How to get your healthcare costs reimbursed in Luxembourg
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How the CNS works in practice
The Caisse nationale de santé is the public body managing health and maternity insurance in Luxembourg. As soon as you work in the Grand Duchy, you're automatically enrolled through contributions deducted from your salary by the Centre commun de la sécurité sociale (CCSS). Your spouse and children can be co-insured at no extra cost.
Reimbursement rates depend on the type of care and the patient's age. In 2026, the key benchmarks are: medical consultations (office visits) at 88% for adults and 100% for under-18s, prescription medication between 40% (moderate interest), 80% (standard rate) and 100% (vital interest) depending on the drug's classification, psychotherapy (with prescription) at 70% for adults and 100% for under-18s, hospitalisation with near-full coverage of stay costs excluding private rooms.
A crucial point many newcomers discover too late: these rates apply to the official tariff set by the CNS nomenclature, not to the total amount your doctor may charge. Some practitioners bill a "personal convenience" supplement (codes CP1–CP7). These overruns are never reimbursed by the CNS.
For example, a general consultation (code C1) has an official CNS rate of €62.60 (nomenclature in force since 1 June 2026). The CNS reimburses 88%, i.e. €55.09. Your co-payment is €7.51. If your doctor adds a CP supplement of €20, your bill rises to €82.60, but you still only get €55.09 back. The rest is on you (or on your complementary insurance, more on that below).
To look up the exact rate for any medical act, the CNS provides a search tool by code (ouvre dans un nouvel onglet) on its website.
3 ways to get reimbursed
Luxembourg's system is in the middle of a digital transition. Today you have three options to recover the CNS share of your medical costs, from the simplest to the most traditional.
PID: you only pay your share
The Paiement immédiat direct is the big change of recent years. When you visit a PID-equipped doctor, you only pay your co-payment (12% for a standard consultation). The CNS transfers its share directly to the doctor via instant bank transfer, in seconds.
PID launched as a pilot in September 2023, then rolled out to all doctors and dentists in March 2024. In September 2025, it covered 289,411 of 587,935 medical fee statements, about half, and 1,372 doctors and dentists used it in the week of 1 September (source: ministerial answer to a parliamentary question, March 2026).
In practice, you don't need to do anything special. Simply ask your doctor if they offer PID. If so, you pay your share on the spot (in cash or by card) and you're done. No envelope, no post, no waiting. The doctor gives you a PID receipt that serves as your invoice: this is the document you'll send to your complementary health insurer if you have one.
Digital reimbursement via GesondheetsApp
If your doctor doesn't offer PID, they can still transmit your fee statement digitally through their medical software. You'll find the invoice directly in the CNS GesondheetsApp (ouvre dans un nouvel onglet) on your smartphone. One click on "Send" and your reimbursement request goes to the CNS. According to the CNS, processing is faster than by mail.
To use the GesondheetsApp, you need to have activated your e-health account (DSP). If you haven't received your activation code yet, you can ask your doctor to generate a QR code for you, or contact the Agence eSanté helpdesk.
Traditional reimbursement by mail
The paper route is still available. You pay your bill at the doctor's and collect the receipted fee statement ("pour acquit" stamp, doctor's signature, your 13-digit social security number). You attach proof of payment (bank debit notice, "paid" note on the invoice; careful, screenshots are not accepted) and send everything by post to: CNS - Service Remboursements - L-2980 Luxembourg. No stamp needed if posting from Luxembourg. The CNS processes your request and transfers the reimbursement to your account.
Timelines depend on complexity: about 1 week for simple invoices (automatic processing), 2 to 4 weeks for standard cases, and up to 8 weeks for complex cases (care abroad, prior authorisations).
For immediate reimbursement, visit a CNS agency (ouvre dans un nouvel onglet) in person (by appointment via MyGuichet.lu). Condition: your total medical costs must reach at least €100 per household, and your invoices must have been paid less than 15 days ago.
Important: you have 2 years from the date of payment to submit your reimbursement request to the CNS. After that, your request will be automatically rejected, without exception.
CNS supplementary reimbursement: the safety net people forget
There's a mechanism many insured people don't know about: the CNS supplementary reimbursement (article 154bis of the CNS statutes). If your cumulative co-payments over a calendar year exceed 2.5% of your annual insurable income from the previous year, you can ask the CNS to reimburse the excess.
