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

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All persons older than 18 years of age who are students in the Grand-Duchy of Luxembourg must be registered with the social security system in order to have their healthcare expenses reimbursed.

This registration may be mandatory or voluntary depending on the personal situation of the student. In point of fact a distinction is made between students residing in Luxembourg, cross-border students and students residing abroad but studying in Luxembourg.

Moreover, provided they are older than 18 years of age or suffering from a serious chronic disease, students may choose their own general practitioner (GP), who will provide ongoing medical monitoring appropriate to their situation.

Who is concerned

All students regularly enrolled in a university establishment in Luxembourg must have health coverage, regardless of their place of residence.

Final registration in the university establishment, that is, after paying enrolment fees, confers entitlement to student status and the issuance of a certificate of student enrolment.

Health insurance benefits are paid by the relevant health insurance fund. For students who are personally enrolled, benefits are covered by the National Health Fund (Caisse nationale de santé - CNS).

If they are covered by the insurance of a third party, the student will depend on that party's health insurance fund, i.e., either the National Health Fund (CNS or "Gesondheetskees") for the private sector, the Health insurance fund for civil servants (Caisse de maladie des fonctionnaires et employés publics - CMFEP) or Health insurance fund for communal employees (Caisse de maladie des fonctionnaires et employés communaux - CMFEC) for the public sector, or the Health insurance fund of the CFL for Luxembourg railway workers (Entraide médicale des CFL).

Foreign students must enrol with the Joint Social Security Centre (Centre commun de la sécurité sociale - CCSS) if they are not covered by health insurance in their country of origin.

How to proceed

Enrolment of resident and cross-border students

Enrolment of resident students for health insurance coverage

Resident students are generally enrolled for mandatory health insurance as a co-insured party (with the main insured person being their father or the mother). Such students are entitled to health insurance benefits through their parents' health insurance fund.

Co-insured status must be applied for from the competent health insurance fund. The application must specify the applicant's identity and their relationship with the main insured individual. The application can be made in person at the reception desk, by telephone, email, fax or post. Supporting documents, such a a copy of the family record book or the certificate of student enrolment, may be requested in order to document the co-insured's status.

If the student is not a co-insured party and does not have any other form of insurance, they must personally enrol with the Joint Social Security Centre.

To do so, they must submit their enrolment application to the CCSS using a 'Student's mandatory insurance' application form, accompanied by:

  • a copy of their ID card, if they do not yet have a social security number (matricule);
  • a certificate of student enrolment or similar.

The amount of health insurance contributions is calculated based on the social minimum wage.

The CCSS will send the student a letter of enrolment providing information on the start of coverage and the monthly contribution amount.

Resident students (co-insured or personally enrolled) will automatically receive a social security card, which proves their entitlement to health insurance benefits. This card must be returned to the CCSS at the end of studies.

Enrolment of cross-border students for health insurance coverage

Cross-border students may also enrol as a co-insured party under their parents' insurance:

  • if a foreign student is entitled to benefits in Luxembourg because one of their parents is affiliated with the social security in Luxembourg, the cross-border intern is insured as a resident student and is therefore entitled to health insurance benefits without restriction if the parent (the main insured person) concerned is benefiting from a tax reduction.
    The co-insured status has to be requested from the health insurance fund of the main insured person (by going in person to their reception desk, by telephone, email or by post), and by specifying the main insured person's identity and their connection to the applicant. The cross-border student must justify the request by providing a copy of the family record book and of the certificate of student enrolment.
    The co-insured status is attested by the automatic issuance of a social security card, which is required in order to receive social security benefits.
  • if, on the other hand, the right to benefits only exists in the neighbouring country, the student can receive healthcare benefits in Luxembourg by applying for the European health insurance card from the social security agency in their country of residence.

Students who are not a co-insured party and who do not have any other form of insurance must personally register with the Joint Social Security Centre.

To do so, they must submit their enrolment application to the CCSS using a 'Student's mandatory insurance' application form, accompanied by:

  • a copy of their ID card (if they do not yet have a social security number - matricule);
  • a certificate of student enrolment or similar.

The amount of health insurance contributions is calculated based on the social minimum wage.

The CCSS will send the student a letter of enrolment providing information on the start of coverage and the monthly contribution amount.

Cross-border students who are personally enrolled for health insurance, will be automatically sent a social security card serving as proof of their entitlement to health insurance benefits. This card must be returned to the CCSS at the end of studies.

Enrolment of foreign students for health insurance coverage

Enrolment of students covered by insurance in a Member State of European Union, the EEA or Switzerland

When entitlement to benefits exists in another Member State of the European Union (EU) or in a Member State of the European Economic Area (Norway, Iceland, Lichtenstein) or Switzerland, students can receive in-kind benefits in Luxembourg by applying for the European health insurance card from the social security agency in their country of residence.

Such students can then register with the National Health Fund (CNS). This registration is only necessary when healthcare is actually provided and when the desired reimbursement is requested from the CNS.

In order to be enrolled with Luxembourg social security agencies, students must register with the CNS, producing the following:

  • their European health insurance card or, in its absence, an S-1 form or the E109 form;
  • a certificate of student enrolment or similar.

