As of 09.01.2023, you must use the online form to submit your written request to the CNS.
What is the complementary payment/reimbursement?
During a calendar year (from 1 January to 31 December of year N), if an insured person's total personal participation to health care services, as a contributor to compulsory health insurance, exceeds the threshold of 2.5% of their annual contributory income for the previous year (N-1), the insured person is entitled, on request, to a complementary reimbursement of the part of the participations that exceed this threshold.
This reimbursement is in addition to the other reimbursements to which the insured is entitled, and is therefore called a "complementary reimbursement".
Monthly gross earnings of the insured person (2022): € 3,000
Annual gross income (2022): 3,000 x 12 = € 36,000
Threshold according to article 154bis fixed for the year 2023: 2.5% of 36,000 € = 900 €.
Conclusion: For a person with a monthly gross income of €3,000, the threshold is reached if the combined amount is more than €900.
Therefore, in the example given, the insured person can submit a request if their combined participation during a calendar year (01.01 to 31.12) exceeds € 900.
Thus, if the insured person has paid contributions for a total amount of € 1,050 in the course of 2023 at the time of their declaration, they can claim an complementary reimbursement of € 150.
The monthly contributory income figure is the figure shown on the monthly pay slip/pension statement.
Where can I find the amount of the combined personal participation?
On the reverse side of each reimbursement statement, under the section " Complementary payment ", the insured person can see the total amount of their personal participation on the given date, for the current year N as well as for the previous year N-1.
The contributions of the co-insureds are added to the calculation of the participations for the main insured. Therefore, only a main insured person can apply for a complementary reimbursement.
The amount of the insured person's participation for the previous year (N-1) may still vary/increase.
If the insured person sends a refund request in the current year N for services received the previous year N-1, their personal participation to these healthcare services will be added to the total amount of their personal participations for the previous year N-1 and will appear on the reimbursement statement.
The monthly contributory income may not be less than a certain amount set out in Article 154bis of the CNS Statutes, it is not necessary to apply if the amount of the combined participation (indicated on each reimbursement statement) is less than:
- € 450.50 for the year 2021
- € 453.31 for the year 2022
- € 470.41 for the year 2023
Which services are subject to complementary reimbursement?
The insured person's personal participations to the following services and supplies are taken into account:
- Medical treatments;
- Dental treatments excluding prosthetic treatments;
- Services provided by nurses;
- Services provided by dieticians;
- Physiotherapy and massage treatments;
- Speech and language therapy treatments;
- Midwife treatments;
- Psychomotor therapy treatments;
- Medical thermal cures;
- Costs associated with orthopaedic prostheses, ortheses and craniofacial prostheses;
- Pharmaceutical products;
- Medical equipment and devices covered by the health insurance;
When and how to make the request?
An online form allows the insured person to submit a written request to the CNS.
Certain deadlines must be met in order to make the request:
- At the earliest from 1 May of year N for the combined participation of the same year N.
In March 2023, the insured person finds that the amount of their personal participation for the year 2023 already exceeds their maximum participation. They can submit their request from 1 May 2023 at the earliest.
- In order for the insured persons request to be valid, they must submit it before the end of the second calendar year following the year in which they reached the threshold.
The threshold is reached in the year 2023, the request can be submitted until 31.12.2025.
A new request must be submitted each year.