Healthcare in Luxembourg: from the CAK's S1 to the CNS, and then 88 percent back

Luxembourg has one health fund, the Caisse nationale de santé, and a system Dutch people have to learn briefly: you pay the doctor, and the fund pays you.

Retired: the S1 route through the CAK

Luxembourg is on the list of treaty countries. If you have a Dutch statutory pension or benefit, you report to the CAK. You get an S1 form, and with that you're entitled to care in Luxembourg at the expense of the Netherlands.

For that you no longer pay a Dutch health premium but a treaty contribution, which in most cases is withheld automatically from your pension. Luxembourg charges you no premium of its own on top: you don't fall under the Luxembourg insurance but under the Dutch, and Luxembourg only provides the care.

Apply for the form well before your departure — count on six weeks — and only cancel your Dutch policy once it's settled. A gap between two systems is the most expensive thing that can happen to you in this journey.

Registering with the CNS

With your S1 you register with the CNS, by post or at the counter. The CNS registers your cover, reports it back to the Netherlands, and you get the Luxembourg social security card with your matricule — the number every doctor, pharmacy and the hospital asks for. From that moment your care is reimbursed at the same rates and conditions as for a Luxembourg insured person.

The form in your drawer is no insurance. Only after this registration are you known in the system.

Free choice, and 88 percent back

The Luxembourg system has no gatekeeper. You freely choose a doctor, and you may go straight to a specialist without first passing a GP. You pay the bill yourself and submit it to the CNS, which at a doctor reimburses 88 percent of the official tariff — 100 percent for children up to eighteen. The remaining 12 percent is your own share, plus anything a doctor charges above the tariff.

Whoever wants to avoid advancing the money looks for a doctor who takes part in paiement immédiat direct: then the CNS pays its share directly to the doctor and you pay only your own share. For a hospital stay of more than three days and for bills above a hundred euros the fund settles directly anyway.

What the system is, and what it isn't

Healthcare in Luxembourg is good and close by, with hospitals in the city, Esch and Ettelbruck, and many doctors who speak French, German and English — Dutch less so. Count on waiting times for specialists, and on an own share at every visit that you didn't know in the Netherlands.

If you work in Luxembourg: the route through the employer

Whoever takes up employment is affiliated to the CNS through the employer, with the Luxembourg premium, and gets the same card that way. Your Dutch insurance ends on the day your Luxembourg one begins, and the CAK doesn't come into it. Whoever is self-employed affiliates through the Centre commun de la sécurité sociale.

The deadline for early retirement

As expected, from 1 November 2026 only new applicants with AOW or a disability benefit will be admitted to the healthcare route for pensioners. Whoever leaves on early retirement without AOW then falls outside it and is dependent on a private policy or, when working, on the CNS through the employer.

Whoever is already a client keeps their rights. Whoever is on the edge has an interest in being registered before that date.