Your browser version is outdated. We recommend that you update your browser to the latest version.

The benefits of the CGP


 

Toutes les prestations et cotisations dans ce site sont calculées sur base du nombre indice 775,17 du coût de la vie en vigueur depuis le 1er octobre 2013

En cas de contestation, font seuls foi les textes statutaires, réglementaires et conventionnels relatifs à la CGP publiés au Mémorial officiel.

For further informations please visit HOMEPAGEFR

The CAISSE GÉNÉRALE DE PRÉVOYANCE (CGP) is a complementary health care insurance company

which was created on February 8, 1880. Recognized by the State, it operates under the Luxembourg Government's control.

Founded in 1880 the CGP has maintained a first-class service to its members, always trying to meet the requirements of a changing world. Since January 1st, 2017, the CGP has more than 42.300 affiliated members.

The CGP can offer you:

  • a lot of advantages, besides death benefits;
  • its Local Assistance fund, whose task is to grant:
    • sickness benefits,
    • maternity benefits,
    • allowance to ambulance transport and reimbursement of such costs.

As the CAISSE GÉNÉRALE DE PRÉVOYANCE (CGP) is affiliated to the Fédération Nationale de la Mutualité Luxembourgeoise FNML (Luxembourg National Health Care Benefits Federation), its members may register as well to the CAISSE MEDICO-COMPLEMENTAIRE MUTUALISTE (CMCM) (Medical and surgical benefits society), which is a complementary fund, offering additional benefits to those provided by the compulsory sickness benefit funds:

  • assistance for hospital stays due to sickness or surgical operations, whether in the Grand Duchy of Luxembourg or abroad,
  • dental treatment (dentistry and dental prostheses),
  • additional hospital and medical costs for patients staying in hospital in a single room (first class) with the special PRESTAPLUS plan,
  • CMCM-ASSISTANCE abroad, in case of:
    • emergency treatment needed requiring a stay in hospital, or of the death of a CMCM member,
    • by covering, along with other services, the repatriation costs of the sick person or the deceased member.

In the case of dispute, the statutory, regulatory texts and agreements published in the «Mémorial», are the only accepted evidence. 




DEATH INDEMNITIES

In the case of death, the CGP's purpose is to grant to all its current members a death indemnity, which ranges between 115,27 € and 2.305,36 € (14,87 € to 297,40 € at index value 100), according to the subscription amount chosen and the membership age.

Death indemnities are adapted to living index value, as defined by the relevant and current legislation.

The death indemnities are increased in favor of those members who have been affiliated for a long period.

In the case of a fatal accident, the full amount of the death indemnity is paid out, without any waiting period.



Membership with the CGP is on a personal affiliation basis, which means that the spouse or legal partner is not automatically affiliated, even though they may possibly benefit from death indemnities of the main affiliate. Therefore, a spouse or legal partner not affiliated with the CGP will not benefit from the very attractive CGP’s Assistance fund. Do not forget to subscribe to a complementary insurance for your spouse or your legal partner!

Plan ahead: Register to a complementary insurance for your spouse or legal partner! By doing so, they may also benefit not only from the death indemnity, but also the CGP Assistance fund. A membership form is available at the Caisse Générale de Prévoyance's secretariat.


To be entitled to the benefits from the Assistance fund, members have to be affiliated for at least three years with the CGP.  Affiliation to this Assistance fund is compulsory for all current and honorary members. The annual contribution, paid together with the subscription amounts to 5,27 € (0,68 € at index value 100) by member.

THE CGP ASSISTANCE FUND

(Please refer to Article 35 of the Articles)

To guarantee payment of benefits, a statutory reserve has been set up which will not be less than half of the annual average (yearly benefits of the last five financial years preceding the current year).

Resigning or delisted members are no longer entitled to benefits. 

All request for reimbursement should be sent to the CGP's secretariat at the latest by May 31th, the following year. 

Those entitled to

SICKNESS BENEFIT

are current and honorary members, as well as legitimate, legitimated, natural and adopted children, under the condition that they are covered by a coinsurance through their father or mother at an official sickness insurance fund.

The fund benefits consist of partial reimbursement of the difference between health charges paid out in advance by the affiliate during a financial year, as a result of the difference between the total costs due and those met by the legal sickness insurance.

