions, rates and tariffs.
In the event of scheduled inpatient treatment with prior authorisation: Upon presentation of the S2 to the health insurance institution of the State indicating where the treatment will be carried out, the insured person is entitled to the same conditions of coverage at the same rates as the insured in the country of treatment.
In case of urgent treatment: The presentation of the European Health Insurance Card guarantees the insured person coverage or reimbursement of medical expenses on site.