Differences and Similarities Between Public and Private Health Insurance in Luxembourg
Luxembourg’s healthcare system features a dual structure combining a comprehensive public health insurance program with supplementary private health insurance options. This dual approach allows nearly universal access to essential healthcare while providing opportunities to enhance coverage through private plans.
Public Health Insurance: National Health Fund (CNS)
The cornerstone of Luxembourg’s public health insurance is the Caisse Nationale de Santé (CNS), which covers about 99% of the population, including employees, self-employed individuals, pensioners, students, and asylum seekers. CNS offers broad coverage of essential healthcare services such as general practitioner and specialist visits, hospital care (including emergency and maternity services), basic dental care, prescription medications, vaccinations, cancer screening, rehabilitation, psychotherapy, and psychiatric treatment.
Funding for CNS comes primarily from employer and employee contributions, supplemented by government subsidies. Contributions are income-based and capped annually at around 5% of personal income. Patients typically pay upfront for services and then receive reimbursement, with copayments ranging from approximately 12% for medical consultations and hospital stays, to 20-60% for most prescription drugs. Some vulnerable groups (e.g., low-income individuals, pregnant women) may benefit from reduced or waived copayments.
Access within the CNS system is generally broad, allowing patients to choose among public and some private providers affiliated with CNS. Emergency ambulance services are free of charge for all residents, regardless of insurance status. However, the system faces challenges: CNS is experiencing increasing financial deficits, with a forecasted shortfall of over €130 million in 2025, prompting calls for reform.
Private Health Insurance
Private health insurance in Luxembourg serves a complementary role, designed mainly to cover gaps left by the public system. It typically reimburses copayments, covers treatments or services not fully included in the CNS package (such as private hospital rooms, elective procedures, dental and vision care), and provides faster access to specialists and private healthcare facilities.
Private plans are voluntary and regulated by the Commissariat aux Assurances (CAA). Premiums vary widely based on the scope of coverage, age, and health status of the insured. Popular providers include international companies like Allianz Care, which offers tailored policies particularly appealing to expatriates and residents seeking international coverage or premium services.
Private insurance also helps new residents avoid the public insurance waiting period (three months) and may cover international medical evacuation or repatriation services. Many Luxembourg residents opt for private plans to reduce out-of-pocket costs and to access enhanced healthcare options beyond the standard CNS offerings.
Key Similarities
- Both public and private health insurances aim to provide access to necessary healthcare services and protect residents from high medical costs.
- Both systems require regulation and oversight, with CNS managed publicly and private insurers regulated by the CAA.
- Both involve some form of cost-sharing—public via copayments and private via premiums.
- Residents often use both systems concurrently, combining universal coverage with supplementary private benefits.
Key Differences
| Aspect | Public Health Insurance (CNS) | Private Health Insurance |
| Coverage | Essential medical services, hospital care, prescriptions | Supplementary services, copayment coverage, elective and private care |
| Cost | Income-based contributions with copayments | Premium-based, varies by provider and coverage |
| Eligibility | Mandatory for all residents | Voluntary, often chosen to supplement public care |
| Access | Public and some affiliated private providers | Private providers, private hospitals, faster access |
| Financial Status | Facing significant deficits requiring reform | Growing market, driven by expats and premium demand |
Top Public Health Insurance Providers in Luxembourg
Luxembourg’s public health insurance system is predominantly centralized under a single main public entity, the Caisse Nationale de Santé (CNS), which provides near-universal coverage. Unlike other countries with multiple public insurers, Luxembourg’s public health insurance is largely unified, but some related social security funds and schemes complement CNS. Below is a detailed overview of the key public health insurance providers and schemes in Luxembourg.
1. Caisse Nationale de Santé (CNS) (Official website: https://cns.public.lu/)
- Cost:
CNS coverage is financed through employer and employee social security contributions. Contributions are income-based and capped annually at about 5% of the insured person’s income. Patients typically pay upfront for services and are reimbursed 80-100% for primary care and 40-80% for specialized treatments. Copayments usually range around 12% for medical visits and hospital stays, and 20-60% for prescription drugs. - Available Services / Coverage Features:
CNS covers a wide array of essential healthcare services: general practitioner and specialist consultations, hospital inpatient and outpatient care, emergency services, maternity and childbirth care, basic dental treatments, prescription medications, vaccinations, cancer screenings, rehabilitation, psychotherapy, and psychiatric care. - Open for All or Limited:
CNS coverage is mandatory and open to all residents, including employees, self-employed, pensioners, students, asylum seekers, and recognized refugees. New residents may face a three-month waiting period before full coverage. - Core Financial Features:
Funded primarily by social security contributions (both employer and employee), supplemented by government subsidies. Copayments apply but are capped and partially reimbursed. CNS operates with a reimbursement model where patients pay upfront and claim back expenses. - Consumer Satisfaction Score:
Generally high, with Luxembourg residents expressing trust in CNS’s comprehensive coverage. However, some dissatisfaction exists regarding upfront payments and reimbursement delays. Satisfaction surveys rate CNS between 70-80% positive feedback, especially valuing access to essential care and financial protection.
2. Fonds National de Solidarité (FNS) (Official website: https://fns.public.lu/ )
- Cost:
FNS is a solidarity fund that provides additional financial support and subsidies for those with low income to cover healthcare costs. - Available Services / Coverage Features:
Supplements CNS by covering additional out-of-pocket costs for vulnerable populations, including exemptions from copayments and coverage of some services otherwise unpaid. - Open for All or Limited:
Limited to low-income residents and those qualifying under social assistance criteria. - Core Financial Features:
Funded by the government and social contributions, it aims to reduce financial barriers in healthcare. - Consumer Satisfaction Score:
Highly valued by beneficiaries for improving healthcare affordability; specific consumer data is limited.
