Thursday, April 21, 2011

User’s Guide: Medical Care in Luxembourg

I think I am about to enter fun withdrawal. The last month has been a bit insane, in an awesome but crazy busy way. Since my last post, Nick and I have been happy to host several guests. First up was a college friend of mine who I dragged all over Luxembourg, out to Trier and Cochem, to Champagne and then off to Paris. The day after I left her in Paris to catch her flight home, my aunt, uncle and cousin arrived and were given the grand tour of the Grand Duchy. The day they left to go to France, I left for Frankfurt to catch a flight to the US for the weekend to attend a friend’s wedding. I returned home yesterday, a little jet lagged and happily exhausted from my friend’s beautiful wedding and a terrific weekend of catching up with old friends that I adore, and ready to see my husband, who I feel like I’ve only seen briefly in passing for the last two weeks.
The tapenade that caused
all of my ER drama.

So, naturally, not long after Nick returned home from work last night, I gashed my left hand while trying to open a jar of olive tapenade for dinner with a bread knife. (Dumb idea, I know…I often have a tendency to learn things the hard way.)

I had never cut myself that deep before and I was pretty sure that it was too deep to heal on its own under a Band-Aid, so I told Nick I thought we should go to the hospital. I keep emergency numbers on a post-it in a kitchen cabinet, but when we reached for it, it felt a bit silly to call an ambulance for a cut hand. After all, I was in pain but not in any kind of mortal danger. So, we called a taxi instead.

I’m interrupting this post to give a quick thank you to Colux Taxis for arriving in less than three minutes to take me to the hospital. I’ve added them to our emergency numbers post-it, and you should keep their number in your files too: (+352) 48 22 33.

Our taxi driver booked it to the ZithaKlinik and we checked in. In the US, prior to receiving medical treatment, it is typical that a patient must fill out several forms asking for insurance information (most people have private, non-government insurance in the US, so each patient has a different type and level of coverage), information about past medical problems, allergies, current medications, family medical history, etc. At ZithaKlinik, the reception desk asked only for my national social security card and a payment of 2,50€. That was it. No ridiculous paperwork. A nurse bandaged my hand and sent me to join Nick, who had already settled in the waiting room.

The waiting room was the strangest I had ever been in. It was eerily silent at first but that may have just been because Nick and I were new people who had just walked in; shortly after, the low murmurs among waiting patients and their families began to crescendo into full blown cheerful chatter so loud that at times it was difficult to hear the nurse calling for patients. An older couple that had arrived just before us ran into a good friend. Other patients exchanged notes in Luxembourgish or French about what ailed them and how long they had been waiting. The televisions silently broadcasted news headlines and a recent cycling competition. If the chairs had been a little more comfortable and if the wait hadn’t lasted so long, the experience would have almost been downright pleasant.

Five hours after arriving at the ER, a little before 3am, I was finally stitched up. (I thought I might only need one or two stitches, but I left with five!) The doctor was very apologetic about the wait when she arrived, telling me that it was uncommon for them to be so busy, and that the constant barrage of patients had lasted all day long.

A nurse bandaged my stitched up hand and scheduled an appointment for two weeks from now to have the stitches removed, then Nick and I were on our way to the taxi stand near the clinic to catch a cab home. I had received a bill – which was so much smaller than I anticipated – but I didn’t even have to pay that night; I am to transfer the money from our bank account as soon as I can, then send in proof of payment in order to get reimbursed by the government.

So, the April adventure continues. We have more friends arriving this weekend for Easter and for Easter Monday’s upcoming Emaschien celebration (blog recap forthcoming). The weather is supposed to be beautiful and Emaschien is a fun time, with the standard beer and sausage trucks (of course), so it will be a terrific weekend…as long as our friends don’t mind cooking their own Easter dinner on Sunday. I’m staying away from knives for a while.

Working the System
Just in case you need medical support while you’re living in Luxembourg, here are a few things to know:

Emergency numbers. Dial 112 for all medical emergencies (people and pets). Dial 113 for police. Dial 44 22 44 for the fire department. Click here for a more extensive list of emergency numbers, in addition to useful medical phrases in French.

Front of social security card.
Social Security Card. If you live here, you must have one of these in order to be treated. If you’ve recently relocated to Luxembourg, your relocation company or your employer should be able to tell you how to obtain one of these. Important to note: this card is good for medical treatment in Luxembourg and throughout the EU. Be sure to check the reverse side of your card, though, because there is an expiration date; if the card is “expired” you can still get treatment in Luxembourg but may not be able to while abroad in other EU countries.

