Luxembourg operates a state-funded health insurance system managed by the Caisse Nationale de Santé (CNS). Everyone legally working or residing in Luxembourg is required to be affiliated with the CNS through the Joint Social Security Centre (CCSS).
🏥 Who Can Access Care?
Residents and Employees
If you work in Luxembourg (even if you live in a bordering country as a cross-border worker) or reside there legally, you are automatically enrolled in the social security system by your employer or via voluntary registration. You receive a CNS card with a 13-digit matricule number.
Tourists and Temporary Visitors
If you are visiting from another EU country, your European Health Insurance Card (EHIC) will cover medically necessary care, including PEP, under the same conditions as a resident. If you are from outside the EU, you will need travel insurance, though emergency care will never be denied.
Anonymous testing services provided by NGOs like HIV Berodung do not require a CNS card or any form of ID, making them ideal for tourists, undocumented individuals, or those awaiting their CNS registration.
🚪 The Key Navigation Principle
Unlike systems with strict gatekeeping, Luxembourg allows direct access to specialists. You do not need a referral from a General Practitioner (GP) to see a specialist.
However, for specialized sexual health services—such as starting PrEP, getting PEP, or managing an HIV diagnosis—the National Service for Infectious Diseases at the Centre Hospitalier de Luxembourg (CHL) is the definitive hub.
📝 Registration Process for New Residents
- Employment: When you start a job, your employer registers you with the CCSS.
- Matricule: You will receive an affiliation declaration containing your 13-digit national identification number (matricule).
- CNS Card: Shortly after, the CNS will mail your health insurance card.
- Dependents: You can register family members (co-insured) directly through the CNS.
Third-Party Payment (Tiers Payant)
Luxembourg uses a third-party payment system for many services, including pharmacy prescriptions. When you present your CNS card, you only pay the portion of the cost that is not covered by the state (the "patient participation"). For doctor visits, you typically pay upfront and submit the invoice to the CNS for reimbursement (usually around 88% for adults).