Immediate health care treatment may be necessary when travelling abroad. In order to avoid any inconveniences, various steps need to be taken before, during and after the holidays insofar as health insurance is concerned.
We consider three categories of countries:
- Countries of the European Union (EU), the European Economic Area (EEA) and Switzerland
- Countries with which Luxembourg has an agreement
- Countries not covered by an agreement with Luxembourg
Please note: For certain types of treatments scheduled abroad, prior authorisation from the CNS is required. Please find more information here.
Countries of the European Union (EU), the European Economic Area (EEA) and Switzerland
The countries are:
Germany, Austria, Belgium, Bulgaria, Croatia, Cyprus, Denmark, Spain, Estonia, Finland, France, Greece, Hungary, Iceland, Ireland, Italy, Latvia, Liechtenstein, Lithuania, Malta, The Netherlands, Norway, Poland, Portugal, The Czech Republic, Romania, Slovakia, Slovenia, Sweden and Switzerland.
If you do not have the nationality of an EU Member State, the European Health Insurance Card (EHIC) does not entitle you to coverage of medical care during your stay in the following countries :
European Health Insurance Card
European Health Insurance Card
The insured person can use their European Health Insurance Card (EHIC) in these countries.
This card (or the equivalent provisional certificate of replacement) facilitates access to medical treatment, which may be necessary during a temporary stay in another Member State.
Persons residing in an EU Member State but not holding the nationality of an EU Member State, who are staying in either Denmark, Iceland, Liechtenstein, Norway or Switzerland cannot use their European Health Insurance Card in these countries.
This requires a valid European Health Insurance Card.
Before going on holiday, it is therefore essential to check the validity date of the European side of the card.
The presentation of the card guarantees coverage or reimbursement of medical costs in the country, the insured person is visiting.
Health care treatment is provided according to the legal provisions of the Member State, where the insured person is staying and reimbursed in accordance with rates which apply there.
For example, if medical services are available free of charge in the country, the insured person will also be entitled to treatment free of charge on presentation of their European Health Insurance Card (EHIC) or equivalent document.
European Health Insurance Card expired or not available
If the card has expired or if the insured person does not have one, they can order it on the website of the Joint Centre of Social Security The card must be ordered at least three weeks before departure or the expiry date in order to be issued in time. It will be sent to the insured person's official address. If the address is not up to date, the delivery of the card cannot be guaranteed.
If the insured person misses this deadline, a replacement document can be issued by the CNS,on request via MyGuichet. The order can be placed with or without Luxtrust authentication.
In the event of an order without authentication, this document must be ordered at least ten days before departure. In order for the provisional certificate of replacement to be sent correctly afterwards, the address must also be up to date.
When ordering with Luxtrust authentication, the certificate is placed in the insured's private secured digital space on MyGuichet and can be downloaded there if necessary.
For more information on the use of the European Health Insurance Card, we invite you to visit the website of the European Commission.
Reimbursement of costs- Terms and conditions
The following information does not apply to persons residing in an EU Member State but not holding the nationality of an EU Member State and staying in either Denmark, Iceland, Liechtenstein, Norway or Switzerland.
Presentation of the European card to the foreign service provider
If immediate access to healthcare abroad is necessary, the presentation of the European card allows the insured person to have the costs of medical care covered or reimbursed locally. They can therefore be reimbursed directly by the health insurance fund of the country of stay at the tariffs applied there.
In order to do this, they must submit receipted invoices to the relevant institution in that country.
Non-presentation of the European card to the foreign service provider
Not having your European social security card with you means that medical care under the same conditions and at the same price as residents is not covered.
If the insured person needs urgent care during their stay but does not have their card, they must therefore advance the costs of the medical care received and request reimbursement from their competent fund in Luxembourg upon their return.
To their end, they must present the duly paid, detailed invoices (in medical terms and not coded) and denominated in English, French or German to their compettent health fund for verification and possible reimbursement.
The competent health fund in Luxembourg then charges the bills to the health fund of the country of the stay and the insured person will, if applicable, be reimbursed according to the rates and tariffs of the country where they stayed.
On request, the insured person can ask for reimbursement according to the Luxembourg rates and tariffs.
Refusal by the foreign provider to accept the European card
If the insured person can use the EHIC card in the country of stay but the foreign provider consulted does not accept it, the insured person may pay the costs of the necessary medical treatment received and claim reimbursement either from a health insurance fund in the country of stay or from the competent health insurance fund.
- If the invoices are sent to the health insurance fund of the country of stay, they will be reimbursed according to the rates and tariffs of the country of stay.
- If the invoices are sent/delivered to the competent health insurance fund, the latter will charge the invoices to the health insurance fund of the country of stay (by means of form E126 / S067). As soon as the reply is received, the insured will be reimbursed in accordance with the rates and tariffs of the country of stay. In addition, on express request, the insured person may ask to be reimbursed according to the Luxembourg rates and tariffs when sending/submitting the invoices to his/her competent fund.
In the case of a public provider and in the case of necessary care, the card can normally not be refused.
If, in the case of urgent care, Luxembourg makes a pricing request to the health insurance fund of the country of stay, the duration of reimbursement depends on the speed of the reply from the foreign health fund indicating the amount to be reimbursed.
Countries under agreement with Luxembourg
These are the following countries:
Bosnia and Herzegovina, Cape Verde, Macedonia, Morocco, Montenegro, Serbia, Tunisia and Turkey.
