Medicines and medical devices
I need medication, a special medical device or a compression garment!
I'm wondering how to get it, what I need to obtain it, and when and how it will be covered by the CNS.
This section provides answers to all my questions.
Everything I need to know
I click on the tab I'm interested in:
- 1 - Medicines: All the information I need about medication coverage.
- 2 - Medical devices: Details on the coverage of medical devices such as insulin pumps, specialised bandages, wheelchairs, and more.
- 3 - Compression garments: Everything I need to know about the coverage of compression garments.
- 1 - Medicine
- 2 - Medical devices
- 3 - Compression garments
- In a nutshell
- Coverage
- Abroad
- Substitution medicines
- Frequently asked questions (FAQ)
In a nutshell
I need a medication and I'm wondering how to get it, what I need to obtain it and when and how it will be covered by the CNS.
This section provides answers to these questions:
- If the medicine is prescribed by a doctor and included on the so-called 'positive' list, I can be reimbursed at the set rates.
- Certain homeopathic medicines may also qualify for reimbursement.
- If I decline an equivalent substitute medication, I will need to pay the price difference myself.
How and how much am I reimbursed?
With or without a prescription?
Medications generally fall into two categories:
- Prescription-only medicines: These require a doctor’s prescription.
- Over-the-counter medicines: These can be purchased without a prescription but must be dispensed under a pharmacist's supervision.
For a medication to be reimbursed - either partially or in full - I must have a prescription from my doctor. Additionally, the medicine must be included on the Positive List, a list maintained and regularly updated by the CNS on its website.
Dispensing rules to be aware of
- Only one prescription per patient and per consultation, unless exceptions apply.
- In principle, the prescription is valid for 3 months from the date of issue, unless otherwise specified.
- If the prescription provides for successive deliveries, the last delivery must be made no later than 6 months after the first.
- If the prescription does not specify the duration of treatment, the smallest pack on sale will be covered by health insurance.
Method of payment
As a general rule, third-party payment is applied to cover the cost of medicines.
I present my social security card and prescription to the pharmacist, and pay only for the portion not covered by the CNS or not covered by the third-party payment system. This means I only pay the difference between the price of the medicine and the amount covered by health insurance.
- A receipt is issued in exchange for the original medical prescription or certified copy, which the pharmacist keeps after the medicines have been issued.
- The reimbursement rate is displayed on the receipt and can also be consulted on the positive list of medicines.
Coverage rates
In Luxembourg, the health insurance scheme covers all or part of the cost of medicines on the positive list of medicines. This list includes medicines that have received marketing authorisation and a public price, and whose inclusion has been requested with and granted by the CNS.
Medicines are classified into three categories and benefit from a specific rate of reimbursement:
- 40% for medicines of moderate benefit and intended to treat the symptoms of benign pathologies,
- 100% for medicines with a specific therapeutic indication and
- 80% for all other medicines.
Medicines that are not included on the list are generally not reimbursed.
What if I buy my medicines abroad?
Whether costs are covered depends on several criteria:
- whether the medicine was purchased in a country in the EU, EEA or Switzerland, or outside the EU;
- whether the purchase was made in an emergency situation abroad;
- if the purchase abroad was planned.
Purchasing in a country of the EU, EEA and Switzerland
As a resident of the European Union, I have the right to move freely within the EU and to buy the medicines I have been prescribed there.
To do this, the foreign pharmacy must be authorised to sell it in its country.
If I buy a medicine abroad, I must pay for it in full and then send the invoice and prescription (issued before the purchase) to my health insurance fund to be reimbursed.
Reimbursement is only possible if:
- the medicine purchased is on the positive list (check the list on the Internet if possible)
- the milligrams of the medicine purchased must correspond exactly to what is indicated on the positive list;
- the name must match that on the positive list;
- the medicine was purchased in a country of the European Union, the EEA or Switzerland.
