*Update 03.03.2023 clarification of the changes announced for mid-February: all tests previously covered by «bons roses»[**]  are now to be done via the health screening programme in order to be reimbursed at 100%.*

We start with some context: the annual medical check-up, that obligation that is not generally enforced, is done by only around 1/3 of staff [1]. Why might this be? Well, cost is an issue: while the check-up itself and associated laboratory tests are normally reimbursed at 100%, anything stemming from that check-up (‘diagnostic examinations’ or ‘additional treatments’, for example) will be reimbursed in the normal way (85% up to set ceilings which may or may not correspond to reality, we hear you Luxembourg [2]). So, for those of you passing the test with no follow-up, well done! For anyone else, it is not uncommon to have additional tests and there is frequently some associated cost to the individual. This was always how the annual check-up worked.

Note: the annual check-up is still working time 

The annual check-up was always working time [3] and the new Working Time and Hybrid Working (WTHW) frequently asked questions (FAQs) confirm that this has not changed.

‘Only the annual medical visit, as foreseen under the staff regulations, is counted as working time.’ (FAQs, p. 17)

Note: complementary health insurance

The Joint Sickness Insurance Scheme (JSIS) now openly encourages colleagues to purchase complementary health insurance (to cover the 15% and other costs).

‘We also advise all JSIS members to opt for private complementary insurance to supplement the JSIS reimbursement in the event of major medical expenses (hospitalization, etc.).’ (JSIS, Practical information).

So what is new? More costs pushed to the individual

Now, unfortunately, for the long term, the annual medical check-up for the majority of Brussels-based colleagues will be done via the family doctor (general practitioner (GP)). While this was always an option for all colleagues on all sites, for most Brussels-based colleagues it is, from now on, the only means available.

‘The annual check-up takes place at the Medical Service in Brussels only for staff holding a post at risk: driver, security guard, crèche, garderie, kitchen staff, staff in delegations and returning from delegation, interpreters, printers.’ (Staff Matters, Annual check-up, Brussels)

When the Brussels medical service restarted annual check-ups in a limited way (exclusively for those in ‘high-risk’ professions) in August 2022 (post-Covid closure), it was almost inevitable that this limited service would be confirmed to be the standard going forward, that it  was unlikely to ever go back to normal.

As with many parts of ‘the new normal’, this pushes additional costs (time, money and admin) onto the individual, the doctor and our PMO colleagues such as:

• GPs charging for a double appointment when undertaking this task,
• Colleagues having to request and print forms, pay all costs up front and then upload all paperwork via check-up (not ‘standard reimbursement),
• PMO colleagues having to process and rectify an additional administrative load.

How to ensure you have the best chance of reimbursement

Brussels-based colleagues, to ensure that the visit is reimbursed as an annual check-up (100%) and not as a standard reimbursement (normally around 85%):

• Contact the medical service for the paperwork in advance, chose language, print forms and take them with you to your GP,
• Pay all bills as you would for any other GP visit,
• Submit the bills to the Joint Sickness Insurance Scheme (JSIS) using the correct section,
• Note that laboratory tests done as part of the annual medical visit are also to be reimbursed at 100% *but these may be done at the medical service, please confirm with them (thanks to the colleague who wrote to add this)*

Annual check-up figures in the future?

Given the additional costs of teleworking and the huge increase in utility bills, the obligation to do an annual check-up is one more (potential) cost and therefore one more reason to dissuade colleagues from doing it: is the figure of 1/3 of colleagues fulfilling this obligation likely to increase or decrease with this change?

Luxembourg, Ispra and the External Action Service (EEAS)

Luxembourg and Ispra: the annual check-up continues as before for the foreseeable future. Ispra sends out email invitations. Luxembourg will start to do this also soon, targeting staff by date of birth, with the youngest staff being invited last.

EEAS: the medical service appears to be overly focused on either setting colleagues up in delegation or on potential medical evacuation, we find nothing on MyIntracomm related to a general follow-up on staff health. The associated EEAS special-leave rules (to facilitate medical check-ups in the EU) adopted at the end of 2022 have not yet been put in place.

Note the change in invalidity documentation

On this topic, please also notice that the documentation concerning invalidity has also changed recently (November 2022). We take this opportunity to remind you of your rights concerning your medical file.

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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[*] Around €200 by Luxembourg January 2023 prices. The «bon rose» enables this to be reimbursed at 100% and not 85%.

[**] ‘A Bon Rose is an authorisation to perform an exam outside Tthe Medical Services and the exam will be reimbursed at 100%.’ (2011). Also called ‘pink forms’/’consultation form for a medical visit’.

[1] Stated at Central Staff Committee (CSC) 553 plenary Thursday 26.01.2023

[2] See the Caisse Nationale de Santé (CNS) hospital tariff list. An inter-institutional taskforce led by PMO to address hospital pricing in Luxembourg (not one of the 12 action items, but yes, a long-standing issue) was expected to present its first results by the end of 2022.

RCAM/JSIS members are charged more for services in Luxembourg than users of the national system. The overcharging was previously set at 15% but this was overturned in court, leaving the overcharged undefined. So far this has resulted in an increase in the administrative burden and uncertainty for colleagues undergoing non-emergency care since they must first request an estimate (yes, like for work on a car) and submit it to the JSIS who then decide whether the price is acceptable.

Please consult the Luxembourg CHL price list before paying any medical bill.  If you believe there may be overcharging involved, consult the PMO before paying the bill.

[3] ‘Only the annual medical visit as foreseen under the Staff Regulations and the preventive check-up by the PMO, assimilated to the annual medical visit, are considered as working time (record by choosing “work at the workplace” under PERIOD TYPE dropdown menu). (ATTENTION!! The other medical visits do not count as working time. Consequently, you should indicate the time you leave your workplace to attend such medical visits, and when you resume work, where necessary).’ Working time and time recording – Guidance for staff, 29 October 2019