Subject to paragraphs 3 to 5 of article 36, the reimbursement amounts to 25% of the difference between the total costs due in 2016 and the reimbursement from the sickness insurance fund, with a minimum of 348,83 € (45 € at index value 100) and a maximum of 9.689,63 € (1.250 € at index value 100) per member. The same lower limit is applied when two spouses or partners are simultaneously affiliated in the sense of the law of July 9th, 2004 relative to the legal impact of certain partnerships.

Requests to get sickness benefit for charges not covered during a financial year should be sent to the CGP's secretariat at the latest by May 31, the following year. Reimbursement statements from the legal sickness insurance fund, as well as the receipts from the pharmacy and from other medical expenses need to be attached.

Supporting documents considered, are healthcare invoices that have already been accepted by the legal sickness insurance funds. Invoices incurred abroad will be treated in accordance with Luxembourg tariffs.



MATERNITY BENEFIT

Maternity benefit is paid out for each child, per affiliated member or parent. Prior to having the right to claim this benefit, members need to have been affiliated with the CGP for at least three years.

In case of multiple births, the benefit is paid out for each child. The same amount is paid for the birth of a natural child, an adopted child under 4 years old or a stillborn child. 

Maternity benefit is calculated, in accordance with the index value, as defined by the legislation pertaining to it, and effective on October 1st, of the year preceding the birth of the child. So the benefit amounts to 232,55 € (30 € at index value 100) for each child born in 2016, per affiliated member or parent. This amount is the same for children born in 2017.

Maternity benefit is paid out upon presentation of a birth certificate, respectively a child's death certificate. For an adoption a new birth certificate may be provided. 

The delay of foreclosure,  beyond which affiliates or their entitled are no longer permitted to assert their rights to the statutory benefits, is set to 3 years, counting from the birth date, the presentation of a death certificate, or the judgment date for an adoption.

Those entitled to

ASSISTANCE WITH AMBULANCE TRANSPORT COSTS

 (art. 38 of the statutes) are:

  • actual and honorary members;
  • children belonging to the affiliate's household and for which legal statutory family benefits are paid out.

Ambulance transport costs inside and outside the country, according to the form B6 and codes "Travel and transport benefits" in the Union des Caisses de Maladie (Legal Sickness Benefit Fund Union) statutes and listed respectively in annexes I and II of the Caisse Générale de Prévoyance statutes.

Subject to the application of the appropriate clauses below, participation in ambulance transport costs amount to the difference between the rates foreseen in sub 2 before and the benefit coming from the legal sickness insurance and, the case being, from the Caisse Médico-Complémentaire Mutualiste (CMCM).

Further to the above, the maximum benefit amount is calculated as follows:

  • the amount of legal sickness benefit insurance to be reimbursed is defined by the rates or codes appearing in annex I,  “ambulance transport within the country”;
  • the amount of the legal sickness benefit insurance and that of the CMCM to be reimbursed are taken from the rates or codes appearing in annex II, "ambulance transport abroad".
  • However, the total amount of benefit cannot exceed the sum of 500 € (fixed amount) per beneficiary and per calendar year.

Furthermore, the benefit cannot, in any case, exceed the amount remaining to be paid by the eligible person, after the sickness benefit insurance and/or the CMCM's contribution.

To be entitled to the benefit, the following supporting documents need to be handed in:

  • request for reimbursement, available for claimants through the CGP's secretariat;
  • original invoices from the ambulance transport company for the expenses exceeding the amount covered by the sickness insurance, respectively, copies of the invoices for expenses already paid by the insurance holder;
  • the reimbursement statements from the legal sickness insurance.

As supporting documents are considered the invoices relating to the aforementioned transport, as long as this transport has been covered by the legal sickness insurance.

If during the course of the year, the legal sickness insurance modifies any clauses relating to the ambulance transport, the Caisse Générale de Prévoyance governing board can step in and support.

Transport by air and taxi-ambulances are not covered by the Caisse Générale de Prévoyance's emergency insurance fund.

All requests to obtain reimbursement of ambulance transport expenses, concerning the expenses not covered during a particular financial year, should be sent to the CGP's secretariat at the latest by May 31, the following year.

TO BECOME A MEMBER OF THE CGP AND THE CMCM

... only fill in a membership form, and send it to the the CGP secretariat, who remains at your disposal for any further information:

Secretariat: 51 rue de Strasbourg à L-2561 Luxembourg (1st floor, Tel.: 47 45 93)