International considerations

International considerations in matters concerning long-term care insurance

Anyone who is covered by Luxembourg sickness insurance is also covered long-term care insurance. Remember that a person is considered dependent if they have a significant and regular need for assistance by another person to perform activities of daily living. The activities of daily living in question include bodily hygiene, elimination, nutrition, dressing and mobility. There must be a need for at least 3.5 hours of care a week in the areas mentioned above, and the state of dependency must be ongoing for at least 6 months or be irreversible.

Your rights

To apply for long-term care insurance benefits, an application form, along with an R20 medical report produced by your primary care physician, must be submitted. The form and medical report should be sent to the National Health Fund (Caisse nationale de santé).

Benefits in general

Benefits in kind

Benefits in kind are payable for care and assistance provided through a care and assistance network at the dependent person's home or in an inpatient setting in a care and assistance establishment (integrated centre, nursing home).

Cash benefits

Dependent persons receiving care and assistance at home may receive cash benefits in place of benefits in kind if they are assisted by a qualified caregiver. The maximum cash-benefit allocation is EUR 262.50 a week. The caregiver's pension contributions may be covered by the long-term care insurance provider if they are not covered by a personal pension scheme and provided the caregiver is registered with the Joint Social Security Centre (Centre commun de la sécurité sociale – CCSS).

Benefits at international level

Insured persons should bear in mind that:

• Only one country may provide their social security coverage (generally the country where they work and pay social security contributions).
• Only one country can be classed as the country of residence.
• These two countries may or may not be the same (see examples below).

Cash benefits are payable by the country that provides your social security coverage, and can be "exported" to another country in the European Union.

Benefits in kind are delivered by your country of residence based on the rules in force in that country.

Where long-term care insurance is concerned:

• Care and assistance for activities of daily living, delivered at home through a network of healthcare professionals, are benefits in kind.
• Care and assistance for activities of daily living, delivered in a care and assistance establishment – integrated centre for the elderly, retirement home, nursing home – through a network of healthcare professionals, are benefits in kind.

If you receive home care and/or assistance from a caregiver, your benefits in kind can be replaced by a cash benefit. In concrete terms, you will receive a certain sum of money to pay your caregiver.

The assistive technology/products and home/car adaptations referred to in the 'Amended Grand-Ducal regulation of 22 December 2006 establishing 1. the conditions and limits of long-term care insurance coverage for assistive technology; 2. the conditions and limits of long-term care insurance coverage for home adaptations; 3. the products required for the care and assistance' are benefits in kind.

If you are insured in Luxembourg and reside in another European Union Member State

• This is the case for cross-border workers who work in Luxembourg and live in another country in the European Union.
• This is the case of Luxembourg-insured retirees who go into a care and assistance establishment in another country in the European Union.

• In concrete terms, a cross-border worker who works in Luxembourg and lives in another country can receive a cash benefit from Luxembourg if care and assistance is provided by a caregiver at their home.
• In concrete terms, a Luxembourg-insured retiree who goes into a care and assistance establishment in another country in the European Union must contact the authorities in their place of residence abroad for coverage of their benefits in kind.

If you pay your contributions in Luxembourg and reside abroad

• In principle, your dependency status will be evaluated by the competent authorities in your country of residence.

If you are insured in another country in the European Union and reside in Luxembourg

• this is the case of persons who have never paid social security contributions in Luxembourg, and who are covered by the social security system in another country in the European Union, and who come to live in Luxembourg

In concrete terms, a person who is insured in another country in the European Union, and lives in Luxembourg, can receive benefits in kind from Luxembourg if they receive care and/or assistance at home through a care and assistance network, or if the care and/or assistance is provided in a care and assistance establishment.

CNS - Long-term care insurance department

For any information on benefits provided abroad, please contact the Long-term care insurance department (Département Assurance dépendance) of the National Health Fund (Caisse nationale de santé - CNS):

adetra.cns@secu.lu