For 2026, the minimum threshold is €518.18 (€509.68 for 2025). If you exceed this amount, submit your request online on the CNS website (ouvre dans un nouvel onglet), a simple form to fill in. The request can be filed from 1 May of the current year, and no later than the end of the second following year.
This mechanism is especially useful after a year with heavy medical expenses (orthodontics, long-term physiotherapy, several specialists). Your co-insured family members' co-payments count towards the total.
Complementary health insurance: covering the rest
The CNS provides solid coverage, but there's always a portion left to pay. This is where complementary health insurance (also called mutuelle) comes in. It covers the co-payment (your 12%), fee overruns, and services poorly or not covered by the CNS: dental prosthetics, orthodontics, optical, alternative medicine, private hospital rooms.
The benefit is clear with a concrete example. PID consultation at your GP: rate €62.60, you pay €7.51 on the spot. You send your PID receipt to your complementary insurer, which reimburses the €7.51. Result: zero out-of-pocket cost. And if your doctor had added a CP supplement of €20, your complementary insurance can also cover part of that overrun, depending on your contract limits (often between €500 and €1,500 per year).
For your tax return: complementary health insurance premiums are deductible under article 111 LIR, up to €672 per person in your tax household (children included). This ceiling is shared with other eligible insurance premiums (liability, life, death) and interest on consumer loans (2026 figures). A tax adviser can help you optimise your deductions if you're unsure.
Getting treated abroad
If you fall ill during a stay in an EU or EEA country, Switzerland, North Macedonia, Montenegro, Serbia or the United Kingdom, your European Health Insurance Card (EHIC) entitles you to care under the host country's rules. Order your EHIC online on the Centre commun de la sécurité sociale (CCSS) website. If you lose or forget it, MyGuichet.lu issues a provisional replacement certificate valid for 3 months (details on the CNS website (ouvre dans un nouvel onglet)).
The EHIC only covers "medically necessary" care, meaning care that can't wait until you're back in Luxembourg. If you're planning scheduled care abroad (an operation, a specific treatment), you may need prior authorisation from the CNS (form S2). Without authorisation, reimbursement isn't guaranteed beyond the Luxembourg rate.
For care outside the EU/EEA, coverage is much more limited. In all cases, reimbursement for care abroad takes longer: allow at least 6 to 8 weeks.
If you're a cross-border worker, the rules depend on your country of residence. French, Belgian and German cross-border workers can in principle get treated in their country of residence or in Luxembourg, with reimbursement arrangements that vary. Your best bet is to check your situation directly with the CNS.
Heading far away? We cover it all in preparing your first trip outside Europe.
Frequently asked questions
With PID, there's nothing to wait for: the CNS share is paid to the doctor in seconds. For digital or postal reimbursement, the delay ranges from 1 to 8 weeks depending on how complex the file is. Simple invoices (standard consultation, compliant fee statement) are often processed in under 2 weeks.
A system where you only pay your co-payment at the doctor's. The CNS pays its share directly to the practitioner via instant transfer. It is growing fast (about half of medical fee statements in September 2025), but it is not mandatory: each doctor decides whether to offer it. Just show your social security card and ask your doctor whether they're equipped.
Yes. Complementary health insurance premiums are deductible under article 111 LIR, up to €672 per person in the tax household per year (2026 figures). This ceiling is shared with life, death and liability (car/home) insurance premiums and interest on personal loans. To benefit, file your tax return (model 100) and attach the tax certificate provided by your insurer.
Check whether you're entitled to the CNS supplementary reimbursement. If your cumulative co-payments exceed 2.5% of your annual insurable income (minimum threshold: €518.18 for 2026, €509.68 for 2025), you can request reimbursement of the excess via the CNS online form (ouvre dans un nouvel onglet). And if you don't have complementary health insurance yet, now might be the time to think about it.
As a cross-border worker insured with the CNS, you can get treated in Luxembourg or in your country of residence. For care received in your country of residence, your local fund handles the reimbursement (CPAM in France, mutualité in Belgium, Krankenkasse in Germany). For care in Luxembourg, it's the CNS. PID works exactly the same for you as for residents.