The hospital sector in Luxembourg includes acute care hospitals as well as the "Centre hospitalier neuro-psychiatrique", the "Centre national de rééducation et de réadaptation fonctionnelles", the "Institut national de chirurgie cardiaque et cardiologie interventionnelle pour la chirurgie cardiaque" and the "Centre pour radiothérapie François Baclesse" in Esch-sur-Alzette.
List of hospitals (12 in total)
Course of the patient's stay
Except in emergencies, the patient has the free choice of the hospital as well as the doctor among those admitted to practice in the hospital.
For inpatient treatment
Insured persons are admitted to an inpatient treatment under the responsibility of a licensed hospital doctor, who registers the date and time of admission.
At the end of an inpatient hospital stay, the attending physician sets the date of the insured person's discharge.
For outpatient treatment
Outpatient treatments are covered according to the same terms as consultations/treatments in medical practices.
The patient has the right to leave the hospital at any time, at his own risk. When the discharge poses a danger to the patient and is made against the doctor's advice, the patient is required to sign a certificate of discharge against medical opinion, after having been informed of the risks of his discharge.
Standard room: one or more sinks, a toilet, a shower, an electronic nurse call equipment with integrated radio
What is covered
Outpatient or inpatient treatments and hospitalisations in standard rooms, with the exception of medical fees, are fully covered.
The attending physicians must invoice the acts and services provided for in the table of the nomenclature of acts and services of doctors and dentists.
The hospital shall adequately inform the patient of the financial conditions of his or her stay, including the amounts to be paid by the patient.
Maximum coverage
The CNS covers hospitalisations in rooms that fall within the definition of a standard room without extra charge.
In the event of hospitalisation of a child under 14 years of age, accomodation costs (provision of a bed), with the exception of catering costs generated by the presence of an accompanying person in the hospital, are covered by health insurance.
Accommodation: a stay during which no further treatment is carried out and the patient is waiting for his discharge, a classic case, is a patient waiting for a place available in a retirement home.
What is not covered
Treatments not covered by health insurance
Benefits not prescribed by the legislation, regulations and statutes in force are not covered, in particular: accommodation, cosmetic surgeries (unless authorised by the Medical Board of Social Security and unless the first treatment results in complications).
Amounts to be paid by the patient (in standard rooms)
Daily participation:
- Insured persons, with the exception of children under 18 years of age, participate in their maintenance during an inpatient hospital stay at a rate of € 25,50 for each day of hospitalisation started, up to a maximum of 30 days per calendar year. In the event of hospitalisation during childbirth, this contribution is not due during the first 12 days.
- Insured persons, with the exception of children under 18 years of age, placed under surveillance in a hospital or admitted to hospital day care participate in their maintenance at a rate of € 12,75 per day. Specific rules apply to treatments in psychiatric day hospitals.
Various supplements (personal convenience/individual rooms)
Personal convenience:
- telephone, TV, internet access etc.
A stay in individual rooms leads to:
- the invoicing of a supplement per day according to the type of room occupied. This supplement per day varies according to the type of room occupied (with or without shower, etc.)
- a 66% increase in medical fees. In this case, the physician or other intervening physicians (anaesthetist etc.) are entitled to apply a rate increased by sixty-six percent (66%) over the official rate applied for medical procedures and services in standard rooms.
The supplement per day for individual rooms and the 66% increase are not covered by health insurance.
The 66% increase:
A 66% increase in the rate cannot be applied when hospitalisation in an individual room is necessary for medical reasons.
Surgical procedures in the operating room may also be increased by 66% if the insured person's occupancy of the individual room only begins within 48 hours of the surgery or exit from the intensive care unit.
If, during hospitalisation, several surgical operations are carried out, at least one of which is not covered by health insurance, the costs normally covered and incurred during the period of hospitalisation shall be covered only if the most important operation is covered by health insurance.
Reimbursement
Method of payment
Invoice for hospital services
This invoice includes the hospital costs of the various visits to the hospital's units or services. For a treatment covered by health insurance, this invoice is sent directly by the hospital to the CNS and is covered by the latter.
Invoice for medical fees
Each doctor consulted as part of a hospital treatment (outpatient or inpatient) issues his or her own medical invoices. The insured person must pay the costs upfront and send the reimbursement claim to the CNS.
However, in the case of inpatient treatment, if the hospital stay exceeds three days or if the invoice for medical fees per specialty exceeds €100, the doctor may send the medical invoices directly to the CNS.
Coverage rates
Invoice for hospital services
These invoices are fully covered by the CNS.
Invoice for medical fees
Medical invoices for outpatient treatments are covered at a rate of 88% of the rates set for adults, and 100% for children and young people under 18 years of age.
In the case of inpatient or semi-stationary treatment (=outpatient but under surveillance), medical invoices are covered at a rate of 100% of the tariffs provided for by the nomenclature of acts and services of doctors (not including the 66% increase for treatments in individual rooms).