The CNS covers all acts and services carried out by midwives at the provided rates and tariffs, set out in the nomenclature of acts and services provided by midwives. The insured person is free to choose any midwife.
Services by midwives
Midwives may invoice all acts and services listed in the table of the nomenclature of acts and services provided by midwives, provided that they have actually and personally performed them and only outside the hospital environment.
Pregnant women can use the services of a midwife in the prenatal period, i.e. before the birth. The services of midwives can be called upon, among other things, for preparation for birth and parenthood or for monitoring and carrying out obstetrical care.
Pregnant women who plan to give birth outside the hospital, e.g. at home, can be accompanied and supervised by a midwife of their choice during their delivery.
After birth, in the postnatal period, midwives can be consulted for postpartum care or to accompany and advise the women during breastfeeding.
In the event of a pathological pregnancy or a pathology following childbirth, the insured person must consult her gynaecologist or general practitioner before being able to use certain midwifery services.
If the insured person is in possession of a medical prescription and if the prescription does not indicate a period within which the treatment should begin, the treatment has to begin within 30 days of the prescription’s issuance.
In the context of sexual health and family planning, outside of pregnancy, midwives can also be asked for a preventive consultation for sexual and family education. This consultation can take place at most twice a year and must last at least 30 minutes.
The code VSF81 will only be reimbursed by the health insurance if the related sessions are carried out within twelve months of the date of delivery (VSF81: Post-partum perineal rehabilitation, maximum 8 sessions).
Health insurance covers the fixed price corresponding to code VSF62 of the nomenclature of midwives' acts and services only in the situations listed below:
- for first-time mothers, on prescription,
- in case of multiple births,
- in case of premature delivery,
- in case of a Caesarean section,
- in case of in utero death,
- in the event of early discharge from hospital on the day or the day after the birth.
Prescriptions issued by midwives
Midwives may prescribe, under their own responsibility, certain medicines and biological tests.
If the prescription does not indicate a precise validity deadline, the prescribed medical supplies and acts have to be delivered within 3 months following the prescription’s issuance.
Important: for requests for maternity leave, the CNS only accepts pregnancy certificates issued by doctors.
Compensation for lost fees
If the insured person failed to keep an appointment or was away from home at the time they were supposed to receive the treatment, and if the insured person failed to notify the midwife at least during the day before the appointment, the midwife is entitled to a compensation for lost fees
This compensation, as well as potential travel costs incurred, are not covered by health insurance.
The travel expenses include the travel allowance as well as the travel costs per kilometre driven.
Travel expenses for midwives can be covered, provided that:
- the doctor indicates on the prescription that the insured person is unable to leave their home for medical reasons;
- the journey takes place on Luxembourg territory. Journeys beyond the borders cannot be covered;
- the treatment has been carried out in a non-hospital setting.
Midwifery care abroad
When it comes to midwifery care delivered in the country of residence of a cross-border worker, these services are exclusively reimbursed by the local health fund of the country of residence, in accordance with the rates, tariffs and conditions of that country.
Midwives established in Luxembourg may only provide care in Luxembourg.
Method of payment an coverage rates
In general, the fees for the care provided are paid directly by the CNS to the midwife under the third-party payment system.
If the insured person receives a bill, she must pay the costs in advance and send the duly paid bill to her competent fund, accompanied, where appropriate, by the necessary supporting documents.
The acts and services listed in the midwives' nomenclature are reimbursed at the rate of one hundred per cent (100%), with the exception of
- post-partum perineal rehabilitation (act VSF81), which is reimbursed at the rate of 70%;
- teleconsultation as part of the COVID-19 epidemic (act S45), which is covered at a rate of 88%.