Registering with the social security system and having healthcare expenses reimbursed while studying abroad

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Students living in Luxembourg but studying abroad must be enrolled for social security coverage in order to have their healthcare costs (incurred both in their country of study and in their country of normal residence) reimbursed.

Their enrolment may be individual or collective (as a co-insured party), and may or may not be mandatory depending on the student's personal situation.

Who is concerned

All students officially enrolled in a university establishment and officially resident in the Grand Duchy of Luxembourg must be covered by health insurance, regardless of their place of study.

In Luxembourg, health insurance benefits are paid by the relevant health insurance fund. For students who are personally enrolled, this is the National Health Fund (Caisse nationale de santé – CNS).

If the student is a named beneficiary of a joint policy (i.e., has co-insured status), then their benefits are paid by the health insurance fund with which the main policy-holder is enrolled. This is the CNS (or 'Gesondheetskees', in Luxembourgish) for the private sector; for the public sector, it is either the Civil Servants' and State Employees' Health Insurance Fund (Caisse de maladie des fonctionnaires et employés publics) or the Communal Employees' Health Insurance Fund (Caisse de maladie des fonctionnaires et employés communaux); and for Luxembourg railway employees, Entraide médicale des CFL.

How to proceed

Prior enrolment in Luxembourg

To have their healthcare expenses incurred in Luxembourg or abroad reimbursed, the student must first be enrolled with a health insurance fund in Luxembourg.

Students who are residents in Luxembourg may also be covered as a co-insured party. Failing that, they will be individually enrolled through their mandatory student insurance.

Additionally, students enrolled with the social security services in Luxembourg who are over 18 years of age or suffering from a chronic disease, may choose a primary care physician to receive medical care appropriate to their situation.

Enrolment in Luxembourg as a co-insured party

A main policy holder's mandatory health insurance can be extended to cover their children as long as the main policy holder receives the tax reduction for children.

If this is the case, a resident student has health insurance coverage as a co-insured party (the main policy holder being their mother or father). Such students are entitled to health insurance benefits through their parents' health insurance fund.

To obtain co-insured status, the student must file an application with the competent health insurance fund, specifying the main policy holder’s identity and their connection to the applicant. They must also submit the following with their application:

  • a copy of the family record book;
  • where applicable, a copy of the enrolment certificate from the establishment where they are studying.

The application may be submitted to the appropriate health insurance fund in person, by telephone, email, fax or post.

Co-insured resident students will automatically receive a social security card to prove their entitlement to health insurance benefits.

A co-insured student who loses that status may apply to have their enrolment maintained on a voluntary basis. This application must be submitted to the Joint Social Security Centre (Centre commun de la sécurité sociale – CCSS) within 3 months of the discontinuation of their enrolment.

In that case, the student will be enrolled as an individual policy holder.

Student registration on an individual basis

If the student is neither covered as a co-insured party nor insured in another capacity (as an employee, for example), they may enrol with the CCSS as a student.

Students wishing to enrol have 2 options open to them:

  • if the student was previously insured and has lost that status, they may apply to voluntarily continue their insurance, on condition that:
    • they were insured for at least 6 months continuously before losing that status;
    • the application for continuation of their insurance is filed with the CCSS within 3 months of the loss of cover. If not, the application can no longer be accepted;
  • if the student is resident in Luxembourg and is no longer entitled to health insurance in any other capacity, they must apply to the CCSS for mandatory student health insurance, submitting the following with their application:
    • an enrolment certificate or an attendance certificate issued by the establishment where they are studying;
    • where applicable, a document showing the amount of income received by the student (grant, salary, etc.).

The amount of the contributions which the student must pay to the health insurance fund is calculated on the basis of the minimum taxable income (which corresponds to the amount of the social minimum wage) and is paid in advance by monthly direct debit. Contribution amounts may be adjusted in consideration of the taxable income (capped at 5 times the social minimum wage) actually reported to the Luxembourg Inland Revenue (Administration des contributions directes).

Resident students enrolled with the social security services on an individual basis will automatically receive a social security card proving their entitlement to health insurance benefits. The card must be returned when the person completes their studies.

Social security enrolment in the country of study

Generally speaking, students should seek information, in the host country, on healthcare coverage and procedures for the reimbursement of healthcare expenses in that country.

It is helpful to distinguish a student's situation according to their country of study:

Studying in a Member State of the European Union (EU), European Economic Area (EEA) or Switzerland

Students should contact the institutions in the host country to have themselves enrolled. They will need to present their European Health Insurance Card (EHIC).

Although the EHIC is sufficient to receive benefits, enrolment with the institution in the host country facilitates reimbursement formalities.

Studying in a country that has a bilateral agreement with Luxembourg

Students require a form certifying their entitlement to benefits in kind during their stay.

The required form must be applied for from the relevant health insurance fund in Luxembourg, at least 15 days before the planned departure.

Which form is needed depends on the country of study:

These forms can be ordered directly online on the CNS website. When doing so, applicants must:

  • specify the number of people (national identification numbers) for whom the form is to be issued;
  • the applicant's national identification number;
  • the departure and return dates for the planned trip;
  • where applicable, an email address, so the health insurance fund can get in touch with the applicant quickly.

The student takes the corresponding form in to the institutions in the host country to have themselves enrolled. Doing so will entitle them to benefits in kind under the same conditions as a resident.

Studying in a third country that does not have a bilateral agreement with Luxembourg

During their stay abroad, the student will be covered by their Luxembourg health insurance. They may need to contact the social security institutions in the country of study for further details.

In any case, the student's medical expenses will be reimbursed by the Luxembourg social security institutions.

Reimbursement of students' healthcare expenses

The reimbursement of students' healthcare expenses may vary depending on the country of study.

Healthcare delivered in an EU or EEA Member State, in Switzerland or in a country that has a bilateral agreement with Luxembourg

Students enrolled with social security in the country of study enjoy access to healthcare, and can have their medical costs reimbursed, in the same conditions as the residents of that country.

Thus, students will be reimbursed at the rates and in the conditions in force in the country of study. Therefore, they must send their bills to the social security body with which they are enrolled in the country of study. However, they may also send them to the Luxembourg social security institutions.

Healthcare delivered in a third country that does not have a bilateral agreement with Luxembourg

The student must advance the fees for any healthcare services received in the country of study. The relevant bills must be sent to the competent Luxembourg health insurance fund, which will then reimburse them at the rates in force in Luxembourg.

To obtain reimbursement, the student must send a letter to the health insurance fund, mentioning:

  • the insured party's identity and national identification number;
  • insured party's bank account details, if it is a first-time request, or if their bank details have changed;
  • the original receipted statement of fees, or if the payment took place later, proof of payment in the form of a bank statement. The bank statement can be either a copy of the original or printed from an online banking website. However, a transfer order alone is not sufficient.

The health insurance fund will only reimburse medical procedures or healthcare services listed in the Luxembourg classification of medical procedures and rates, at Luxembourg rates.

Healthcare expenses differ from country to country. It may therefore be wise for students to take out additional insurance covering the difference between the expenses they actually incur and the amount reimbursed by the Luxembourg health insurance fund.

Online services and forms

Who to contact

  • National Health Fund (CNS) Department 'National reimbursements'

    Address:
    4, rue Mercier L-2144 Luxembourg Luxembourg
    L-2980 Luxembourg
    Phone:
    (+352) 27 57 1
    working days from 8.00 to 16.00

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