General information about FHL
The Luxembourg Hospital Federation (FHL) is the association that represents hospitals, clinics, and certain long-term care establishments.
The FHL has concluded an administrative arrangement with the PMO to simplify the procedures for obtaining automatic coverage of medical expenses by thefor healthcare services provided in one of these establishments.
People covered by the JSIS (members and primary insured dependents) can generate a specific JSIS coverage certificate to use for hospital stays, childbirth, or major outpatient treatments provided by certain FHL member establishments.
Using this certificate, invoices for these hospital services are sent directly to the PMO for payment from the JSIS budget. You will then receive a statement showing any amount you may still need to pay, along with a copy of the invoice.
The following national hospitals and centres are covered by the direct billing arrangement (invoices are sent directly to the PMO):
- CHL – Centre Hospitalier de Luxembourg
- CHEM – Centre Hospitalier Emile Mayrisch
- CHDN – Centre Hospitalier du Nord
- HRS – Hôpitaux Robert Schuman, including:
- Centre hospitalier du Kirchberg
- Clinique privée du Docteur Bohler
- ZithaKlinik
- Centre François Baclesse
- INCCI – Institut National de Chirurgie Cardiaque et de Cardiologie Interventionnelle
Hospitals and centres not included
The following centres and establishments are not covered by the direct billing arrangement:
- REHAZENTER – Centre de rééducation et de réadaptation
- Centre hospitalier neuropsychiatrique
- Therapeutic centres in Useldange, Manternach, and Diekirch
- CHNP – Centre Pontalize
- Nursing home of the Intercommunal Hospital of Steinfort
- Rehabilitation Centre of Château de Colpach
Eligibility and exclusions
All people insured by the JSIS who go to a hospital that is a member of the FHL (listed above) for:
- a hospital stay,
- childbirth, or
- major outpatient treatment.
This includes:
- JSIS members, and
- persons insured primarily by the JSIS,
You do not need to live in Luxembourg to benefit from this arrangement.
Dependent family members who are already covered by another social security or health insurance scheme (for example, Luxembourg’s CNS or the health insurance of another EU Member State) are excluded. This also includes family members covered by the JSIS as a complementary insurance.
In these cases, the usual complementary reimbursement procedure applies:
- you must pay the invoices yourself, and
- submit a reimbursement request to the JSIS via MyPMO or JSIS Online.
No. Direct billing does not apply to standard outpatient treatments.
It does apply to:
- major outpatient treatments (such as dialysis or chemotherapy),
- day hospitalisations or outpatient procedures involving invasive and/or costly examinations (such as a colonoscopy), and
- outpatient pre-hospitalisation examinations.
Most services provided by FHL hospitals correspond to treatments that can be reimbursed by the JSIS. However, some differences exist, and certain treatments require prior authorisation. A list of treatments requiring prior authorisation is available via the relevant JSIS link : https://ec.europa.eu/assets/pmo/prestation_AP.pdf
The following services are not covered by direct billing:
- Any treatment related to orthodontics, periodontics, dental implants, or dental prostheses
- Medically assisted reproduction (e.g. insemination, fertilisation, embryo reception)
- Any surgical procedure related to gender reassignment
- Hospitalisation in psychiatric care units (except in emergencies)
- Any cosmetic or aesthetic plastic surgery
For some of these services, this does not mean that direct billing by the JSIS is impossible. However, you must follow the standard direct billing procedure by submitting a request to the JSIS (via MyPMO or JSIS Online), as your case must be assessed in advance.
How it works and how to use direct billing ?
Before going to an FHL member hospital for a hospital stay or major outpatient treatment, you must generate a JSIS coverage certificate via MyPMO or JSIS Online.
When generating the certificate:
select the hospital where your hospitalisation will take place;
print the certificate;
give it to the hospital (admissions department).
At this stage, the certificate must be printed and handed over in paper form. In the future, the process will become fully electronic. The FAQs will be updated accordingly.
Please make sure you choose the correct certificate template.
The invoice for the care provided by the hospital will then be sent directly to the PMO.
You will not need to pay a deposit or pay the hospital invoice yourself.
If you prefer to pay your hospital invoice yourself and then request reimbursement from the JSIS, simply do not generate the JSIS coverage certificate.
In that case:
the hospital will send the invoices directly to you;
you must pay them;
you then submit a standard reimbursement request via MyPMO or JSIS Online.
If required, make sure you follow the usual prior-authorisation procedures.
Invoices are sent directly to the PMO for payment from the JSIS budget.
At present, invoices are sent in paper form. Technical developments are underway and will soon allow electronic transmission of invoices.
Based on the invoices received, the PMO:
calculates the eligible amounts for each service, and
determines the amount reimbursable by the JSIS.
Any amount remaining at your expense will be shown on the statement you receive.
This outstanding amount will be offset against:
future JSIS reimbursements, or
your salary, allowance, or pension.
You will receive a copy of the invoices with your statement, and you will also be able to view them in MyPMO and JSIS Online.
Information about the JSIS coverage certificate
The certificate can be used by:
- JSIS members, and
- persons insured primarily by the JSIS,
provided that their primary JSIS coverage:
- is open-ended, or
- has an end date that is at least three months away.