Special rules for Belgium
If the pharmacy in Belgium keeps my prescription, I must add a copy of the prescription to my claim for reimbursement. Electronic proof of prescription is not accepted by the CNS. The CNS needs a traditional prescription to be able to proceed with any reimbursement, as proof of prescription has no legal value.
Coverage by prescription
If the prescription only states that two boxes are prescribed, with no details of dosage or duration of treatment, only one box will be reimbursed. Only if a precise dosage is indicated on the prescription, i.e. if my doctor indicates exactly how long I should take how many pills/tablets, can two boxes be covered.
The CNS cannot reimburse more than 2 boxes of medication for the same medication on the same prescription (except in the case of prescription renewals).
If I need to buy medication while I am abroad and I submit the paid invoice to my health insurance fund when I return, reimbursement will be in accordance with foreign legislation.
Purchase in a country outside the EU, the EEA and Switzerland
Emergency
If it is an emergency and a medicine that is not on the positive list has been prescribed, but the active ingredient of the medicine is known, reimbursement will be based on a medicine with the same active ingredient that is on the positive list.
If the active ingredient is not known or not clearly identifiable, or if it is an active ingredient for which no reimbursement is provided, the claim will be refused.
Deliberate purchase abroad
The costs of medicines deliberately purchased outside a medical emergency in a country outside the EU, EEA or Switzerland are entirely at my expense. In this case, the competent health insurance fund will only reimburse the cost if the purchase was made by a student or a person officially seconded to such a country for a prolonged period.
IMPORTANT
The fund in the country of residence is responsible for reimbursing invoices for medicines purchased in the country of residence. If I am a cross-border worker, I must submit my pharmacy invoices from my country of residence to my local fund and not to the CNS.
What is a substitute medicine?
A substitute medicine is a medicine with the same therapeutic activity but at a lower price than the original medicine prescribed. It is manufactured by a different laboratory and bears a different name. Some of the non-therapeutic components, called excipients (which give the medicine its shape or taste, for example), may vary between the substitute medicine and the original medicine. The therapeutic efficacy, dosage and method of administration remain the same. The medicine substitution policy defines groups of medicines for which pharmacies must offer a cheaper substitute.
These medicines are sometimes referred to as 'generics'.
Groups of substitution medicine
Two groups of medicines currently quality for substitution:
- lipid-lowering drugs (statins) and
- gastric acid secretion inhibitors (proton pump inhibitors - PPIs).
If a medicine from one of these two groups is prescribed, the pharmacist compares its retail price with the reimbursement basis set by the CNS for that medicine.
Two scenarios then arise:
- If the price of the medicine prescribed is lower than or equal to the calculated reimbursement basis, the pharmacist may dispense the medicine prescribed.
- If the price of the medicine prescribed is higher than the calculated reimbursement basis, the pharmacist must propose substitution by the cheapest medicine in the same group. The pharmacist informs me that the substitution does not affect the doctor's prescription and that the medicine is just as effective.
The choice is mine!
I accept the substitute medicine: I am helping to reduce reimbursement costs without jeopardising the efficacy and safety of my treatment.
I refuse: if I ask for the medicine indicated on the prescription to be dispensed, I will pay, in addition to the part not covered by the CNS (80% reimbursement rate), the difference between the set reimbursement basis and the public price of the medicine supplied.
Another scenario...
In principle, the pharmacy dispenses the medicine prescribed by my doctor or requested by me. However, if a requested medicine is out of stock or unavailable, the pharmacist may be able to find a replacement for the medicine prescribed or requested.
Frequently asked questions (FAQ)
Where can I buy my medicines?
In Luxembourg, prescription medicines are typically dispensed by pharmacies. Non-prescription medicines are also available at pharmacies and can be purchased upon request or based on the pharmacist's advice.
Pharmacists' role:
- They ensure that products are used correctly by checking medical prescriptions and the products dispensed.