Certificate of entitlement to benefits in kind
An insured person wishing to stay temporarily in Bosnia-Herzegovina, Cape Verde, Morocco, Tunisia or Turkey is required to submit a certificate to the social security institution of the place of stay, certifying that they are entitled to benefits in kind during the period of their stay.
The appropriate form must be ordered at least 15 days before departure.
|Bosnia and Herzegovina||LU/BiH111|
|Cape Verde||LCV/5 (5-40)|
As the agreements in question do not provide for the CNS to act on behalf of the insured person, it is preferable that the procedure described above be applied in order to avoid possible problems in the event of a claim for reimbursement.
Macedonia, Montenegro and Serbia - European card
Persons insured in the Grand Duchy of Luxembourg can use the European Health Insurance Card in the event of a temporary stay in Macedonia, Montenegro or Serbia if they need urgent medical care.
Reimbursement of costs- Terms and conditions
Reimbursement of costs on presentation of the certificate
The insured person must advance the costs of health care and may request reimbursement directly from the health insurance fund of the country in which they are staying. Reimbursement will be made according to the rates and tariffs applied in that country.
Please note: non-emergency, planned outpatient health care services (e.g. visual aids, crowns or dentures) are not reimbursed.
Reimbursement if the form is forgotten or refused
The insured person must advance the costs of the medical treatment received and claim reimbursement from the competent health insurance fund in Luxembourg upon return.
To this end, they must submit the duly paid, detailed (in medical terms and not coded) invoices in English, French or German.
The competent fund will then calculate the cost of the invoices with the fund of the place of stay and the insured person will be reimbursed according to the rates and tariffs of the country where they have stayed. Private sector providers will not accept these forms. Bills must be paid and reimbursement requested from the relevant country.
Hotel costs, accompanying costs or repatriation are not covered.
Any treatment provided in a country with which Luxembourg has an agreement, which is not urgent but scheduled on an outpatient basis (e.g. visual aids, dental crowns, dental prostheses, simple consultations without diagnosis etc.) is not reimbursed.
Countries outside the agreement with Luxembourg
These are all other countries that are not part of the European Union, the European Economic Area and Switzerland or that are not linked to Luxembourg by treaty.
Reimbursement of costs- Terms and conditions
Advance payment of costs
In the event of urgent care in one of these countries, the insured must advance the costs of the care received.
Invoices from these countries are reimbursed by the CNS according to Luxembourg rates and tariffs, provided that the tariffs applied in Luxembourg cover the situation in question.
To do this, it is essential that the invoices are :
- detailed (in medical terms and not coded) and
- in one of the following languages: English, French or German.
In the event of urgent treatment in a country with which Luxembourg does not have an agreement, the cost of accommodation, accompanying costs or repatriation are not covered.
Any treatment provided in a non-conventional country, which is not urgent but scheduled ambulatory (e.g. visual aids, dental crowns, dentures, simple consultations without diagnosis etc.) is not reimbursed.
Important difference between costs and possible reimbursement
The costs of medical and hospital services can differ significantly from one country to another and even cost substantially more than in Luxembourg.
There may therefore be a considerable difference between the costs incurred and the reimbursement from the CNS, to the disadvantage of the insured.
If the insured wishes to take out additional insurance, they can contact an insurer specialised in this type of cover.
Special case: United Kingdom
Using your European Health Insurance Card in the UK
On 1 January 2021, the UK left the EU's single market and customs union, and with it all EU policies.
To minimise any disruption, the EU and the UK have signed a 'Trade and Cooperation Agreement' which governs their future relationship, now that the UK is a third country.
The agreement contains a number of social security coordination measures aimed at protecting the rights of EU citizens temporarily staying in the UK.
For example, a Luxembourg insured person can continue to use their European Health Insurance Card (EHIC) in the UK from 1 January 2021 for medically necessary treatment during their temporary stay.
Important: For treatments in the United Kingdom, any treatment that is not urgent (e.g. visual aids, dental crowns, dentures, simple consultations with no diagnosis etc.) will not be reimbursed.
Incapacity for work during a stay abroad
Declaration of incapacity for work occurring abroad
Deadlines for information in the event of incapacity abroad
Two different sets of circumstances need to be distinguished:
Stay in a member state of the European Union or in a state with which the Grand Duchy has reached an international agreement on social security matters
The insured person must send the certificate of incapacity for work to the CNS before the end of the third working day that the insured has been on sick leave. The date of the postmark is noted as proof of date of submission.
Stay in a a state not linked to the Grand Duchy by any international accord or protocol establishing the procedure to be followed in the case of incapacity for work or the extension of a period of incapacity for work
The insured person must send a medical certificate to the competent national health fund in Luxembourg within three days (the date of the postmark will be noted as proof of date of submission).
Certificate of incapacity for work - Required elements
Certificates of incapacity for work must include the following elements:
• the 13-digit number of the concerned person (in the case of leave for family reasons, the numbers of the parent and child must appear on the certificate; furthermore, it must be clearly stated that the child's state of health requires the parent's presence)
• the beginning and end dates of the period of incapacity for work
• the date the certificate was issued
• the stamp or signature of the prescribing doctor
• the diagnostic
Caisse nationale de santé
4, rue Mercier
Insured persons have the possibility to send their certificate of incapacity for work by e-mail to the address: email@example.com. Please also indicate your 13-digit NATIONAL NUMBER in the SUBJECT of your e-mail.