While Luxembourg ensures basic protection through its public health service, numerous private insurance products are available for people looking for more comprehensive coverage. But how to treat virus patients presents new challenges for the insurance sector.

“People who are infected or who have tested positive for covid within the last three months cannot immediately take out a contract,” said Franck Marchand, chief operating officer at insurance company Foyer.

Following this three-month period, “an analysis will be made with our appointed doctor/advisor on a case-by-case basis, in order to analyse whether a private insurance company is able to cover these costs,” the COO said.

This could present an additional burden for people who suffered severe symptoms and lasting damage, for example to their lungs, or are among the so-called long haulers, who experience side effects for months after their infection.

“There exists a risk that exclusions or an additional premium may be applied at the time,” said Franck. “It is really better to take out insurance before getting ill,” he said.

Estimates on the number of patients experiencing long term symptoms vary widely. A study by King’s College London using data from 4,182 users of an app to track their infection symptoms found that 5% experienced side effects for more than eight weeks.

With Luxembourg having reported 47,149 cases of coronavirus since the start of the pandemic as of 5 January, this would translate into hundreds of people affected by long term illness.

DKV, which provides health insurance products for Lalux, also said it was treating insurance requests by former covid-19 patients on a case-by-case basis, although it said it does not “in general” refuse them.

“All insurers are currently updating their database in order to get a better understanding of the coronavirus related risks,” a spokeswoman told Delano. “There are no general guidelines/parameters how to evaluate this risk.”

The Luxembourg Insurance and Reinsurance Association (ACA) commented that it “does not cover medical insurance acceptance criteria and thus has no position or guidance in this matter.”

The World Health Organization estimates that around 5% of coronavirus patients become critically ill, with 10 to 15% of cases progressing to severe disease. And while people typically recover within two to six weeks, even people with mild symptoms may suffer much longer.

Persisting symptoms include fatigue, shortness of breath, loss of taste or smell, headaches and body aches, nausea and confusion, WHO said in a September 2020 coronavirus update based on a US study tracking the progress of the disease in 274 adults.

A study by the Chinese University of Hong Kong on the long-term effects of another type of coronavirus, which caused the 2003 outbreak of severe acute respiratory syndrome (SARS), found that 40% of those diagnosed still suffered chronic fatigue symptoms three and a half years after first being diagnosed.

The CMCM, a Luxembourg mutual health fund, does not exclude members for pre-existing conditions and doesn’t require applicants to fill out a medical survey. “Just as with all other diseases, we do not exclude anyone,” a spokesman said by email.

For patients hospitalised with covid-19, the CMCM decided to waive a three-month waiting period normally in place for new members to begin benefitting from their health plans.