Health Insurance Funds for the Public Sector and Similar Sectors

The Health Insurance Fund for Communal Civil Servants and Employees (Caisse de maladie des fonctionnaires et employés communaux – CMFEC), the Health Insurance Fund for Civil Servants and Public Employees (Caisse de maladie des fonctionnaires et employés publics – CMFEP) and the Health Insurance Fund for Luxembourg Railway Workers (Entraide médicale des CFL) are the bodies in charge of health insurance for public-sector employees and similar (except for manual workers employed by the State, who are covered by the National Health Fund (Caisse nationale de Santé – CNS).

They are responsible for the:

  • reimbursement of health care services paid for in advance by the insured person (benefits in kind);
  • payment of sickness or maternity benefits (cash benefits);
  • organisation of medical checks of the insured persons;
  • payment of funeral benefits to the surviving family members of the deceased insured person.

Some services and procedures previously covered by the Union of Health Insurance Funds (Union des caisses de maladie), which is now part of the CNS, are now automatically covered by the CNS – in particular:

  • applications for authorisation for transfers abroad and for the completion of S2 forms;
  • approvals of payment for services provided by masseurs, masseurs-physiotherapists, speech therapists, psycho-motor therapists and for treatments and recurring transportation;
  • special approvals required as a result of the regulations governing certain medicines.

Hence, those insured by public-sector funds must send these authorisation or payment requests to the CNS.

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