- They also give advice on how to take them (duration of treatment, quantity and method of administration), and check and warn against possible interactions with other medicines, foods or substances (such as alcohol, for example).
- They can also provide information on possible undesirable side-effects (risk of falling asleep if you have to drive, etc.).
What about homeopathic medicines?
They are reimbursed if they appear on a specific list of homeopathic medicines covered, which is validated by the CNS and updated periodically. The list of homeopathic medicines can be consulted on the CNS website.
- In a nutshell
- Devices covered
- Coverage
- Abroad
In a nutshell
I need a wheelchair, a special device or an instrument for health reasons: this guide to medical devices tells me what is meant by medical devices, the different lists in which they are included and, above all, how the CNS can contribute to the costs of such equipment.
What are medical devices?
- A medical device is a supply, appliance, instrument or other item used to treat an illness or injury or to improve a patient's anatomy or physiological condition.
- There are several lists of medical devices and supplies that may be covered by the CNS (appendix A of the CNS statutes).
- In most cases, the CNS will cover all or part of my costs. Before buying or renting the equipment or product I need, I check what the correct procedure is...
Lists of equipment and products covered
There are 6 different lists of equipment or products.
File B1 - 'Small' medical products
These mainly include special bandages, syringes and needles, catheters, products for urinary incontinence, blood and urine tests, glucometers, insulin pumps, inhalation devices, canes and crutches, lower/upper limb or spinal column supports, wigs, eye prostheses, breast prostheses and accessories, nappies for children in the event of incontinence, etc.
File B1 contains the full list with prices and reimbursement rates.
Important! When making a purchase, please check that the device or product is listed before applying for reimbursement.
File B2 - Larger-scale products
These are mainly supplies that are only sold on a rental basis (with a rental contract), in particular:
- Oxygen therapy equipment for out-of-hospital use
- Anti-bedsore cushions and mattresses
- Canes with 3 or more legs, walking frames with or without wheels
- Wheelchairs
- Patient lifts
- Feeding tube
- Detachable beds and bases with motorised adjustment
- Cardiorespiratory monitoring - Monitoring of children at risk of sudden death
Medical devices on the B2 list are usually rented by the Service Moyens Accessoires (SMA), usually as part of a long-term care insurance package. The rent is either set out in the B2 list or established on the basis of an estimate. The rate of reimbursement is set out in the list and is normally 100%.
The B2 file contains the complete list with prices and reimbursement rates.
File B3 - Hearing aids
This list covers all hearing correction devices, earmolds and accessories.
More practical information about the conditions for reimbursement, the procedures to be followed beforehand, renewal deadlines and the terms and conditions of reimbursement can be found on our 'Hearing aids' page.
File B3 contains the full list with prices and reimbursement rates.
File B5 - Medical food products
This list covers medical food products, including various special baby milks, gluten-free products, protein-free products, etc.
Medical food products for babies and children
If I need special food products for children, I can contact my paediatrician directly, who will take care of the necessary procedures.
Gluten-free products
These products fall under the medical food products covered up to a maximum half-yearly amount of €276.75.
Conditions for reimbursement
To claim the half-yearly lump sum for the purchase of gluten-free products, I must submit a request to the CNS. My application must be accompanied by a medical diagnosis of coeliac disease.
Title to cover
The medical prescription should be sent to the following address:
Caisse nationale de santé
Service Autorisations médicaments, dispositifs médicaux, orthopédie et transport
L-2980 Luxembourg
If my request is approved, I will receive a certificate of coverage which I will send, together with my invoice for gluten-free products, to my health insurance fund. It is imperative that I have the certificate of coverage BEFORE I buy the products.
Requesting reimbursement
To claim reimbursement, I must submit detailed, receipted invoices, excluding till receipts, WITH the certificate of coverage. These invoices must clearly indicate the precise nature of the goods and their brand name.
How and how much am I reimbursed?
Do I need a prescription?
