Social third-party payer (TPS)

Because access to healthcare shouldn’t be a financial burden, the Social Third-Party Payment (TPS) scheme allows people on low incomes to receive medical and dental care without having to pay upfront.

A valuable support for those who need it most since 2013!

TPS is a real lifeline for people in financial difficulty, enabling them to get the care they need without worrying about upfront costs. If I think I'm eligible, I contact my local social office to apply.

This page explains everything I need to know about TPS.

Everything I need to know

What is the Social Third-Party Payment (TPS)?

The Social Third-Party Payment (TPS) is a scheme designed to make medical and dental care more accessible for people facing financial difficulties. With this system, beneficiaries no longer need to pay upfront for medical expenses—the CNS directly covers the cost of the eligible treatments.

What are the conditions for receiving TPS?

To qualify for TPS, I must be affiliated with health insurance. When my request is submitted, the social office will first verify my health insurance status and, if necessary, arrange for my affiliation.

It is then up to the social office to assess, based on my personal situation, whether TPS should be granted.

Who can benefit from the Social Third-Party Payment (TPS)?

Anyone who is legally residing in Luxembourg can apply through the social office of their municipality.

The social office in my municipality is the only body authorised to determine whether I meet the criteria to benefit from TPS.

What treatments are covered?

The social third-party payment currently covers services provided by doctors and dentists.

How to apply through the social office?

  1. I contact the relevant social office, which is determined based on my place of residence.
  2. My affiliation with health insurance is checked. If necessary, the social office will arrange for my registration.
  3. The social office assesses my financial situation and decides whether to grant TPS.
  4. I receive a certificate and a booklet of labels, if my application is approved.

How to find the social office handling my application?

Around thirty social offices provide social assistance across the country. The relevant social office is determined based on my place of residence.

Each social office is responsible for residents of one or more municipalities.

I can check the list of relevant social offices on the website of the competent ministry.

I click here to access the list of social offices in Luxembourg

How do I use TPS?

  1. I present my TPS certificate and one label to my doctor or dentist.
  2. The doctor or dentist sends the bill directly, with the label, to the CNS.
  3. The CNS pays the full amount of the bill (except for CP1-CP7) to the doctor.
  4. The CNS contacts the social office to receive the patient’s share (the amount that, in principle, remains my responsibility).
  5. Depending on my situation, the social office may ask me to repay part of this amount (= patient share), if it deems I am able to do so.

Note: Some supplementary fees (CP1-CP7) are not covered and remain my responsibility. Special rules apply for CP8 convenience under the TPS (see the FAQ section).

Foire aux questions (FAQ)

Which documents do I receive from the social office?

If I am granted the social third-party payment, the social office hands me the following in person:

  • a time-limited certificate,
  • accompanied by a booklet of labels.

The certificate and the booklet of labels are issued in my name. They contain my 13-digit identification number along with the granted period, referred to as the validity period, of the Social Third-Party Payment.

Important: Labels are issued separately for each family member. In other words, bills for services provided to a child are not accepted under the TPS if they bear a label for the father or mother. The invoice must be accompanied by a label for the child.

What is the period of validity of TPS?

The validity period is determined by the social office.

  • Standard duration of 3 months (exceptionally 6 months).
  • Renewal possible upon request to the social office.
  • Automatic termination on the date indicated on the certificate and labels.
  • The TPS may be revoked before the end date by the social office. In this case, the social office will, as far as possible, retrieve the certificate and any remaining labels.

The start and end dates of the TPS define the validity period and are stated on the social third-party payment certificate as well as on the accompanying labels.

What are my duties?

By benefiting from the TPS, I must follow certain rules:

  • Present my valid certificate and labels at each appointment.
  • Identify myself with my social security card or another form of identification (ID card).
  • Avoid unnecessary multiple consultations (e.g.: visiting more than two doctors of the same speciality within six months without justification accepted by the CMSS, etc.).

What are the special cases that require validation by the social office?

Certain procedures require double validation from the social office before being covered:

  • Estimates for major dental care (e.g. orthodontics, prosthetics)

    Dental procedures requiring a prior cost estimate (DSD), such as certain orthodontic treatments or prosthetic-related care, need a second validation from the competent social office. The dentist attaches a label to the estimate and gives it to the beneficiary, who then submits it to the social office for prior approval. This approval determines the amount of the social office’s contribution and records it on the estimate. If an authorisation from the Medical Board of the Social Security (CMSS) is required, the beneficiary must first send the estimate to the CNS for approval. The social office validation takes place only after this authorisation. Coverage under the TPS for these services is only possible after both validations by the social office.
  • Personal convenience supplements (CP8) if the price exceeds €25:

    CP8 refers to an additional charge billed by dentists for material costs agreed with the insured (e.g. porcelain, gold) that exceed standard pricing and are not covered by health insurance.
    If this additional charge exceeds €25 per session, TPS coverage is only granted after validation by the social office. The social office determines its contribution, specifically the amount exceeding CNS coverage. If the additional charge is €25 or less, prior validation is not required.

What is excluded from TPS cover?
  • Personal convenience supplements (CP1-CP7) that may be charged by doctors or dentists are excluded from the TPS procedure and remain the beneficiary’s personal responsibility.
  • No service provided outside the validity period of the TPS, as stated on the certificate and labels, can be covered under the TPS scheme.

What about public sector funds?

For the Social Third-Party Payment (TPS), the CNS is responsible for all insured individuals, including those covered by the three public sector health insurance funds (CMFEP, CMFEC, EMCFL).

What other measures are there besides TPS?

If I am temporarily in a difficult economic situation and the payment of a medical invoice represents an insurmountable burden for me, I can request exceptional assistance from the CNS.

What is exceptional assistance?

Exceptional assistance allows me, as an insured person in a precarious economic situation, to ask the CNS to directly pay the amount that it would normally reimburse to me after payment of a specific medical invoice.

In other words, the CNS pays the sum directly to the healthcare provider, without my having to advance the money and wait for reimbursement.

However, I still have to pay my own personal contribution.

What are the conditions for eligibility?

To benefit from this assistance, several conditions must be met.

  • Approved provider: The invoice must come from a healthcare provider or supplier approved by the CNS.
  • Compliance with regulations: The service or supply in question must meet all the coverage conditions prescribed by the CNS statutes.
  • Amount and financial burden:
    1. The amount of the invoice or fee note must exceed 250 euros, after deducting costs related to personal convenience or estimate overruns (DSD, dépassement sur devis) AND
    2. The payment must represent an insurmountable financial burden for me, given my situation.
  • Application deadline: The issue date of the invoice must not exceed three months at the time of my application.
  • Exclusion from third-party payment: This aid does not apply to treatments covered by the third-party payment system, where the CNS directly settles its share with the provider.

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