Healthcare is the part of an international move that people postpone until they are ill. In Luxembourg, you can get ahead of it with a few simple steps, because for most people the cover is automatic. This guide sets out how healthcare in Luxembourg works for newcomers: who is covered, how to get the card and what to do if you do not work.
How does healthcare in Luxembourg work for employees?
It is built on social security. If you work in Luxembourg, your employer declares you to the Centre commun de la sécurité sociale (CCSS) within eight days of your start date. You are then insured with the Caisse nationale de santé (CNS), the national health fund, which reimburses care. There is nothing to sign at your end. Contributions are taken from your salary by the employer.
A self-employed person has to affiliate personally, using the self-employed entry form, online or on paper. Guichet.lu notes an exemption from compulsory enrolment for people whose professional income does not exceed one third of the annual social minimum wage, who can still join voluntarily if they live in Luxembourg.
What is the social security card and how do you receive it?
The CCSS prints your social security card automatically and posts it to your official address of residence, within about three weeks of the declaration, free of charge. It carries your 13-digit national number (see your Luxembourg matricule number). One side is the European health insurance card, so you can use it on temporary stays in other European countries.
Make sure the commune has your correct address, since that is where the card goes.
How can your family be covered?
Spouses, partners and children can be co-insured under your policy, which means they are covered without paying their own contribution. According to Guichet.lu, co-insured persons can include:
- your spouse or partner;
- children who qualify for family allowances;
- children under 30 whose resources do not exceed the REVIS threshold for a single person;
- relatives up to the third degree living in the household, if you have no spouse or partner.
You apply to the CNS with a simple request that states the identity of the main insured person and the relationship, with proof (a family record book or a university attendance certificate, for example). It can be done online through MyGuichet.lu, in person, by phone, e-mail or post. A person can be co-insured by only one main insured person: if several people qualify, the older one is the main policyholder.
Joining a partner, retiring from another country, working remotely for a foreign employer, or arriving between jobs: each case triggers a different route. Moovy can check the official criteria with you and prepare the documents to ask for, so you do not discover a three-month gap after the first doctor's bill. The CNS and the CCSS decide your cover; Moovy helps you prepare.
What if you move without a job?
You have two realistic options.
Keep your cover from home for a time. If your home country remains responsible for your health, for example because you are a pensioner paid by that country, ask for an S1 form from the paying body before leaving and give it to the Luxembourg health fund. For a short period, the European health insurance card (EHIC) covers medically necessary care during a temporary stay, but it is not an installation insurance: it does not cover planned treatment, private care or repatriation.
Join voluntary insurance. You ask the CCSS to be admitted to voluntary health and maternity insurance, by post, fax or e-mail. Contributions are calculated on the minimum contributory income, whose amount you should check in the social parameters for the year. Reimbursements start only after a three-month waiting period counted from your request. That gap is the trap: arrive with a plan for the first three months.
The commune also requires inactive residents to hold health insurance covering all risks in Luxembourg when they register, as we explain in residence in Luxembourg for EU citizens.
What about retirees and British people?
A retiree from another EU country with an S1 is covered by the Luxembourg CNS, which then bills the paying country. British nationals use the GHIC instead of the EHIC for temporary stays. GOV.UK says UK State Pensioners get an S1 from the NHS Overseas Healthcare Services and register it with the CNS, and a UK national who does not work can join voluntary insurance. If you work in Luxembourg, affiliation by the employer is the same as for anyone else.
What goes wrong most often?
- Assuming the EHIC is a residence solution. It is for temporary stays.
- Skipping the three-month waiting period when you plan. Voluntary insurance does not pay in the first three months.
- Letting voluntary insurance lapse. It ends automatically after two unpaid instalments.
- Being co-insured twice. You can only have one main insured person.
- Not updating your address. The card goes to the address on file.
Where do you find a doctor?
Luxembourg has out-of-hours medical houses in Luxembourg City, Esch-sur-Alzette and Ettelbruck, open evenings, nights, weekends and public holidays, plus a pharmacy duty rota at pharmacie.lu. For emergencies call 112; the police is 113. For the rest of the daily routine, see living in Luxembourg.
How do you use healthcare in Luxembourg once you are covered?
Once you hold your social security card, you use it like a health insurance card with doctors, pharmacies and hospitals. The CNS reimburses care according to its rules. Ask your doctor whether the practice takes the card directly or whether you pay and are reimbursed later, since that varies. Keep invoices and prescriptions until a reimbursement is confirmed. The CNS and MyGuichet.lu let you follow your file online once you have a way to authenticate.
If you need care before the card arrives, which can happen in your first weeks, use your European health insurance card for medically necessary care and keep every receipt, then ask the CNS how to claim it once you are affiliated.
What should you do about healthcare in Luxembourg if you work part-time or freelance?
A part-time employee is affiliated by the employer just like a full-time one. A self-employed person must affiliate personally with the CCSS, unless professional income stays at or below one third of the annual social minimum wage, in which case enrolment is not compulsory but possible. Check your situation early, since a gap in affiliation is the kind of problem you discover with the first bill. If you lose your job, Guichet.lu says that after six continuous months of enrolment, benefits continue for the current month plus three more months, and ongoing treatment can extend this by three months.
Health rules vary by situation and change. Confirm the details with the CCSS or the CNS before you rely on them.