Moving to or working in Luxembourg also means learning to cope with a different health system. Although Luxembourg and Germany are neighbouring countries, their approaches to health may be surprising, especially when it comes to reimbursements, insurance and administrative procedures. This guide aims to help you sort it all out: whether you are a resident, a cross-border worker or just curious, find out about everything you need to know in order to make the right choice when it comes to your health.
Luxembourg: Extended public health, but sometimes incomplete
In Luxembourg, health insurance is managed by the National Health Fund (CNS), which guarantees universal health cover for all its members. Reimbursement generally varies from 80% to 100% depending on the treatment received. One of the major advantages of Luxembourg’s system is the freedom of access to treatment: you do not need to consult a GP to see a specialist, thereby giving you quick and direct access. How it works is simple: you pay the costs upfront, then send your invoices to the CNS for reimbursement.
In the case of treatment abroad, particularly for cross-border workers living in Germany, costs may be reimbursed either by the CNS or by the local German health insurance fund, depending on bilateral agreements. Nevertheless, even if you get treatment in Germany, reimbursement is determined according to the Luxembourg scales, which may bring about differences in cover.
To bridge these gaps and enhance your protection, choosing complementary health insurance from DKV Luxembourg might be a wise decision. It covers expenses not paid for by the CNS, particularly for eye, dental or hospitalisation costs.
Find out more about the Luxembourgish healthcare system in our article dedicated to that topic.
Germany: solid cover in a general framework
Germany relies on a compulsory insurance system, divided between:
- Statutory health insurance (GKV) financed by contributions from wages and salaries.
- Private health insurance (PKV): often reserved for high earners or the self-employed.
In Germany, most insured parties are members of the compulsory public health insurance (GKV). Known for its reliability, this system covers a large part of medical expenses, but there are certain rules of access involved, particularly if you want to consult a specialist: in many cases you must first see a GP to get a referral.
Managing your healthcare in Germany is straightforward: simply present your insurance card and, by default, your public health insurance fund (GKV) will pay your medical expenses directly. You will only have to pay for a few supplements (e.g. tooth fillings) and the average reimbursement rate is around 70%.
For more flexibility, there is alternative option called KEP (Kostenerstattungsprinzip). With this mode of reimbursement, you pay your medical fees upfront and you then request reimbursement from your health insurance. The advantage? Better access to specialists and shorter waiting times. The drawback? Doctors often apply higher fees and the GKV does not generally reimburse more than 25% of these fees.
Useful information:
DKV policies do not automatically cover the remaining 75% if the rates charged exceed the normal rates for the same treatment in the Grand Duchy of Luxembourg.
| ITEM | GERMANY | LUXEMBOURG |
|---|---|---|
| Third-party payer | Frequent third-party payer, especially for routine care. | You pay all costs in advance, except in the case of PID (Immediate Direct Payment). |
| Basic reimbursement | Around 70% via GKV, which varies depending on the services. | 80 to 100% on average by the CNS |
| Reimbursement for children | Good coverage; in general, the health insurance fund covers 100% of hospitalisation and consultation costs. | 100% by the CNS for hospital stays and consultations |
| Eye/dental care | Very low level of reimbursement via the GKV. Often covered by supplementary health insurance. | Also low reimbursement level. |
| Hospital stays | A fixed contribution is often applied, but some costs may still need to be paid by the patient. | Similar principle: the health insurance fund covers most of the costs, but a personal contribution may also be required. |
| Reimbursement periods | Generally, fast reimbursement (a few days to a week via GKV). | On average, reimbursement periods are longer than in Germany. |
Working in Luxembourg while living in Germany: how to arrange your health cover?
Are you a German cross-border worker and you work in Luxembourg? Whether you are an employee or self-employed, you have to be affiliated with the Luxembourg social security system, specifically the Joint Social Security Centre (CCSS). This affiliation covers you for many risks: sickness, maternity, occupational accidents, disability, dependency, old age, etc.
- Are you an employee? If so, your employer will automatically take care of your membership.
- Are you self-employed? If so, it is up to you to complete the membership process directly on the CCSS website.
Once you are a member, you will automatically receive the S1 form issued by the CNS (also known as a certificate of entitlement), a key document for all cross-border workers residing in Germany. This form allows you to register with the German public health insurance fund (GKV) of your choice. Once your registration has been approved, you will be entitled to medical care in Germany as if you were insured locally, while being financed by the Luxembourg National Health Fund (CNS).
Find more details on the steps to take as a cross-border worker on the CNS website.
And what about supplementary health insurance in Luxembourg?
Although the CNS offers extensive coverage, some services remain the responsibility of the insured party, particularly dental care, eye care and specialised treatments. This is where supplementary health insurance steps in, becoming an important tool for avoiding nasty financial surprises.
DKV Luxembourg’s EASY HEALTH supplementary health insurance is specifically designed for policyholders who wish to fill the gaps in the basic CNS insurance scheme. It gives you:
- Reimbursement of up to 100% of actual costs for certain treatments
- Specific coverage for eye care, dental and private hospitalisation costs
- Useful services such as international third-party payment, useful for cross-border workers
Advice for successfully managing your health between Luxembourg and Germany
Navigating between two healthcare systems can quickly become a headache if you are not well informed. Here are some essential best practices for all cross-border workers residing in Germany and insurance-affiliated in Luxembourg:
- Request your S1 form from the CNS as soon as you have been affiliated. This document is essential for registering with a German health insurance fund (GKV).
- Choose your German health insurance fund and submit the S1 form to receive medical care in Germany as if you were insured there.
- Keep your invoices, proof of treatment and reimbursement statements in a safe place: they may be useful for future procedures, particularly in the event of additional reimbursement.
- Find out about the bilateral agreements between the CNS and German health insurance funds in order to optimise your rights and avoid nasty surprises.
- Consider taking out appropriate supplementary health insurance, especially if you regularly visit the doctor in Germany or if you have specific needs for your family. Find out which insurance cover to choose with our health insurance guide and feel free to contact a LALUX Group agent for assistance with our health insurance solutions.
By understanding the specifics of each healthcare system and arranging yourself accordingly, you will enjoy peace of mind... and reimbursement!
EASY HEALTH de DKV Luxembourg
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