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Coordinating social security systems for cross-border workers and their families

Marine Yeral works as Policy Officer “civil society and health” at EGTC Alzette-Belval.

The cross-border structure covers a territory of 13 municipalities, including more than 100,000 residents from France and Luxembourg.

Our objective is to develop a cross-border conurbation based on the principle of sustainable development and living together. The EGTC has a multi-year strategy that gives a roadmap in a number of areas, including health, spatial planning, living together, education and the environment”, says Marine.

That's on the health sector that Marine and her colleagues opted to concentrate when requesting help from b-solutions on three different cases.

“Our participation in the b-solutions process fits perfectly with the dynamics of the strategy of the EGTC Alzette Belval, which aims to provide healthcare on both sides of the border, regardless of the place of employment or of residence, and to develop a barrier-free healthcare pathway”, she explains.

One of the cases concerns the lack of coordination between the French and Luxembourg social security systems which causes difficulties in terms of reimbursement or insurance coverage for cross-border workers and their families.

For example, a family living in France may face issues obtaining insurance for their child if only one of the parents works in Luxembourg and thus contributes to the Luxembourg health insurance agency. Another example is the lower reimbursement rate of pensioners living in France but who have worked in Luxembourg throughout their lives and seek medical treatment there.

b-solutions’ expert Jean-François Devemy listed some possible remedies to these challenges, like creating bilateral agreements that would modify the laws to reflect the territory's cross-border nature or providing greater compensation by the French government for its workers in the border region. Establishing a cross-border healthcare center at the border where national laws from both nations might be applied on demand is another possible approach.

The discussions with the expert went very well and the issue was well understood. This means that we now have "workable" proposed solutions for the future”, says Marine.

Participating in the b-solutions initiative has enabled us to take a proactive approach to finding solutions to the problems encountered. It is not possible to build a cross-border conurbation with a "two-speed" health system, and the solutions proposed provide various approaches for a health system that reflects the reality of this cross-border living area”, she adds.

Looking to what is left to do, Marine is optimistic: “EGTC Alzette Belval has the advantage of already having a cross-border governance on its territory, which enables to set up cross-border experiments in order to check whether the proposed solutions are feasible. The solutions described in the case will be presented to the competent authorities, which will implement them as far as possible”.


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