3. Caisse pour l’Assurance Pension (CAP) (Official website: https://cnap.public.lu/ )
- Cost:
CAP manages health-related pension benefits and ensures coverage continuity for pensioners. - Available Services / Coverage Features:
Provides coverage continuation for retirees, ensuring access to medical care under CNS provisions. - Open for All or Limited:
Limited to pensioners registered in Luxembourg. - Core Financial Features:
Funded through pension contributions; coordinates with CNS for healthcare coverage. - Consumer Satisfaction Score:
Positive, especially for ensuring healthcare access in retirement.
4. Caisse pour l’Assurance Maladie des Fonctionnaires (CAMF) (Official website: https://cmfep.public.lu/ )
- Cost:
CAMF administers health insurance for civil servants and public sector employees. - Available Services / Coverage Features:
Provides similar coverage to CNS but tailored to public employees, including preventive care, specialist visits, and hospital treatment. - Open for All or Limited:
Limited to civil servants and public sector workers. - Core Financial Features:
Funded through employer and employee contributions specific to public service. - Consumer Satisfaction Score:
Generally high among civil servants due to tailored services.
5. Fonds pour l’Assurance Médicale des Indépendants (FAMI) (Official website: https://www.cleiss.fr/docs/regimes/regime_luxembourg-independants.html )
- Cost:
FAMI serves self-employed workers, coordinating with CNS to provide health coverage. - Available Services / Coverage Features:
Covers essential medical services under CNS regulations, including doctor visits, hospitalization, and medication. - Open for All or Limited:
Limited to self-employed individuals and independent contractors. - Core Financial Features:
Funded by self-employed contributions. - Consumer Satisfaction Score:
Positive feedback due to comprehensive coverage and coordination with CNS.
Top Private Health Insurance Providers in Luxembourg
Luxembourg has a robust public healthcare system, but many residents and expatriates also opt for private health insurance to supplement public coverage, access faster services, and benefit from extended features. While the private health insurance market in Luxembourg is relatively small compared to neighboring countries, there are a few reputable providers offering a range of plans. Here are the leading private health insurance providers in Luxembourg:
1. Foyer Global Health (Official website: https://www.foyerglobalhealth.com/)
- Cost: Premiums typically range from €80 to €300 per month depending on age, health status, and coverage level.
- Available Services/Coverage Features: Comprehensive international health insurance, including hospitalization, outpatient care, mental health, dental, maternity, and chronic condition coverage. Telemedicine and second medical opinion services are also included.
- Open for All or Limited: Open to expatriates and international professionals in Luxembourg; offers global coverage.
- Core Financial Features: Multiple deductible options, reimbursement up to 100% of actual medical costs (depending on the plan), and 24/7 customer support. Policies are customizable with modular add-ons.
- Consumer Satisfaction Score: High (4.6/5); praised for responsive customer service and fast claims processing.
2. DKV Luxembourg (Official website: https://www.dkv.lu/)
- Cost: Monthly premiums typically start around €70 and can go up to €250, depending on the plan.
- Available Services/Coverage Features: Offers supplementary coverage for hospital stays, specialist consultations, dental, optical, and alternative medicine. Also provides plans for long-term care.
- Open for All or Limited: Available to residents, with specific plans tailored for civil servants and self-employed individuals.
- Core Financial Features: Co-payment options available, reimbursement rates up to 90% for private treatments. Offers direct settlement with hospitals in many cases.
- Consumer Satisfaction Score: Solid (4.3/5); users report a high level of satisfaction with clarity of policy terms and reliable reimbursement.
3. Bâloise Assurances Luxembourg (Official website: https://www.baloise.lu/)
- Cost: Premiums usually range from €60 to €200/month based on plan details and individual profile.
- Available Services/Coverage Features: Covers hospitalization, outpatient treatment, preventive screenings, dental, and psychological services. Also includes coverage for travel and expatriate healthcare needs.
- Open for All or Limited: Open to all residents and cross-border workers; also offers international coverage.
- Core Financial Features: Offers tiered plans with various deductible and co-insurance levels. Also provides family discounts and bundled insurance packages.
- Consumer Satisfaction Score: Good (4.2/5); known for flexible plan structures and customer-centric policies.
4. La Luxembourgeoise (LLSA – La Luxembourgeoise Société Anonyme) (Official website: https://www.lalux.lu/)
- Cost: From approximately €65 to €180/month depending on coverage levels and age.
- Available Services/Coverage Features: Offers complementary health insurance to cover the gaps left by the CNS system. Includes enhanced reimbursement for dental, optical, and physiotherapy.
- Open for All or Limited: Available to all insured under Luxembourg’s social security system.
- Core Financial Features: Works in conjunction with public health coverage, offering top-ups. Reimbursement usually within 7–10 working days.
- Consumer Satisfaction Score: Moderate to high (4.1/5); customers highlight transparent conditions and reliability.
5. Allianz Care (Luxembourg) (Official website: https://www.allianzcare.com/)
- Cost: Monthly premiums typically from €100 to €350, influenced by age, global coverage needs, and chosen benefits.
- Available Services/Coverage Features: Full international health insurance with inpatient, outpatient, maternity, dental, vision, and evacuation/repatriation services.
- Open for All or Limited: Primarily targeted at expats and international professionals.
- Core Financial Features: High reimbursement limits, global direct billing network, multilingual support, and digital claims tools.
- Consumer Satisfaction Score: Very high (4.7/5); clients appreciate the global reach, easy-to-use app, and swift processing.
