This article explains everything you need to know:

• The Luxembourg system in a nutshell

• Healthcare cost reimbursement in Luxembourg 

• EASY HEALTH complementary health insurance from DKV Luxembourg 

• The specific case of cross-border workers still being member of the French social security system

In Luxembourg, the CNS (National Health Fund) manages the healthcare system. It reimburses a substantial portion of healthcare costs (often between 80 and 100%), but there's a major difference compared to France: you must almost always pay the costs upfront and then submit your invoices to be reimbursed. In recent months, the Luxembourg system has changed and now offers an Immediate Direct Payment (PID) system, which means you no longer have to pay the part covered by health insurance upfront. The health professional receives an instant transfer for this amount directly from the CNS. 

The standard reimbursement process is as follows: 

1. You consult a health professional: 

• Either you pay in full for the service

• Or your health professional uses the PID (Immediate Direct Payment), and you only pay the remainder.

2. If you pay for the service in full: 

• You receive a receipted invoice → It must include the word ‘paid’ and a stamp. 

3. You send the invoice to the CNS:

• By post: CNS – Service Remboursements – L-2980 Luxembourg

• If the payment is not made directly to the doctor, you send the invoice with proof of payment.

4. The CNS reimburses you by bank transfer. All the information can be found on the CNS website. 

Even though the Luxembourg system is comprehensive, certain services (eyecare, dental care, psychological care, alternative medicine, etc.) are reimbursed only partially or not at all by the CNS. EASY HEALTH complementary health insurance from DKV Luxembourg is useful in that case. It supplements CNS reimbursements by covering all or part of the remaining costs. It covers in part the care that is not reimbursed by the CNS. For residents affiliated with the CNS, DKV Luxembourg works like a standard French mutual insurance company, without connection to the CPAM.

If your healthcare professional uses the PID, please follow this guide for reimbursements with your DKV Luxembourg supplementary insurance. 

Two factors significantly differentiate how supplementary health insurance in Luxembourg works compared to France:

• A questionnaire or medical examination is required when you take out this insurance. Unlike the French model, where anyone can join a mutual insurance company regardless of their medical status, Luxembourg insurers require a health questionnaire (and sometimes a check-up) before admitting new policy holders. This approach ensures that the system is viable and stable while providing solid coverage over the long term.

• Contributions change with age. In Luxembourg, most supplementary health insurance policies set premiums based on age: the older you get, the higher your premium becomes. However, some policies operate differently thanks to what is known as a provision for increasing age. In this case, from the start you pay a fixed premium, which remains the same for the whole duration of the policy. It is a little higher when you are young, but it does not increase with age. It especially has benefits over the long term since you avoid hikes in your premium at the age where healthcare fees also increase.

Are you a cross-border worker and you are a member of the French social security (CPAM)? Do you get care in France and have also subscribed a DKV Luxembourg's EASY HEALTH complementary insurance? In this case, it works differently.

Without activated remote transmission between CPAM and DKV Luxembourg

You must handle the process yourself:

• Healthcare treatments reimbursed by Social Security: Send DKV Luxembourg your CPAM reimbursement statement (which can be downloaded from ameli.fr)

• Non-reimbursable healthcare treatment (psychological care, alternative medicine, etc): Send the receipted invoice directly to DKV Luxembourg.

With activated remote transmission 

Once the connection between the CPAM and DKV Luxembourg has been activated:

• Healthcare treatments that are reimbursed by the CPAM: There’s nothing for you to do, the CPAM automatically sends information to DKV Luxembourg

• Non-reimbursable healthcare treatments: You must always send your invoice to DKV Luxembourg

• Third-party payer: Possible with certain professionals (pharmacies, physiotherapists, radiologists, dentists, etc.)

Navigating between the Luxembourg and French healthcare systems can seem complex at first, particularly when you move to a new country. While the CNS offers solid basic coverage, certain expenses, particularly for eye, dental, psychological, or alternative medicine services, must be borne by you.

That’s why taking out supplementary health insurance such as EASY HEALTH from DKV Luxembourg can be a real asset, whether you are a resident of Luxembourg or a cross-border worker who is a member of the French CPAM.

It effectively supplements reimbursements and the provision for increasing age allows you to stabilise your contributions over time.

This is a smart move if you want to live with peace of mind as a cross-border worker.