Expiration date circled in yellow.
If your card is set to expire soon (which it probably is), you can easily request a new card (it’s free) by filling out the form at this link, which is in French but translates perfectly to English with the Google Translate toolbar application. Just enter your social security number and that’s it, they’ll mail you a new card within two weeks.

Doctor visits. In Luxembourg, the health plan allows you to see any doctor, dentist, or specialist. Just call and make an appointment. You will receive a bill from the doctor after your consultation and will probably be asked to pay on the spot; see “medical reimbursement” below for instructions on getting your refund.

The doctor you visit may or may not accept credit/debit cards, so have some cash on hand if you can, just in case. If you’re short on cash, though, I’m sure they will let you run to a cash machine or pay via bank transfer later.

English-speaking doctors. The American Embassy keeps a list of English-speaking doctors at this link. Note that this is not a referral or a recommendation of any doctor on the list, only a list of those that are known to the Embassy to speak English.

Prescriptions. You’ll need a prescription for pretty much any kind of drug, including things as benign as allergy medicine (for my fellow seasonal allergy sufferers). You can get this from any doctor and take the prescription to any pharmacy in the country to have filled. Prescriptions are already heavily subsidized by the government when you purchase them, so you will not need to submit for reimbursement for these.

24 hour care. There is always one hospital and one pharmacy available for 24 hour care. The emergency dispatcher at emergency number 112 will of course know where to take you; if you plan to drive or call a taxi, you can also find out what hospital is open for care by calling 112. All of the material I have indicates that this number is an emergency number and also a number to call for medical information (e.g. which veterinary hospital is open all night, what pharmacy is on call that night, etc.)

To see today’s list of pharmacies open overnight, follow this link. The list is updated daily and appears beneath a map that indicates where pharmacies are located. The page is in French but translates fast with the Google Translate toolbar.

Medical reimbursement. After you’ve paid for your doctor, hospital or clinic visit, just send a cover letter indicating your name, social security number and bank transfer information to the Caisse Nationale de la Santé (CNS) and they will process your reimbursement. It’s not a full reimbursement, but they cover a very large percentage. Just be sure to keep a backup copy of your receipts, just in case.

Not sure what to write in your cover letter? I created a downloadable template that you can use at this link.  To download, click “file” then “download as” and choose your preferred file type. Just replace the yellow highlighted text on this template with your own, print and send it in with your receipts attached. My version is in English and French (thanks, Google Translate!), which I included because the government officially recognizes only French and German – though I’m sure you’d be fine with an English-only cover letter. It’s only the receipts and your bank transfer information that they will really need in order to process payment. And they are fast; after submitting my first claim, the reimbursement appeared in our bank account less than two weeks later.

Your cover letter and receipts can be sent to the address below. And you don’t even need to use a postage stamp. Really, it’s true: you don’t need a stamp. I confirmed this with the post office twice before sending in my first claim in an unstamped envelope, and I received my reimbursement just fine.

L-2980 Luxembourg

Link Roundup
Colux Taxi  (in English)
Renewing your Luxembourg Social Security card (in French)
Emergency telephone directory from AngloInfo (in English)
English-speaking doctors from the US Embassy (in English)
Today’s 24 hour pharmacy, updated daily  (in French)


  1. I don't even send a cover letter to the CNS. I just put the receipts in an envelope (yes, no postage required). The receipt has the SS number of the family member, and, usually our address. CNS already has my banking details. About two weeks later, I get a notice that money has been (or soon will be) deposited into our account.

    Somewhere I also read that if you prefer, the money will be delivered to you in cash. I'm curious to see how that would work.

  2. Cash?! How funny. I wonder if you can also request to be reimbursed in small denominations? :)

  3. Very useful for English speaker!

  4. This comment has been removed by the author.

  5. Nice blog.Thanks for all the information.

  6. Thanks so much for this blog, really helpful!

  7. nice info about everything thanks, 2 months ago i had a toothache and my dentist was on vacation so i had to go to an emergency one , he drilled a hole to try to fill my tooth but said he couldnt do it as i needed a specialist and he made me a r.d.v with a dentist in esch for 2 mnths later , then i had to pay 78€ on the spot , ok i went to esch and she said its not worth doing its better i take it out so i ask her to do it as she had touched a nerve and i was in pain, she said she doesnt do that so i had to go back to the emergency dentist today, my taxi was late and i arrived 15 minutes late but i phoned them and told them i would be a bit late, he said i had to pay 25 € extra because i was late, i never had this before with anyone so can anyone tell me if this is the norm please .k.beech