Reimbursement of the annual medical check-up during COVID

Under Article 59(6) of the Staff Regulations, staff are obliged to undergo a medical check-up every year either via the institution’s medical officer or by a medical practitioner chosen by them.

Due to the COVID-19 pandemic, the medical service is closed for annual medicals for the foreseeable future, as is the in-house laboratory [1], so colleagues are left with no choice but to do their annual medical examination outside and then be reimbursed according to the standard Joint Sickness Insurance Scheme (JSIS) reimbursement rate of 85% [2].

We asked PMO for clarification and they confirmed ‘that JSIS can reimburse medical exams at [a] rate [other] than 85% only in a limited number of situations (for instance serious illness or check-up under the specific programmes of the JSIS, etc.).’

We fail to understand why the annual medical visit at the medical service is free of charge but when staff are forced to go to an external laboratory to do the obligatory annual medical check-up they are reimbursed at the rate of only 85% and up to a fixed ceiling we already know to be below the real cost.

This additional expenditure and admin for staff arranging their own annual medical check-up might dissuade them from doing so (or this item might simply fall off the never-ending to-do list). Will missed annual medicals result in future in JSIS refusals to reimburse treatments for illnesses which, had they been discovered earlier, would have been easier (and cheaper) to treat?

We belive that the institions should cover 100% of the cost incured and where you have received less please contact us: we can help you lodge an Article 90 complaint.

Please do not hesitate to contact us to share your experience of this workaround system.

[1] The annual medical check-up – Is it the same this year? 10.02.2021

[2] Administrative Notice N° 46-2014 (09.12.2014) states that ‘Reimbursement of fees for a consultation with a doctor as part of the annual medical visit … will be covered by the PMO. The principle of a free annual medical visit is, of course, maintained (i.e. 100% of expenses will be reimbursed)’ but note footnote 1: ‘… the reimbursement for this examination remains limited to the set ceiling.’ That ceiling is often well below the real cost (particularly in Luxembourg: see point 8.4 (French only)).

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