Enrolment of students covered by insurance in a state that has signed by a bilateral agreement with Luxembourg

When entitlement to benefits exists in a state that has signed a social security agreement with Luxembourg, students must provide the CCSS with documentation proving that they are covered by the social security system in their country of origin in order to receive in-kind health insurance benefits in Luxembourg.

Such students can then register with the National Health Fund (CNS). This registration is only necessary when healthcare is actually provided and when the desired reimbursement is requested from the CNS.

In order to be enrolled with Luxembourg social security agencies, students must register with the CNS, producing the following:

Enrolment of students not covered by insurance in their country of origin

If a student does not have co-insured status or any other form of insurance, or if their country of origin has not signed a social security agreement with Luxembourg, they must personally enrol with the Joint Social Security Centre (CCSS).

To do so, they must submit their enrolment application to the CCSS using a 'Student's mandatory insurance' application form, accompanied by:

  • a copy of their ID card (if they do not yet have a social security number - matricule);
  • a certificate of student enrolment or similar.

The amount of health insurance contributions is calculated based on the social minimum wage.

For the summer semester of 2012, a monthly flat rate contribution of EUR 33 was payable by such students.

The CCSS will send the student a letter of enrolment providing information on the start of coverage and the monthly contribution amount.

Cross-border students who are personally enrolled for health insurance, will be automatically sent a social security card serving as proof of their entitlement to health insurance benefits. This card must be returned to the CCSS at the end of studies.

Benefits-in-kind received in Luxembourg include medical and dental care, drugs, and hospitalization, as well as direct payments to reimburse the cost of these benefits.

Reimbursement of students' healthcare expenses

Procedure for repayment of expenses advanced by students

When visiting a healthcare professional, students must pay the provider's/supplier's fees or bills immediately, or subsequently by bank wire.

The insured individual must then prepare a letter to be sent to the health fund with which they are enrolled:

  • for students enrolled in a Luxembourg health insurance fund, the letter, which does not require a stamp, must:
    • indicate the student's identity and national identification number (matricule);
    • mention the insured individual's bank account details, if it is a first-time request, or if their bank details have changed;
    • contain the original receipted statement of fees, or if the payment took place later, proof of payment in the form of an account 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 reimbursement will be made by wire transfer within a few weeks. The amount reimbursed depends on the contractual or statutory rate.
  • for students with a European Health Insurance Card from another EU Member State, the application for reimbursement of healthcare expenses must be sent either to the CNS (by following the aforementioned instructions) or to the health insurance fund in their country of origin.
    If a student is requesting a reimbursement from the CNS (without having been affiliated with the CNS before), the following information/documents must be submitted together with the request:
    • proof of their identity (a copy of the ID card may be attached);
    • a bank account identification document (relevé d'identité bancaire) specifying the IBAN and BIC codes;
    • a valid copy of the European health insurance card;
    • a certificate of student enrolment or similar;
    • the original receipted statement of fees, or if the payment took place later, proof of payment in the form of 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 reimbursement will be made by wire transfer within a few weeks. The amount to be reimbursed depends on the contractual or statutory rate;
  • for students enrolled for social security in a foreign country that has entered into a bilateral social security treaty with Luxembourg, the application for reimbursement of healthcare expenses may be sent either to the CNS (by following the aforementioned instructions) or to the health insurance fund in the intern's country of origin.
    If a student is requesting a reimbursement from the CNS (without having been affiliated with the CNS before), the following information/documents must be submitted together with the request:
    • proof of their identity (a copy of the ID card may be attached);
    • a bank account identification document with IBAN and BIC codes;
    • a copy of the conventional form issued by the social security agency in the country of enrolment;
    • a certificate of student enrolment or similar;
    • the original receipted statement of fees, or if the payment took place later, proof of payment in the form of 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 reimbursement will be made by wire transfer within a few weeks. The amount reimbursed depends on the contractual or statutory rate.

Direct payment by the health insurance fund

In some cases, such as for the cost of hospitalization or drugs, medical laboratory tests, physical therapy and rehabilitation in specialized establishments, or blood transfusions, or for procedures performed by certain healthcare professionals in healthcare establishments or in certain healthcare and assistance networks, insured individuals will not need to make advance payment for the entire amount of the costs incurred. The system of direct payment by the competent health insurance fund, referred to as the third-party payer system, requires the production of a social security card, or in its absence, a European health insurance card.

Insured individuals are only required to pay service providers for the portion of their expenses that remains to be borne by them.

Student who are not enrolled with a European health insurance fund must produce a valid certificate of enrolment with a health insurance scheme. This document, certifying their health insurance coverage abroad, will allow them to benefit from third-party payer system if there is a bilateral social security agreement between Luxembourg and the student's country of origin.

Without a certificate of enrolment in a health insurance scheme, such students will have to pay expenses up front, and subsequently request reimbursement from the health insurance fund in their country of origin.

In the calendar year, an insured individual's contribution to their healthcare costs is capped. In the case of payment for care exceeding 2.5 % of the annualized contributory income, the insured individual is entitled to an additional reimbursement from their health insurance fund for contributions exceeding the threshold in question. To determine the amount exceeding the threshold, the contributions made by both the insured and the co-insured parties are added.

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