Info flash Health Insurance Card and Reimbursement of Medical

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                                 Health Insurance Card and
                             Reimbursement of Medical Expenses
13-08                                                                                                     Brussels, 25 June 2008

At the meeting of the CCP on 19 and 20 June 2008, the PMO informed participants of the latest information
regarding the functioning of the JSIS.

   Despite the hopes raised among some people by                     the application… Only a few years after getting rid of
the PMO’s distribution of “membership cards”, these                  this on the basis that shortened payment periods
unfortunately do not amount to anything more than                    made it pointless! The PMO does in fact recognise
what already exists: simply a document confirming                    that processing periods, which are currently thought
that you are covered by the JSIS, nothing more nor                   to be only a week, vary considerably at different
less in fact than the proof you can get via the intranet.            times. But that hardly matters since, on average,
This card does not automatically take care of hospital               everything is fine…
expenses and doesn’t provide access to the “third                        And last but not least – the already optimum
party paying” system for pharmaceutical and other                    turnaround times should be further improved – a
expenses which operates in a number of Member                        contradiction surely? – once the IRIS encoding
States (in Belgium, for example). Furthermore, the                   system is in place: in fact, each of us will then have
card is only distributed to officials and those who                  to encode all the details of benefits on electronic
have retired; for agents under contract, the PMO has                 reimbursement application forms; a huge advantage
reservations regarding its possible use once cover                   according to the PMO, as each of us will immediately
ceases at the end of the contract and “is looking into               know whether or not a particular medicine is
solutions”.                                                          reimbursable and will be able to monitor the
   It seems that access to the European card poses                   processing of their applications on-line. It seems
major problems as the JSIS is not covered by the                     clear that the PMO has not weighed up the
Community legislation that provides for mutual                       advantages for colleagues of decoding medical
recognition between national health insurance                        prescriptions and carrying out on-screen encoding,
systems. And the PMO doesn’t exactly appear to be                    which is not among the priorities set out its by
working flat out to come up with alternative                         hierarchical superiors, nor the delays in payment and
solutions.                                                           inevitable problems due to processing errors. The
   And that is quite apart from the matter of care                   PMO claims that the work of the PMO’s contractual
insurance – an additional system of coverage that                    colleagues will be made that much more interesting.
some colleagues, and our pensioners in particular, are               However, we would like to wager that the intended
increasingly keen to see brought in; since this is not a             result is primarily to make savings on human
matter for the PMO but for ADMIN/C1, because of                      resources at the Office, even if this leads to an
the partitioning off between departments, the fact that              enormous squandering of resources throughout the
the matter is at a standstill hardly seems to matter!                whole of the Commission.
   As for the “missions” credit card, which was                          Once again, the president of the Staff Central
meant to be more widely available for the payment of                 Committee has kept on good terms with the hierarchy
medical expenses, the PMO has decided not to issue                   by allowing PMO officials to come and show us how
these any more for another reason: because the card                  efficient they are and how we are wrong to complain.
doesn’t allow you to pay for medical consultations                   And once more, our requests for more detailed
and would lead to “uncontrollable” withdrawals of                    information have allowed us to reveal the
cash. The PMO also believes that the current                         contradictions in the information supplied and to
reimbursement periods are sufficiently short to render               check whether the PMO is perhaps doing all it can,
the credit card system superfluous.                                  but the situation is not ideal as far as our demands are
   According to non-official information, it would in                concerned.
fact seem that the system is considered too costly…                  We can only regret the lack of fighting spirit shown
and the Brussels doctors’ lobby would be against it.                 by the present CCP and commit ourselves to fighting
   So the PMO is going back to the good old system                   for improvement at trade union level.
of priority reimbursement applications where
expenses exceed €500 in the fifteen days preceding
                                                                                                    The Executive Committee


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