You can generate the JSIS coverage certificate via MyPMO or JSIS Online.
Steps to follow:
- Select the person for whom you want to use the certificate (yourself or a dependent family member insured primarily by the JSIS).
- Choose the language.
- Select the hospital where the hospitalisation will take place from the drop-down list.
- Print the certificate and give it to the hospital’s admissions department when you register.
In the near future, it will be possible to send the certificate directly to the hospital from MyPMO or JSIS Online. The FAQs will be updated as soon as this option becomes available.
Please contact us via the Staff Centre Portal or by calling the PMO single number +32 2 29 11111 to request standard direct billing.
- The cover page contains identification details of the JSIS member and, where applicable, of the person insured primarily. These details vary depending on the user.
- The following pages contain general information and are identical for all certificates.
Page 2 is addressed to hospitals and recalls the key elements of the administrative arrangement, including the list of services excluded from direct billing.
The next page contains useful information for the certificate holder. You are strongly advised to read it carefully, especially before using the certificate for the first time.
If you still have questions about the certificate or how to use it, you can contact the Settlements Office via the Staff Centre Portal.
The hospital must be sure that you are still covered by the JSIS and that the invoice will be paid.
- If you already have a certificate that is still valid, you may reuse it.
- If it has expired, you must generate and print a new one.
Please note that a certificate is valid only for the hospital selected in the drop-down menu.
If you are hospitalised in another FHL member hospital, you must generate a new certificate for that hospital.
The data shown on the cover page are the identification details of the JSIS member and, where applicable, of a dependent family member insured primarily.
You generate the certificate yourself and provide it to the hospital of your choice. By doing so, you consent to the hospital sending invoices for the care provided directly to the PMO.
Before sending the certificate, you must give your consent in MyPMO or JSIS Online.
If needed, the hospital may contact the PMO with questions about the certificate. In that case, the PMO may confirm personal data and/or the validity date shown on the certificate.
Your medical data are managed exclusively by the hospital and healthcare providers.
The PMO may see certain medical information only for the purpose of processing the reimbursement. The PMO receives only the hospital invoice; no medical report is sent by the hospital.
In specific cases, the JSIS may ask you to provide a copy of a medical report.
For more information on how your personal data are processed and protected by the PMO, how they are used, and which rights you can exercise, please consult the privacy statement.
Why choose direct billing?
Direct billing was introduced as a simplification for JSIS members and is a first step towards better management of medical expenses in Luxembourg.
With direct billing:
- you do not have to pay hospital or treatment costs in advance,
- you do not need to request direct billing letter, and
- you are exempt from providing a cost estimate (quote) for Luxembourg hospitals covered by these agreements.
Before sending your certificate:
- make sure the treatment you need is not on the list of services requiring prior authorisation or on the list of excluded services;
- if required, submit a prior-authorisation request to the JSIS via MyPMO or JSIS Online;
- check that the hospital is an FHL member and is included in the list of hospitals covered by the administrative arrangement.
No. Cost estimates are no longer required for Luxembourg hospitals covered by these agreements.
Only the certificate must be provided to the hospital.
Special cases and specific conditions
For major and repeated outpatient treatments (such as chemotherapy, radiotherapy, or dialysis), the certificate is valid for the duration of the treatment, but:
- not beyond the insured person’s JSIS coverage end date, and
- not longer than one year.
For lifelong or multi-year treatments, a new certificate must be provided to the hospital at the beginning of each year.
- Generate your coverage certificate
You generate the certificate that gives access to direct billing, print it, and give it to the admissions department of the hospital of your choice.
- Check whether prior authorisation is required
You check whether your hospitalisation or treatment requires prior authorisation.
If so, you submit a prior-authorisation request to the JSIS following the usual procedure.
- The hospital sends the invoice directly to the JSIS
The hospital sends the invoice directly to the JSIS, which pays the full amount directly to the hospital.
- The invoice is processed and your statement is issued
The JSIS processes the invoice according to the usual procedures.
You will receive a statement showing:- the amount reimbursed,
- the amount, if any, that remains at your charge , and
- a copy of the invoice.
- Any amount due is recovered automatically
Any amount that remains at your charge will be recovered from:- future JSIS reimbursements, or
- your salary, pension, or allowance.
If you do not have access to MyPMO or JSIS Online, you can contact us to obtain a copy of the invoice.
In the event of an emergency hospitalisation, please contact us as soon as you can , so that the JSIS can send a standard direct billing letter to the hospital.
A hospital may refuse to accept the JSIS coverage certificate for direct billing after checking the information shown on the certificate.
In particular, the hospital may:
- check the validity date of the certificate, and
- refuse direct billing if the certificate has expired or is close to its expiry date.
If you believe that the hospital has wrongly refused your certificate, please contact the PMO. The PMO will check your file and assist you with the necessary steps, if needed.
If you receive an invoice directly from a doctor, you must:
- pay the invoice yourself, and
- then submit it to the JSIS via a standard reimbursement request.
This is because, in some hospitals, doctors bill their fees directly rather than through the hospital. In such cases, the doctor may not have been aware that automatic coverage or direct billing was in place.