Enrolling for voluntary health and maternity insurance

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Luxembourg residents who do not otherwise have health insurance may obtain insurance voluntarily through continued or optional health insurance.

The voluntary health and maternity insurance entitles its members to coverage of the services provided by the National Health Fund (Caisse nationale de santé - CNS) and to the reimbursement of health care expenses under the same terms and conditions as a person enrolled for mandatory insurance.

Contributions to voluntary health and maternity insurance may be covered by the State under certain circumstances. State coverage of healthcare contributions is primarily available to minors, the disabled, asylum seekers, army volunteers, young people enrolled for voluntary service, and elite athletes participating in elite sports.

Who is concerned

Any person residing in the Grand-Duchy who is not enrolled with the Joint Social Security Centre (Centre commun de la sécurité sociale – CCSS) either individually (as an insured party) or as a family member (as a co-insured party) may voluntarily enrol for health and maternity insurance.

Prerequisites

To qualify for voluntary continued insurance, applicants must:

  • be Luxembourg residents;
  • be at least 18 years old;
  • have been validly enrolled with the CCSS as an insured party or a co-insured party for a continuous period of 6 months immediately preceding the loss of such status. The 6-month period is considered continuous even in the event of interruptions in insurance, provided such interruptions were for fewer than 8 days;
  • have lost their status as a primary insured party, or co-insured party, fewer than 3 months after the month in which insurance was interrupted.

To qualify for voluntary optional health insurance, applicants must:

  • be Luxembourg residents;
  • not be covered by any other health insurance.

In certain situations, contributions to voluntary health and maternity insurance may be covered by the State on behalf of the voluntary insured party. To qualify for State coverage of contributions to voluntary health insurance, applicants must:

  • be Luxembourg residents; and
  • be under 18 years of age and not be insured in any other capacity (as a co-insured family member, for example); or
  • be unable to earn a living due to a physical or mental disability, and not be insured in any other capacity; or
  • be a volunteer in the army; or
  • be a young person carrying out voluntary service; or
  • be an elite athlete who participates in elite sports.

It may also apply, under certain circumstances, to asylum seekers and people receiving assistance from a social welfare office.

Application for State coverage of contributions must be submitted on a form that is to be sent to the Joint Social Security Centre (Centre commun de la sécurité sociale – CCSS).

How to proceed

Enrolment for voluntary continued health insurance

Any person who is at least 18 years old, resides in Luxembourg, and loses the status of insured party or co-insured party may request continued enrolment.

Procedures for enrolling for voluntary continued health insurance

To enrol for voluntary continued health insurance, interested parties must apply for admission into the voluntary health insurance system.

The application must be sent to the CCSS by post no later than 3 months following the month in which their insurance was interrupted. The starting point for the deadline is the effective date of the interruption of insurance, not the date on which the CCSS receives the notice of withdrawal, which may be sent by the employer.

Following voluntary enrolment, the insured party receives a social security card serving as proof of enrolment.

Amount of contributions and payment

Contributions are calculated on the basis of the minimum income subject to contributions.

Insured parties who wish to have contribution payments automatically withdrawn from their bank account must enclose a direct debit authorisation with their application.

Contributions are due from the end of the period of continuing coverage, in other words, generally, the month in progress and the 3 months following the interruption of insurance.

Reimbursement of healthcare expenses is subject to payment of contributions.

Termination of voluntary continued health insurance

Voluntary insurance may be terminated by the insured person in writing by sending the CCSS the declaration of withdrawal form. The form can be sent by post, email or fax.

In addition, voluntary insurance is automatically terminated:

  • in the event of non-payment of 2 successive contributions;
  • in the event of a new enrolment in the mandatory insurance scheme for a continuous period of 6 months, conferring entitlement once again to continued insurance (for example, where a person begins to work again).

Any person who is validly enrolled for voluntary insurance with the CCSS will have their medical expenses reimbursed under the same terms and conditions as a resident employee.

Enrolment for voluntary optional health insurance

Residents of the Grand-Duchy who do not otherwise qualify for health insurance coverage may take out insurance on a voluntary basis.

Procedures for enrolling for voluntary optional health insurance

To enrol for voluntary optional health insurance, interested parties must apply for admission into the voluntary health insurance system.

The application must be sent to the CCSS by post, fax, or email.

Entitlement to health insurance benefits in kind will only commence 3 months after applying to enrol with the CCSS. Thus, a voluntary enrollee must be enrolled for at least 3 months in order to qualify for reimbursements of healthcare services and pharmaceutical drugs.

Following voluntary enrolment, the insured person will receive a social security card which serves as proof of their enrolment.

Amount of contributions and payment

The basis for calculating the amount of contributions to voluntary health insurance is the minimum income subject to contributions.

Insured parties who wish to have contribution payments automatically withdrawn from their bank account must enclose a direct debit authorisation with their application.

Contributions are due as from the day the application for affiliation is submitted to the CCSS.

Reimbursement of healthcare expenses is subject to payment of contributions.

Termination of voluntary optional health insurance

Voluntary insurance may be terminated by sending a declaration of withdrawal form to the CCSS by post, email, or fax.

In addition, voluntary insurance is automatically terminated:

  • in the event of non-payment of 2 successive contributions;
  • in the event of a new enrolment in the mandatory insurance scheme for a continuous period of 6 months, conferring entitlement once again to continued insurance (for example, where a person begins to work again).

Any person who is validly enrolled for voluntary insurance with the CCSS will have their medical expenses reimbursed under the same terms and conditions as a resident employee.

Appeal

Enrolment-related decisions may be challenged at any time.

To challenge a decision, the interested party may file an appeal before the Social security arbitration tribunal (Conseil arbitral de la Sécurité sociale - C.A.S.S.) in Luxembourg City. The appeal may be filed as a simple petition on plain paper.

The appeal must be submitted within 40 days of notification of the contested decision, failing which it will be considered inadmissible.

Decisions handed down by the C.A.S.S may themselves be appealed before the High Council of Social Security (Conseil supérieur de la Social security).

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