For the CNS to reimburse or cover the cost of a medical device, I need a medical prescription. Typically, my doctor knows the conditions and formalities required to receive the device or any authorisation for the device.
Prescriptions for devices registered in files B1 or B2 must be used either within the deadline noted by the doctor on the prescription or, if no deadline is indicated, within three months of the date of issue.
Certain medical devices may only be reimbursed if they have been previously approved...
I need a device that is not included in the B-files...
Unfortunately, a medical device, apparatus or supply that is not on one of the lists (B files) of the CNS statutes cannot be reimbursed by the health insurance scheme.
Delivery method and reimbursement rate
Most of the supplies on the various lists (B files) must be purchased.
The list in which the supply (device) is included indicates the reference price or selling price and the coverage rate applied to each supply or to groups of supplies of the same type.
What if I buy my devices abroad?
Whether costs are covered depends on whether the medical device was purchased in a country of the EU, EEA or Switzerland, or outside the EU. A distinction must also be made between a purchase made as part of an emergency abroad and a planned purchase abroad.
Purchases in a country in the EU, EEA or Switzerland
Medical devices in file B1 purchased occasionally abroad, such as compresses, etc., may be reimbursed. The prescription must be issued beforehand. In addition, the brand name must match that on the B1 file. It is possible to obtain reimbursement for more than one device if the prescription so provides.
Purchasing in countries outside the EU, EEA and Switzerland
Medical devices may be purchased in a country outside the EU, the EEA and Switzerland in an emergency or if I need them urgently during a prolonged stay (for example, if I forget or lose the device, or if I am unable to take the device with me due to space constraints during the journey).
To be reimbursed, I must send the CNS the invoice and the doctor's prescription explaining the circumstances justifying the purchase. However, if the purchase is made deliberately, without any emergency or immediate need for the device, I will be liable for the full cost.
IMPORTANT
The fund in the country of residence is responsible for reimbursing invoices for medical devices purchased in the country of residence. If I am a cross-border worker, I must submit these invoices from my country of residence to my local fund and not to the CNS.
- In a nutshell
- Coverage
- Abroad
- Overview
In a nutshell
I need to wear a compression garment.
Here are some useful information about the cost of compression garments.
The CNS will pay for my compression stockings/tights at a rate of:
- 60% for circular-knit compression stockings/tights used mainly for the treatment of venous diseases;
- 80% for flat-knit compression stockings/tights;
- 100% for compression garments intended for other parts of the body.
Please note: Circular or flat knit compression garments containing silver thread are not covered by the CNS.
How and how much will I be reimbursed?
Renewal periods
Over a 12-month period, I am entitled to 2 pairs of circular-knit compression stockings/tights and 4 pairs of flat-knit compression stockings/tights. At the end of the 12 months, the prescription may be renewed.
For other compression garments, the decision will be made on the basis of a justified medical prescription. I should discuss it with my doctor!
What is the therapeutic protocol for?
The 'therapeutic protocol' replaces the 'medical prescription'. With this document, I can buy my compression garments directly from my pharmacist or orthopaedic shop. I don't need to send the protocol to the CNS in advance.
Depending on whether the product has to be custom-made or approved in advance by the CNS (flat-knit garments or other compression garments), I may not be able to receive the product directly. If the CNS's authorisation is required before the compression garment can be delivered, the supplier will generally take care of the necessary procedures.
Where can I buy them?
I can buy compression garments in pharmacies or orthopaedic shops. If possible, I should find out in advance whether the prescribed compression garments are available locally.
For flat-knit compression stockings and other compression garments costing €125 or more, the supplier of my choice must submit a quotation to the CNS. This request must be approved by the CNS before delivery (with a certificate of civerage, 'titre de prise en charge').
What documents should I send to the CNS for reimbursement?
The claim for reimbursement of compression stockings/tapes must contain the following documents:
- the receipted invoice from the pharmacy or orthopaedic store/supplier;
- the full therapeutic protocol (Annex N);
- the estimate (only for flat-knit compression garments costing ⩾ 125 €);
- a measurement sheet (details in Annex H).
