Healthcare in the Duchy of Luxembourg is of a high standard and you should have no trouble accessing the care that you need, whether you are signed up to the Caisse Nationale de Santé (CNS), or are covered by private health insurance, or both.Luxembourg is a modern European nation with a comprehensive universal health insurance system and a number of private clinics.
Public healthcare in Luxembourg
The WHO’s country health profile for 2017 reports that overall, the quality of healthcare in Luxembourg is good, although concerns about cost-effectiveness have led to the overhauling of the country’s healthcare system over the course of the last decade.
Life expectancy at birth in the country was 82.4 years in 2015, is rising, and is well above the EU average: it’s around the 3rd or 4th highest in Europe. The report states that most of the gains in life expectancy have been after the age of 65 and result from a reduction of deaths from cardiovascular diseases, but these are still the leading cause of death among women. Cancer is the foremost cause of death for men.
The percentage of health expenditure is among the highest in the EU: in 2015, Luxembourg spent €5,090 per head on healthcare, compared to the EU average of €2,797.
Treatment of life-threatening conditions is deemed by the WHO to be swift and effective, and residents report good access to healthcare services. The rate of hospital admissions is low in comparison to neighbouring countries, due to effective primary care treatment.
There is little variation among high and low income groups when it comes to finding the care that residents need. The WHO reports that whilst the healthcare authorities respond well to challenges, and primary and acute care are deemed to be good, there isn’t a very effective system for systematic performance assessment. Moreover, treatment for chronic conditions is not very well coordinated, although this is slowly changing.
The nation has a relatively low (but adequate) number of doctors, but a percentage of nurses that is high for the EU. Doctors must train abroad, since there are no medical training degrees available in the country: Luxembourg thus relies on a relatively large number of foreign medical personnel.
The Ministry of Social Security and the Ministry of Health are responsible for health system governance. The Ministry of Health develops health policy and legislation, organises the delivery of care, governs hospital investments and directly co-finances public health programmes.
The Ministry of Social Security controls social policy and oversees public institutions funding healthcare, sickness leave and long-term care. The CNS itself is responsible for health insurance, long-term care insurance, and sickness leave insurance.
95.2% of Luxembourg residents were covered by compulsory health insurance in 2015, and over half of the population has complementary Voluntary Health Insurance (VHI). The statistics are difficult to evaluate for Luxembourg, which has a high ratio of cross-border workers: many people live or work in France, Germany or elsewhere in Europe and may be covered by the healthcare systems in their own nation.
A high percentage of residents (around 16%) seek treatment outside the country and claim reimbursement from the CNS, but it is not clear whether this is because they are cross-border personnel or whether they are seeking treatment outside Luxembourg for other reasons.
The main issue with Luxembourg’s healthcare system is expenditure: it is expensive and the government is currently looking at ways in which to increase efficiency. About 84% of healthcare funding is paid for by the government and from health insurance.
If you are registered with CNS, you will be covered for:
• medical treatment
• basic dental treatment
• visual aids such as spectacles and contact lenses
• treatment performed by healthcare professionals
• medical biology analyses
• medical devices
• hospital treatments and stays
• therapeutic and convalescent cures
• general and occupational rehabilitation
• transport expenses incurred in connection with health care
• palliative care
• blood products and plasma derivatives
• organ transplants
• psychotherapy for mental disorders
• procedures provided as part of preventive medicine schemes (children’s vaccinations, mammograms, etc.)
While there are no public dentists per se in Luxembourg, most are associated with the CNS and can take patients who are covered by the scheme. When you go to the dentist, ask first how much your treatment is going to cost, and how much of it will be covered by national insurance: your dentist will be able to advise you accordingly.
The scheme also covers treatment for mental health problems, such as depression and anxiety.
Although the WHO raises concerns about performance assessment and coordination, the standard of actual medical treatment in Luxembourg remains high.
Private healthcare in Luxembourg
All hospitals in Luxembourg are run by the CNS, so none of these are private. However, there are private doctors and clinics, so for speed of access to medical treatment, or to access therapies that you can’t claim under CNS such as advanced dental treatment, complementary therapies or eye care, you may wish to take out top-up or comprehensive medical insurance.
You can also check with your Luxembourgish employer to see if they offer private health cover as part of any employment package. The big insurance providers all cover the country.
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