What is a cross-border worker?
The insured person is considered a cross-border worker if they work (and are insured) in a different EU country than the one they reside in and under the condition that they return to the country of residence every day or at least once a week. In this case, the country competent in social security matters is the country where they work.
What is the S1 form used for?
The S1 form is a document of legal entitlement to healthcare benefits delivered by the competent country (country where contributions are paid) and allows registration in the country of residence. In this case, healthcare is delivered in the country of residence as if the concerned person was insured there. The S1 form delivered by the competent healthcare fund must be presented to the health fund in the country of residence. The healthcare fund from the country of residence confirms the registration of the form to the competent healthcare fund.
How do I register with the health insurance fund in my country of residence?
The cross-border worker insured in Luxembourg must register with the health insurance fund of their place of residence in order to benefit from health care reimbursements. The CNS issues a document of entitlement for this purpose: the S1 form
Following registration as a cross-border worker from Germany, the S1 form is normally sent automatically to to the private address of the insured person, who should present the form to a German health insurance fund of his choice.
If the insured person does not receive the S1 within the fifteen days following the submission of the declaration of entry to the CCSS (Joint Centre for Social Security) they are advised to order the S1.
What are the conditions for co-insuring family members?
The cross-border insured and the members of their family are entitled to the same benefits under the same terms and conditions as those to which the residents of the Grand Duchy of Luxembourg are entitled.
The law of the insured's country of residence applies concerning the determination of who qualifies for benefits in their capacity as a member of the insured's family.
For this purpose, the health insurance fund of the country of residence contacts the CNS electronically via EESSI (electronic exchange of social security information) using form S071 to request the S072 equivalent to the digital version of the S1 . The health insurance fund in the country of residence will confirm registration by returning form S073.
For more information about insurance for family members, please follow this link.
What do I have to do as a Luxembourg insured person if I am declared ill by a doctor in Germany?
In order to be able to report the incapacity for work to the CNS, you must ask the doctor in Germany to provide you with a printout of the electronic certificate of incapacity for work (printout from the doctor's office software) in duplicate:
- a copy for the employer (without diagnosis)
- a copy for the patient (with diagnosis)
The printed copy for patients, stating your Luxembourg national identification number (13-digit number), must be sent to the CNS no later than the 3rd day of incapacity for work.
- either by post, in which case the patient can make a copy for their file beforehand,
- or by EMAIL to cit.cns@secu.lu, in which case the patient must keep the document and there is no need to send it by post.
Conditions for sending by email:
- Include the 13-digit national number in the subject line of your e-mail
- Document sent in PDF format
For more information on declaring incapacity for work, click here.
Who is responsible for covering the costs of healthcare received in the country of residence?
With regard to reimbursement of healthcare, treatment provided in the country of residence can only be reimbursed by the country of residence according to its own rates, tariffs and terms.
How are the costs of healthcare received in a country other than Luxembourg or the country of residence covered?
A distinction must be made between necessary or urgent care and so-called "scheduled" care.
Urgent or necessary care
Necessary/emergency treatment in an EU, EEA or Swiss country will be covered on the basis of the European Health Insurance Card, EHIC (or possibly a replacement certificate) issued by the competent country. More information is available on our "Holidays abroad" page.
Scheduled care (inpatient or outpatient)
Scheduled inpatient treatment (with overnight stay) in an EU, EEA or Swiss country is only covered if prior approval has been obtained. In the event of an S2 authorisation issued by the competent country, the costs will be reimbursed by the country of treatment in accordance with the rates and tariffs applicable there. In the event of a directive authorisation from the competent country, the insured will advance the costs and will be reimbursed by the competent country according to the rates and tariffs applicable there.
Please note that certain outpatient treatments require the prior approval of the CNS on the basis of a positive advice of the Social Security Medical Board (CMSS-Contrôle médical de la sécurité sociale).
Scheduled outpatient treatment is reimbursed by the competent country in accordance with the rates and tariffs applicable there.
More information about scheduled treatment is available on our "Treatment abroad" page.