The claim for reimbursement for other compression garments must include the following documents:
- the invoice from the pharmacy or orthopaedic specialist;
- the duly completed therapeutic protocol (Annex N);
- the preliminary estimate if the price is ⩾ 125 €.
What if I buy my garments abroad?
Three distinct scenarios exist:
1 - My prescription was issued abroad and I want to buy the compression stockings/garments in Luxembourg.
As foreign doctors are generally unfamiliar with the Luxembourg form (therapeutic protocol/Annex N), foreign prescriptions are also recognised if it is clearly specified which service in Luxembourg corresponds to the one prescribed. Luxembourg tariffs and regulations (estimate, measurement sheet, etc.) apply.
The third-party payment system applies to services costing €125 or more.
2 - My prescription was issued in Luxembourg, but I would like to buy compression stockings/garments abroad.
In this case, Luxembourg prices and regulations (quotation, measurement sheet, etc.) also apply. If the doctor prescribes straight-knit compression stockings or other compression garments, an estimate must be submitted to the CNS and authorised before delivery. However, the patient must advance the costs and submit them to the CNS for reimbursement, together with the necessary accompanying documents (measurement sheet, quotation if required).
3 - My prescription was issued abroad and I would like to buy the compression stockings/garments abroad.
Luxembourg prices and regulations also apply in this case. If the foreign doctor prescribes straight-knit compression stockings or other compression garments, an estimate must be submitted to the CNS and authorised before delivery. In all cases, the patient must advance the costs and submit them to the CNS for reimbursement, together with the necessary supporting documents (measurement sheet, quotation if required).
What if I'm a cross-border commuter?
There are three main situations:
1 - As a cross-border worker, I would like to receive benefits in my country of residence.
In this case, the relevant health insurance fund in my country of residence is in charge. The rates and regulations of this health insurance fund apply.
2 - As a cross-border worker, I wish to receive benefits in a country other than my country of residence (except Luxembourg).
In this case, Luxembourg conditions, rules and tariffs apply and the documents must be submitted to the CNS.
3 - As a cross-border worker, I would like to receive benefits in Luxembourg.
In this case, Luxembourg regulations and rates apply. Documents must be submitted to the CNS.
For garments over €125, the third-party payment system applies.
Overview
I'll take a look at the summary here to quickly check the conditions for reimbursement of my compression garments.
| Socks/tights with circular knitting codes P5010130 to P5010133 | Socks/tights with flat knitting codes P5010134 to P5010137 | Other compression garments | |
Prices |
Maximum price |
With a prior quotation |
|
Prior quote if price ⩾ €125 |
No |
Yes |
|
Coverage rate |
60% |
80% |
100% |
Renewal period |
2 pairs / 12 months |
4 pairs / 12 months | Depending on condition |
Measurement sheet (appendix H) |
Yes |
No |
|
Health insurance coverage for silver wire products |
No |
||
Therapeutic protocol (appendix N) |
Yes |
||
Frequently asked questions (FAQ)
If I'm a cross-border worker, how will I be reimbursed for medicines and medical devices?
If I am a cross-border worker and my children or I acquire medicines and medical devices in our country of residence, these services will be reimbursed exclusively by our local health insurance fund, in accordance with the rates, tariffs and conditions in force in that country.
If I am refused reimbursement/coverage, how can I appeal?
If I am refused coverage by a decision of the President of the CNS, I have the right to lodge a written appeal against the decision within 40 days of notification. This objection must be addressed to the CNS's Board of Directors.
For an objection to be admissible, it must be signed by myself, my legal representative or my authorised representative. The legal representative may be a lawyer or a representative of a professional or economic association to which I may belong. This will be evidenced by a special written power of attorney.
I should send the objection by registered post to the CNS's Board of Directors.
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