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If you’re travelling to Luxembourg on holiday – or you’re an expat planning to live or work in this small European country – it’s important to know about the unique healthcare system, and how to access medical help.
This beautiful place is largely rural, and even its famed capital – Luxembourg City – has strong roots in history, with its cliff-top medieval old town.
That’s not to say healthcare skills, hospitals and other medical provision in Luxembourg has not kept up with modern needs. In fact, it has one of the best healthcare services in the EU. It has both state-funded medical provision and a buoyant private healthcare sector.
However, it would be incorrect to imagine that the Grand Duchy of Luxembourg provides injury and illness care in exactly the same way as the UK.
Why it’s important to know the Luxembourg healthcare situation
Every country has its own way of organising and delivering healthcare. There can also be different systems for residents and visitors, which is certainly true in Luxembourg.
Researching medical care provision and costs before you emigrate to a new country is particularly important, as this gives you important information about your new life in a foreign country, particularly if you have a family. The potential costs of healthcare in countries like Luxembourg could influence your decision making.
If your work is taking you to Luxembourg, you may want to look at arrangements for healthcare with your employer before you agree to the post.
Even if you’re going to Luxembourg on holiday or for a short break, it could be valuable to be aware of how health care is organised, in case you have an accident or you’re taken ill.
If you have a pre-existing medical condition and you’re travelling abroad, understanding where to go for help, and any potential complications or costs, can be vital to avoid delays in treatment, not being able to access medications or bills not covered by your travel insurance.
How healthcare works in Luxembourg
In Luxembourg, basic public sector healthcare is free to citizens, under the National Health Fund (Caisse Nationale de Santé or CNS as it is sometimes called).
Though the CNS pays for some things directly, there are occasions when even local people have to pay for healthcare costs and then claim the money back from the state.
All hospitals in Luxembourg are provided by the CNS, though there are private doctors, clinics and other medical services too.
Citizens of Luxembourg benefit from the CNS thanks to the taxes that they pay as social security contributions. If you are an expat living in Luxembourg, your employer should help you to pay the relevant level of social security contributions.
Once you are registered and covered by the CNS, you have the right to select your doctor, hospital and specialist of choice in Luxembourg.
However, it is not unusual for people who live there to take out health insurance to “top up” what is provided under the CNS. This ensures that specialist health costs are covered, particularly as to meet some medical needs residents need to travel outside Luxembourg.
So, if you go to live, work or even retire to Luxembourg, it is common sense to research the best private healthcare policy to match your current and future needs.
How to get emergency help in Luxembourg
If you’re in an accident while on holiday or living in Luxembourg, or you are taken seriously ill, the way to get immediate assistance is to ring 112.
Just like 999 in the UK, calls to this number are free and can be used for medical emergencies, and to request help from the police and fire brigade too.
Using this number provides access to emergency responders and ambulance services provided by Luxembourg’s public sector (CNS). If necessary, you will be taken to a hospital run by the state.
This is important, as if a hotel or travel company representative makes the call for you, they may ask for medical help from a private healthcare provider in Luxembourg. You may wish to check this before they seek medical assistance on your behalf.
Also, keep in mind that not all Luxembourg hospitals have “accident and emergency” departments. It tends to be only larger facilities that do, but there is a shared duty of care in these situations, that operates on a rota basis.
If you wanted to go direct to hospital to access emergency care in Luxembourg, how will you know which hospital to use? The rota for emergency healthcare is published in newspapers and posted up in pharmacies and doctor’s surgeries.
What Luxembourg emergency healthcare costs are you likely to face? This depends on what your insurance provision is like. You will always be treated in an emergency, but the bill for this could be substantial if it falls outside medical coverage in your travel or healthcare insurance.
See below for information about using an EHIC for emergency care in Luxembourg.
Healthcare in Luxembourg before Brexit
While the UK prepares to leave the EU, the system and potential costs of healthcare in Luxembourg remain relatively simple.
You need to be sure you have potential medical expenses covered in your travel insurance, irrespective of what country you are visiting in mainland Europe.
In an emergency, you will be treated in Luxembourg. Then, you could be asked to pay up front for consultations, medicines and accommodation for example, particularly if you are being treated by a private healthcare organisation.
These costs could be covered or reimbursed if you have:
- Adequate travel insurance
- An EHIC (European Health Insurance Card).
Showing your EHIC card in Luxembourg in a public sector healthcare facility could mean getting medical help free or at a reduced cost. That’s why it is so important to apply for or renew your card. In some cases, you can get free medical help in Luxembourg by showing your EHIC even when you don’t have travel insurance documentation.
However, even your EHIC card doesn’t help you access free healthcare in private facilities. Which is why it is important to be wary if holiday reps or hotel staff make medical arrangements on your behalf.
If you do have to pay for anything medical-related in Luxembourg, keep all the paperwork generated by your visit to a Luxembourg hospital or doctor, especially receipts for any payments. You can then apply for reimbursement, as appropriate.
