If you work in Luxembourg but live in another country such as France, Germany, or Belgium, you are considered a cross-border worker under European Union rules. This status entitles you to healthcare benefits in Luxembourg under the same conditions as residents of the Grand Duchy.
To enjoy full protection, however, you must also follow specific procedures in both Luxembourg and your country of residence.
The official information is available in English, French, and German on the National Health Fund (CNS) cross-border portal here.
When you start working in Luxembourg, the first step is to ensure that you are affiliated to the Common Social Security Center (CCSS). This registration protects you against the main social-security risks, including sickness, maternity, workplace accidents, occupational disease, invalidity, and long-term care. More information on that here.
If you are employed, your employer is responsible for registering you with the CCSS. If you are self-employed, you must take the initiative to register yourself.
When your employment ends, the CCSS will send you a confirmation letter showing that your affiliation has been terminated. To remain insured for healthcare, you should then contact your local health-insurance fund in your country of residence. There you can explore several options, such as personal affiliation, co-insurance through a spouse, temporary maintenance of rights under Article 8 of the CNS statutes, or voluntary affiliation in Luxembourg if you meet the required conditions.
Full details are explained under ‘My procedures in Luxembourg’ on the CNS website here.
Depending on where you live, the steps for registration differ slightly. The CNS provides tailored guidance for each nationality:
As a cross-border worker living in France, you must register with your local health-insurance fund, the Caisse Primaire d’Assurance Maladie (CPAM), to receive care in France. This registration is based on form S1 (also referred to as S072), issued by Luxembourg’s CNS.
If you live in the Grand Est region, in one of the départements Ardennes, Aube, Marne, Haute-Marne, Meurthe-et-Moselle, Meuse, Moselle, Vosges, Bas-Rhin, or Haut-Rhin – the S072 form is sent automatically from the CNS to your local CPAM. No further action is usually required.
If you live elsewhere in France, the S1 certificate will be mailed to you. You must then forward it to your local CPAM. If you do not receive the S1 within fifteen days after your CCSS registration, you should request it directly from the CNS.
The S1/S072 form certifies that you contribute to Luxembourg’s health system and ensures your medical care in France is reimbursed as if you were insured there.
Family members of cross-border workers can also benefit from healthcare coverage under certain conditions. In Luxembourg, they may receive benefits similar to those available to residents, however, as a cross-border worker, it is the legislation of my country of residence that determines who is entitled to benefits as a family member.
Your health-insurance fund (for example, CPAM in France) will contact the CNS electronically through the EESSI system to request a digital version of the S072. The CNS confirms registration by sending back form S073. It is important to check with your local fund that these steps have been completed, ensuring your family members’ coverage is correctly registered.
If you are unable to work due to illness or accident, you must send the original medical certificate to the CNS no later than the end of the third working day of your incapacity. This applies even if you live outside Luxembourg.
To ensure fast processing, ask your doctor to write your 13-digit Luxembourg identification number on the certificate. If this is not done, you can add it yourself on the back before sending it. Prompt submission helps avoid delays in compensation payments.
Healthcare costs are reimbursed differently depending on where you receive care:
Urgent care abroad (in the EU, EEA, or Switzerland) is covered if you show your European Health Insurance Card (EHIC) or a replacement certificate. For scheduled inpatient care involving an overnight stay, you must obtain prior authorisation from the CNS.
As a cross-border worker, you will deal mainly with three institutions:
The most important documents are:
Always keep copies of these forms, as they ensure your rights and facilitate communication between systems.
Check that your employer registers you with the CCSS promptly, ideally within the first week of work. Delayed registration can lead to a temporary loss of healthcare rights. Keep digital copies of your forms and letters from both the CCSS and CNS.
When sick, send your medical certificate to the CNS as soon as possible, and always write your identification number on it but be careful not to use the sections reserved for the doctor. Any changes or additions to these sections are unauthorised and may result in penalties and the invalidity of the certificate. If you plan to receive treatment outside Luxembourg or your country of residence, verify with the CNS whether you need prior authorisation.
Ensure your family’s registration is up to date and that all forms have been exchanged electronically between the Luxembourg and home-country systems.
Carry your European Health Insurance Card whenever you travel, as it grants emergency access to care in other EU or EEA countries. If you change jobs or move house, inform both the CCSS and your local health-insurance fund immediately. Please note that it is the employer who is responsible for registering and deregistering with the CCSS, unless you are self-employed. Cross-border workers should notify the CNS of any change of address as soon as possible to avoid problems with the delivery of important letters, such as registration or deregistration by the CCSS.
This can usually also be done online via MyGuichet.lu.
For change of address please find more information here.
Working in Luxembourg while living abroad gives you access to one of Europe’s most comprehensive social-security systems. By registering correctly with the CCSS and completing the required steps with your local health-insurance fund, you ensure continuous healthcare coverage both in Luxembourg and at home.
Understanding the roles of each institution, the CCSS for registering and deregistering employees or self-employed persons, the CNS for reimbursements and authorisations, and your national health insurance fund for local services and insurance for family members – you can navigate the process more smoothly. Always keep your forms safe and stay informed about updates on the CNS’s official cross-border workers page here.
