*Update 15.02.2025 here’s the January 2025 response we’ve received to our September 2024 note on this topic.*

Original article: We’re all well used to jumping through administrative hoops within the institutions. When hoop-jumping becomes an Olympic sport we fully expect the Commission to be on the podium. In the meantime, we have observed that the hoops related to the new health screening programme appear to have been made just a little more difficult than necessary. In the ‘new normal’ the annual medical has been deconstructed and redistributed with many tests ending up within optional health screening.  As with all such changes, this adds a little to everyone’s life admin and puts additional costs onto the individual.  Those costs are not just financial, there are learning costs, compliance costs and psychological costs.  

We’re wondering to what extent savings are (again) being made at the expense of the individuals concerned: are colleagues missing out on what they’re entitled to? 

Generation 2004  is aware of a number of colleagues who have found themselves out of pocket with the Health screening programme. We have asked PMO to clarify the flexibility available in the system and share the figures in order to make the process more transparent and less disconcerting all round. 

• ‘A single reimbursement request must be made per programme, once all tests and payments have been made’ (Health screening programme Screening Reimbursement>4. Specific rules for requesting reimbursement) 

The instructions above make no mention of the real-world and not-infrequent situation where additional bills are received unexpectedly and long after the others. This risks leaving colleagues with an 80% reimbursement of an intervention instead of a full reimbursement, which they are entitled to. Given that the final (or even estimated) number of bills will never be announced for any intervention, it is almost never possible to know whether this last bill is indeed the last one.  

• ‘Only health expenses incurred up to 18 months prior to the date of your claim can be reimbursed.’ (Reimbursement online) 

The screening invitation has a maximum duration of 18 months, bills can take some time to arrive and as per 1, above, they are to be submitted together. Are screening-related bills subject to the same 18-month limit as JSIS reimbursements? If a colleague has started but not completed the programme at 18 months do they submit a partial claim for reimbursement with a subsequent partial claim for remaining bills?  

• ‘If the deadline for your invitation has expired and you have not yet started your programme, it is possible to change the validity date by contacting the screening team.‘ (Health screening programme A. Request a letter of invitation>A. Request a letter of invitation) 

If a colleague has started but not completed the programme at 18 months what happens? e.g. in Luxembourg there is a known shortage in gynaecological health provision leading to significant delays (sometimes over a year). Please share how this works and the legal basis for any restrictions. Would it be better for colleagues who opt for a letter of invitation without direct billing – non-approved centre to schedule the tests first and only then request the screening invitation as the date of the first intervention approaches? If so, can this please be stated on the MyIntracomm site? 

• ‘Please note that the reimbursement of pharmaceutical products purchased in preparation for a test is subject to the rules on normal reimbursement and these are not reimbursed through the screening programme’ (Health screening programme Screening Reimbursement>4. Specific rules for requesting reimbursement) 

We’d like to know the reasoning behind this choice: is there an option to do these tests without the preparatory pharmaceutical products? Would it be possible to share a list of typical products and their costs? There is no corresponding list available in PMO.3 General Implementing Provisions for the reimbursement of medical expenses and the codes. 

A practical issue: submitting bills twice
If you have the misfortune to have a bill listing some items which are reimbursed at 100% and some which are reimbursed at the standard 80-85% then in the best-case scenario you will have to submit that bill twice, add an explanation on the second submission and hope for the best. We recommend you submit it for 100% reimbursement first. In many other scenarios you will also have to check out what is included in each grouping of tests listed on the invoice and try your best to make those correspond to the prescription and hope for the best. 

And just in case you missed it: working time or not?
While the annual medical is fully work time, the screening programmes can officially only count as 4 hours, no matter how long they take. 

We’ve asked PMO to share the average times for the 6 screening programmes i.e. from attending the first intervention to receiving the reimbursement. We’ve stated there that it would also be useful to see even a rough average of costs and reimbursements for the programmes: seeing the available options and their financial repercussions is key to make informed decisions on whether, when and how to participate in screening. 

We suggest that removing fears of an artificially restrictive and unnecessarily costly process could improve participation, leading to better health outcomes for all. 

As always, we would love to hear from you. Please do not hesitate to get in touch with us or leave a comment below. 

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