In Delegations, expatriate contracts are offered health coverage through the Joint Sickness Insurance (JSIS). While the coverage for most health costs under JSIS is generous in comparison to national schemes it can look a little like a Swiss cheese at times. JSIS does not always cover all costs incurred and there are various reasons for this.
Article written by Michael Steffens
This article deals exclusively with this phenomenon that expatriate colleagues know very well and it explains how you can avoid additional costs.
There are various reasons why you may pay out of your own pocket. First of all, JSIS reimbursements are linked to the General Implementing Provisions for the Reimbursement of Medical Expenses, which lay down the ceiling for each type of treatment or analysis. The normal reimbursement rate under the scheme covers 85% of the invoices. If you are based in Brussels or you have dependents that are not with you at your place of work outside the EU, you will already be aware of this since each account sheet will make this clear. Luckily, in Delegations JSIS is complemented with an additional cover. This usually allows for reimbursements of up to 100%.
In Delegations, expatriate contracts are offered health coverage through the Joint Sickness Insurance (JSIS). While the coverage for most health costs under JSIS is generous in comparison to national schemes it can look a little like a Swiss cheese at times. JSIS does not always cover all costs incurred and there are various reasons for this. This article deals exclusively with this phenomenon that expatriate colleagues know very well and it explains how you can avoid additional costs. There are various reasons why you may pay out of your own pocket. First of all, JSIS reimbursements are linked to the General Implementing Provisions for the Reimbursement of Medical Expenses, which lay down the ceiling for each type of treatment or analysis. The normal reimbursement rate under the scheme covers 85% of the invoices. If you are based in Brussels or you have dependents that are not with you at your place of work outside the EU, you will already be aware of this since each account sheet will make this clear. Luckily, in Delegations JSIS is complemented with an additional cover. This usually allows for reimbursements of up to 100%. Still, most of you may have had occasions in which some costs were not reimbursed, e.g. if the treatment costs exceeded the ceiling. Depending on where you received the treatment or the practitioner you visited, this may weigh differently on your finances. However, less known by many colleagues but more important is the fact that ceilings exist also for surgical procedures or more costly treatments. Other examples are dental work, implants or dental surgeries, where costs often exceed the reimbursement as well. So, you might receive a telephone call while being on mission in Afghanistan. Your daughter is lying in the back of the car with a rather painful infection of the appendix and your partner is on the way with her to the hospital. Anyway, to cut a long long story short, the appendix may need to be surgically removed and a rather heavy bill close to 3.000 Euros at your expense will follow. This may sound surprising to you but this could happen to any of us. JSIS offers reasonable coverage. However, it has some gaps that are hard to close without purchasing additional health insurance coverage. Hospitalisation coverage++ One solution could be to take out a complementary insurance with Afiliatys.eu, which has negotiated for a long time now supplementary health insurance covers to the JSIS with larger insurance companies. AFILIATYS is a non-profit organization under Belgian law, which has more than 37.000 members belonging to EU the Institutions together with EU agencies and European offices, the diplomatic and consular corps of the Member States, international organizations and the European Schools. The HospiSafe Sickness and Accident coverage offers ease of mind in terms of covering you and your loved ones in case of a hospitalisation. This coverage is available at two different levels and it will pay out support in case of hospitalisation following an illness or an accident (depending on the options chosen). While this is relatively affordable, it is limited to all cases involving hospitalisation. Well, a number of expensive procedures fall into this category incl. surgery or other hospital treatments. You may want to choose this if you do not want to invest an excessive amount of money. At the same time, you would like to have ease of mind. Coverage for a family of four can be bought for less than 500 EUR per year. In comparison to the potential cost of hospitalisation this might actually be worthwhile. The benefits of the HospiSafe scheme are explained in detail in the benefits guide. The HospiSafe Plus coverage adds to this a number of other health treatments including consultations and dental work, but is also significantly more expensive. In case of retirement In case you are about to retire it makes sense to consult the Afiliatys website well in advance (minimum 6 months before retirement) to ensure you can benefit. Contact us anytime While this USHU newsletter focusses on how to cope with extra medical costs, USHU has expertise in many questions linked to health insurance and we are more than happy to assist you with any queries you might have. Insurances in your national system If you decide for an insurance of any type in your country of origin it is advisable to be upfront with them and to check the insurance conditions to ensure you are covered. There is case law that does not allow insurances to treat us differently to the ordinary customer because we are insured under the JSIS. However, keeping a written record of exchanges with the insurance is advisable and can be helpful when you process a claim.
USHU is now actively looking into providing further benefits for its members and intends to offer AFILATYS membership for those USHU staff who take out a preferential membership – more information will be provided soon on our website: http://www.ushu.eu.
We will also work with AFILIATYS to ensure that the specific situation of colleagues in EU Delegations, including local agents, is considered for future group insurance packages.
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