The long-term care insurance may cover the expenses for assistive technologies allowing a dependent person to maintain or increase their autonomy in their daily life, namely in the areas of:
- personal hygiene;
- nutrition and the preparation of meals;
- mobility both inside and outside their home;
- assistance with household services;
- oral or written communication.
These assistive technologies can meet the needs in terms of safety, pain prevention and pain relief. Their objective is also to facilitate the tasks of the carers (example: a wheel chair, a nursing bed, a medical lift or transfer lift, video equipment enhancing the image for the visually impaired, etc.).
Assistive technologies are made available free of charge for each person needing it. The amount of the coverage may not exceed EUR 28,000 per assistive technology.
The service provider will be selected and paid by the long-term care insurance.
The long-term care insurance will also cover the costs for the installation of assistive technologies.
Who is concerned
Persons registered with the health insurance and their co-insured family members are entitled to long-term care insurance. Each person is entitled to long-term care insurance, regardless of income, provided they have been recognised as dependent.
Persons who take out voluntary health insurance must have been affiliated with their health insurance fund for at least one year.
Only assistive technologies recorded on the list drawn up by the consultation committee and provided for by Grand-Ducal regulation will be covered by the long-term care insurance.
Individuals registered for health insurance in Luxembourg (National Health Fund - Caisse nationale de santé - CNS) who have been recognised as dependent persons, but who do not reside in Luxembourg (e.g. cross-border workers) have to contact the health fund in their country of residence in order to receive coverage of the costs for assistive technologies.
Persons affiliated with a health fund in another EU Member State but residing in Luxembourg may be eligible for coverage in Luxembourg for assistive technologies which increase their autonomy.
The long-term care insurance can cover the costs of assistive technologies for persons who do not reach the 3.5 hours threshold for basic day-to-day tasks.
Assistive technologies and the related installation costs will only be covered by the long-term care insurance with the prior opinion obtained from the State Office for Assessment and Monitoring (AEC - Administration d'évaluation et de contrôle).
How to proceed
Filing an application
A person who wishes to benefit from long-term care insurance must submit their application for long-term care benefits by post to the National Health Fund (CNS) at the following address:
Caisse nationale de santé - Assurance dépendance
B.P. 1023 - L-1010 Luxembourg
The application consists of2 parts:
- the form to be completed by the applicant who must ensure to check the corresponding box on the form;
- the medical report (R20) attached to the second part of the form and completed by the applicant's general practitioner.
The medical report (R20) is free of charge for the applicant: The general practitioner is paid directly by the long-term care insurance.
In this report, the doctor provides information on the applicant's state of health. While the role of the doctor is important, they are not the ones who decide whether the person is considered to be dependent or not.
The application will only be considered complete when both documents (the form and the report) have been submitted to the National Health Fund (CNS).
Provision of assistive technology devices
Applicants are required to wait for the assessor sent by the State Office for Assessment and Monitoring (AEC) of the long-term care insurance.
In the event of a favourable decision in response to an application for an assistive technology device, the applicant will be provided with the necessary device free of charge for as long as needed.
The provision of the device can take 2 forms:
- the assistive technology can be rented by the long-term care insurance from a provider and made available to the dependent person (in this case, all repair works, if necessary, will be covered by the long-term care insurance);
- the assistive technology can be purchased by the long-term care insurance and given to the dependent person (in this case, all repair works, if necessary, will not be covered by the long-term care insurance).
Assistive technologies purchased by the applicant on their own initiative are not covered by the long-term care insurance. The law does not provide for retroactive reimbursement.
In urgent cases, such as upon discharge from the hospital, an assistive technology device may be applied for:
- by calling the "Technical assistance helpline" of the AEC on (+352) 247-86040 for urgent technical issues (nursing beds, medical commode chair, etc.); or
- by submitting a doctor's prescription to the Accessories Department (Service moyens accessoires - SMA) to obtain items such as a wheelchair or nursing bed. In that event, health insurance will cover the assistive technology device. If the duration of use exceeds 6 months, and if an application has been filed with the long-term care insurance, the device/equipment is automatically transferred to long-term care insurance.
Adaptations to the vehicle
Adaptations to a vehicle will only be covered upon the opinion of the AEC which will assess the need. The AEC can guide applicants in their choice of vehicle.
As a general rule, only adaptations to privately used vehicles are covered by long-term care insurance.
And with respect to adaptations required for the driver's seat and position, only those adaptations mentioned on the driving licence can be covered by long-term care insurance. To receive such indications on the driving licence, it is necessary to contact the Medical Commission of the Department of Mobility and Transport at the Ministry of Mobility and Public Works.
Except for child car seats, adaptations to vehicles may only be renewed every 5 years as of the date of the certificate of compliance for the adaptation. Adaptations which were destroyed or damaged following and accident will not be renewed by the long-term care insurance outside of that time frame.
Guide dogs for the blind
Guide dogs for the blind increase a visually impaired person's autonomy and safety when moving around.
Guide dogs for the blind may be covered, but only if a positive opinion is first obtained from the long-term care insurance's State Office for Assessment and Monitoring (AEC). The law does not provide for retroactive reimbursement. For that reason, applicants are advised not to acquire a guide dog before receiving the AEC's opinion.
The blind or visually impaired person must possess the physical and mental capacity to move around with a guide dog.
The financial aid granted may not exceed EUR 20,500.
The amount covered includes:
- the cost of purchasing the dog from a specialised school approved by the long-term care insurance management body;
- the cost of raising the dog in a host family;
- the cost of training the guide dog;
- and the cost of purchasing a harness.
It also includes the cost of training the visually impaired person to use the harness to guide the dog, both at the school and at the beneficiary's home, as well as supervision of the dog by the school.
The costs of travelling to and staying near the school are borne by the applicant.
Maintenance, food, and veterinary costs, as well as any civil liability costs for damages that may be caused by the dog, are borne the beneficiary of the guide dog.
The beneficiary commits to respect the dog and its needs, and to care for the dog in accordance with the legislation on the protection of animals. The dependent person's living conditions must be compatible with keeping a dog.
If the applicant does not agree with the CNS's initial decision, they may oppose it before the CNS's executive committee. To do so, they need only send a letter to the executive committee of the CNS within 40 days of the decision. The procedure is described in the decision that the person receives.
If the applicant does not agree with the decision of the CNS's executive committee, they may file an appeal, within 40 days of receiving notification of the decision, with the Social Security Arbitration Tribunal (Conseil arbitral de la sécurité social - CASS) located in Luxembourg. A simple petition on plain paper submitted to the CASS will suffice.
CASS decisions can, themselves, be appealed if the amount in dispute is in excess of EUR 1,250. Applicants have to address the High Council of Social Security (Conseil supérieur de la sécurité sociale) within 40 days of the notification of each decision.