Cross-border workers make up a significant part of Luxembourg’s workforce, with many commuting daily from neighbouring countries. Among them is Thomas Lallement, who lives in France and works for a public agency in Luxembourg. Like many commuters, he manages his professional obligations in Luxembourg while handling personal and administrative matters in his country of residence.
Although cross-border employment functions smoothly for most aspects of daily life, healthcare continues to be an area where clarity is not always easy to find. Lallement’s experience reflects a common situation: the system works, but the information surrounding it is not presented in a way that helps users navigate it confidently.
Lallement considers himself generally healthy and not someone who frequently requires medical services. Even so, he finds it difficult to fully understand how healthcare works across the two countries. “I have not really used Luxembourg’s healthcare services much yet, so it is still a bit unclear what exactly is covered on each side,” said Lallement.
He knows the essential framework. As an employee in Luxembourg, he is insured through the National Health Fund (CNS), and routine medical costs can be reimbursed according to Luxembourgish rules. In France, he may also access care, depending on the circumstances, but procedures and reimbursement details can differ between the two systems.
The practical differences between tariffs, paperwork requirements, and administrative steps are not always easy to establish, particularly for those who do not have regular contact with either country’s healthcare providers.
“Because information is not really presented in a clear or accessible way, I have not been able to fully understand the differences between the two systems,” said Lallement. Supplementary private insurance helps cover remaining expenses, but it does not replace the need for clear guidance. Much of the available information is scattered across various institutional websites, and instructions are often written in technical language.
For someone who only occasionally consults medical services, the absence of straightforward explanations makes it difficult to gain a complete understanding of how the cross-border system functions.
Lallement’s treatment in the country involved a few physiotherapy appointments. “Everything went smoothly enough at the time, but I do not fully remember how CNS reimbursement was handled. Part of it was processed automatically, and I submitted the remaining amount to my private insurance via their mobile app,” said Lallement. Because his needs were simple and infrequent, the process did not expose him to the more complex aspects of cross-border healthcare.
This is common among cross-border workers who only access medical services occasionally. Their understanding is shaped by isolated experiences rather than a detailed knowledge of the rules. Without consistent interaction, the administrative elements remain vague, and many do not feel equipped to handle situations that fall outside routine care.
From what Lallement has observed, accessing general practitioners or obtaining routine prescriptions seems reasonably straightforward. “From what I can see, routine care seems straightforward. But urgent or specialist care looks more complicated,” said Lallement.
Urgent situations or specialist appointments often highlight the gaps in available information. Workers may question where they should seek care, which system applies first, or how reimbursement will work depending on the country of treatment. While cross-border healthcare follows shared European principles, the practical interpretation depends on national rules. Without clear and easily accessible guidance, people can feel unsure about how to proceed when the need for urgent or specialist care arises.
When asked whether authorities on either side of the border provide sufficient support, Lallement responded with hesitation. “Not really, unless you already know where to look, procedures and rights are not explained in a very accessible way,” said Lallement.
Official information does exist, but it is often divided between different websites and institutions. Guidance on reimbursements, emergency procedures, cross-border forms, or consulting specialists is rarely found in a single place. For those who juggle work and commuting, finding the correct information can be time-consuming. While the systems themselves generally work, understanding them is made more difficult by the absence of a unified and user-friendly source of information.
Despite these uncertainties, Lallement does not describe negative personal experiences with either system. The complexity involved in navigating two systems often becomes apparent only when a specific situation requires action. Until that moment, the rules remain somewhat abstract, which can make urgent decisions more stressful.
Lallement suggested several improvements that could make cross-border healthcare easier to navigate. He believes the most beneficial change would be the creation of a centralised digital platform. A single portal or mobile application containing forms, clear instructions, frequently asked questions, and explanations tailored to different medical scenarios would simplify the process significantly. It could also include updates on reimbursement progress and information about changes in procedures.
He also sees value in scenario-based guidance. “If the procedures were explained depending on the situation, it would help you know what to do immediately,” said Lallement. Having distinct instructions for routine care, urgent care, workplace accidents, and specialist treatments would enable workers to find targeted advice quickly.
Proactive communication could also support cross-border workers. Instead of expecting individuals to search for updates, authorities could send notifications about changes in processes, upcoming deadlines, or new forms. This would be particularly useful for workers who do not regularly visit institutional websites.
Cross-border reimbursements can vary in timing and procedure, depending on the nature and location of the treatment. Lallement believes simpler and clearer reimbursement instructions would help cross-border workers considerably. Automatic exchanges between institutions or digital submission of documents could reduce paperwork and delays.
He also suggests that employers could play a more active role. Providing onboarding materials or brief information sessions on healthcare rights and procedures could give workers an early understanding of how to navigate the system.
Healthcare is ultimately about people’s well-being, and administrative uncertainty can discourage individuals from seeking timely care. Even for those who rarely need treatment, unclear procedures can become a source of stress. For workers with ongoing conditions or frequent specialist needs, navigating two systems without accessible guidance can create real obstacles.
Although financial coverage is generally reliable, the challenge lies in understanding how to access care in both countries. Knowing where to go, which rules apply, and how to obtain reimbursement is essential. Without clear communication, the responsibility shifts to individuals to interpret the system for themselves.
Lallement imagines a system that is more transparent, modern, and easier to understand. He does not believe that major structural reform is necessary. Instead, he sees an opportunity for better communication, more accessible guidance, and improved digital tools.
A centralised platform, scenario-based instructions, and proactive updates would significantly improve the experience. Combined with employer-supported information and clearer public communication, cross-border healthcare could become easier and more efficient for the many workers who depend on it.
Lallement’s experience highlights the complexity of navigating cross-border healthcare. The system operates and provides coverage, but the lack of accessible, user-friendly information can leave workers uncertain. Solving this does not require changing the core of the system. It requires explaining it clearly.
“If I had clear, simple instructions and one platform to guide me through the process, it would make all the difference,” said Lallement. Small improvements in communication and digital accessibility could make cross-border healthcare easier to understand and more reassuring for the many people who rely on it each day.
