The third-party payment system
Usually, nursing care is covered directly by health insurance through the third-party payment system.
As part of the third-party payment system, the insured person pays the nurse only the proportion payable by them.
The third-party payment system only applies to nursing care provided in the Grand Duchy. Nursing care delivered abroad must always be paid for in full, and the proportion covered by the health insurance fund is then reimbursed upon request. Please note that for cross-border workers, the local health fund is responsible for covering healthcare received in their country of residence and the treatment must be provided by a nurse registered in that country.
The insured person pays the full amount of the treatment and requests a refund
If the insured person receives an invoice, they must pay the costs upfront and send the original, paid and receipted invoice to the competent fund (CNS or public sector fund) along with the original medical prescription. The nurse returns the original prescription to the insured person along with the invoice.
Acts and services from the nurses' nomenclature are covered at a rate of eighty eight percent (88%) of the fixed tariffs.
However, coverage rate is hundred percent (100%) for acts provided by nurses for:
- insured persons under the age of eighteen (18) at the time the medical prescription was issued;
- insured persons who have a care plan, namely persons entitled to services from the long-term care insurance or receiving either a care allowance or a special allowance for persons with severe disabilities.