Post-Brexit healthcare in Luxembourg
The situation regarding accessing healthcare abroad post-Brexit is currently unclear. This includes uncertainty about specific arrangements with individual countries such as Luxembourg, and whether EHIC cards will carry the same level of entitlement.
It is important to check back on this website for information about medical matters for travellers in Luxembourg, once the EU exit date has been finalised.
So, in a nutshell, though your EHIC card currently covers state treatment for pre-existing and new medical issues in a wide range of circumstances in Luxembourg, this may not be the case after the UK leaves the EU.
Are any Luxembourg medical services not covered by EHIC?
Though your European Health Insurance Card is valuable to help in health-related matters in Luxembourg, there are a few exceptions.
For example, it does not render you immune from any costs involved if you have to return to the UK for health reasons. If you need help from mountain rescue services, or medical assistance while on a cruise, these are also beyond the remit of your EHIC cover.
If you are travelling to Luxembourg specifically for medical treatment, you must seek specialist advice and help in your rights and the costs involved if you have an unrelated medical emergency.
The other important thing to keep in mind is that if you go to live in Luxembourg – or stay for work for over 90 days – your EHIC card becomes invalid.
If you are staying in this country beyond that 90-day period, you must register for the Caisse Nationale de Santé (CNS) healthcare provision and pay your mandatory contributions the same as Luxembourg citizens. This then entitles you and your dependents to a level of free healthcare in Luxembourg, without your EHIC.
Lost (or don’t have) my EHIC card in Luxembourg
If the worse happens and you need medical help while in Luxembourg but don’t have access to an EHIC card, what can you do?
The first thing is, not to panic and start paying out for medical expenses in the hope of getting costs reimbursed.
Instead, you need to get something called a provisional replacement certificate (PRC). This is your proof that you an entitled to an EHIC card, even if you don’t currently have one.
To get a PRC, contact an organisation called “Overseas Healthcare Services”, on the numbers below, and request a certificate. This service is available Monday to Friday, from 8am to 6pm (UK time).
Overseas Healthcare Services: while in the UK ring 0191 218 1999; if outside the UK ring +44 191 218 1999.
Travelling to Luxembourg with prescription medications
Before your trip to Luxembourg, you need to gather any medicines you need regularly, in a way that makes everything problem-free. This means having your medications in their original pharmacy packaging. You should also take with you a copy of your prescription and relevant letter from a doctor.
This proves your need, particularly if the substances involved raises red flags with Luxembourg airport security. It also gives you clear paperwork to hand to medical staff if you have a medical emergency in Luxembourg.
If you need to take items to Luxembourg that are covered by the UK’s Controlled Medicines legislation, you must have a special licence and take steps outlined on the Government’s advisory page https://www.gov.uk/travelling-controlled-drugs
Pre-existing medical condition and Luxembourg healthcare
Taking steps to make sure that your travel insurance covers medical bills while abroad is particularly important if you have an existing health-related issue.
Declare your pre-existing medical conditions before your trip to Luxembourg, to make absolutely sure that your insurance is not invalidated. “Hoping” that something won’t become a problem while in Luxembourg is ill-advised, as you could void your travel insurance and find yourself with a very hefty medical bill from Luxembourg’s hospitals or doctors!
It is also sensible to chat to your GP or specialist before you leave the UK. Ask them for advice about how the journey and your holiday in Luxembourg may affect your medical issue, and any sensible precautions you should take. They may even provide a written statement to explain the health matter to any medical professions you need to see in Luxembourg. This letter can also help inform travel representations, airline and hotel staff in an emergency.
If you need a prescription in Luxembourg
What happens if a medical professional advises you to take medication while on holiday, or helps you to obtain replacements or additional supplies for existing medicines?
This is another occasion when having your EHIC in Luxembourg (or your PRC) could prove invaluable. If you have an EHIC, your prescription medicines could be covered completely, or heavily discounted.
The proportion of the cost you need to meet for medicines while in Luxembourg, varies according to what it was prescribed for, and the active ingredients. Clearly, you will be expected to pay a larger contribution to non-essential medications, though you could get free medicines for chronic and serious illnesses.
Luxembourg healthcare and retirees
If you can prove that you receive a state pension in the UK, Luxembourg prescription charges are even lower.
What if you are retiring and going to live in Luxembourg; how does healthcare work then?
Your EHIC card won’t cover you as soon as you are resident in Luxembourg for over the 90-day limit. As you’re not employed, you won’t be registered and paying contributions to the CNS.
However, if you retire to live in Luxembourg and you have an exportable UK pension or benefit, you may still be able to obtain help from the UK in meeting the costs for healthcare services.
For this to happen, you would need to successfully obtain something called an S1 certificate (it used to be called an E106). This website outlines what happens when you are claiming benefits abroad, including how to apply for this S1 certificate: https://www.gov.uk/claim-benefits-abroad
The situation with regard to healthcare and retiring to Luxembourg is also complicated by Britain’s exit from the UK, so keep checking back with us for updates.
Remember, whether you are retiring to Luxembourg or there on holiday, as you don’t qualify for state help under Luxembourg’s Caisse Nationale de Santé, having evidence of private healthcare insurance could prove vital.