Vade Mecum IV

CA/SC/1001
The Vade-mecum is designed to inform third parties of your wishes should you be unable to do so in person:
– Part 1 provides useful information, procedures and rules (in the event of illness, accident or death) for you or who will have to take care of you.
– Part 2 : Forms to be filled
– Part 3 : Useful addresses and complaints
– Part 4 : Forms of the JSIS
This document is intended for retired officials of the European Institutions who do not have access to the internet or to My IntraComm

Most of these forms are available on My IntraComm
www.myintracomm-ext.ec.europa.eu
SFPE – SEPS, 175 rue de la Loi, Office JL 02 40 CG39, BE-1048 Brussels
Bank account: 363-0507977-28 IBAN: BE37 3630 5079 7728 BIC: BBRUBEBB
Tel: +32 (0)475 472 470
ASBL Company n°: 806 839 565

Annex M1 Claim for reimbursement

Annex M2 Specimen reimbursement statement from the JSIS (normal case)

Annex M2.2 Specimen reimbursement statement from the JSIS: rejected   

Annex M4 Prior authorization

Annex M4.1 Annex to prior authorization (declaration)

Annex M6 New combined form for dental treatment and estimate

Annex M9 How to declare an accident

Annex M10 Accident-report 

Annex M10.1 Accident-follow-up

Annex M10.2 Request for the reopening of a file relating to an accident

Annex M11 Direct billing request

Annex M12 Request for priority treatment of a reimbursement claim       

Annex M13 Application for advance on major medical expenses           

Annex M14 Application for direct billing for a convalescent or nursing home   

Annex M15 Medical questionnaire for the evaluation of the degree of dependent   

Annex M16 Registered partnership 

Annex M16.1 form-partnership-

Annex M17 Application form for recognition of non-marital partnership

Annex M18 Serious illness recognition

Annex M18.1 How to declare a serious illness

Annex M19 Programme for screening test N° 3

Annex M20 Programme for screening test N° 6

Annex M22.1 How to benefit of a screening programme.

Annex M22.2    Preliminary questionnaire

Annex M22.3 Full clinical examination

Annex M22.4 Summary report   

Annex M23.1 Health screening centres with which the JSIS signed an agreement

Annex M23.2 Health screening centres  DA-FI-SV-UK

Annex M24 Table of medical treatments

Annex M25 New form for applications under Article 72(3)

Annex M26 Agreements with health professionals 

Annex M 27 Joint sickness insurance scheme – template 

Annex M28 How to ask for a thermal cure

Notes:
The rules on all typical treatment are available on My IntraComm (under « Reimbursement rules » in several languages) and from the SEPS secretariat upon request. : accidents analyses (medical imaging, laboratory tests and other forms of diagnosis) confinement (and pregnancy) consultations (and visits) contact lenses cures : convalescent and post-operative cures cures: thermal cures dentistry / orthodontics diagnosis (medical imaging, analyses, laboratory tests and other forms of diagnosis) funeral allowance hearing aids homes (nursing and convalescent homes) hospitalisation infertility treatments (and in-vitro fertilisation) in-vitro fertilisation (and infertility treatments) kinesitherapy (see miscellaneous treatments) laboratory tests (analyses, medical imaging3 and other forms of diagnosis) medical auxiliaries (nursing care) medical equipment medical imaging (analyses, laboratory tests and other forms of diagnosis) medicines (pharmaceutical products) miscellaneous treatments (kine, psychotherapy, speech therapy, etc.) negative opinions of the Medical Council nursing attendance nursing care (see medical auxiliaries) nursing homes (and convalescent homes) occupational disease orthodontics / dentistry orthopaedic appliances (see medical equipment) ostheopaty (see miscellaneous treatments) pharmaceutical products (medicines) pregnancy (and confinement) preventive medicine programs (screening tests) psychotherapy (see miscellaneous treatments) screening tests (preventive medicine programs) serious illness spectacles (frames and lenses) speech therapy (see miscellaneous treatments) surgery transport visits (and consultations). Sets of the General Implementing Provisions are also available on My Intracomm and upon request from the SEPS secretariat (FR, EN, DE).
The rules and forms that we have selected for inclusion in our Vade-Mecum are those that are of interest to the majority of pensioners. There are other rules and forms on My Intracomm, often in several languages. These can be obtained via the SEPS secretariat.
Documents in annex are extracted from My IntraComm

They are addressed to pensioners of the European Institutions who are not familiar with Internet
Brussels settlement office Postal address (often the former address is given on the forms: rue de la Science).

European Commission Settlements office
RCAM – MERO
41, avenue de Tervuren
B – 1049 Brussels
Other alternative:
PMO – JSIS Reception area for retired officials MERO
The permanence of PMO “Medical insurance” is at the disposal of pensioners on the ground floor of the
MERO building – Bur. 00/P026 every day, without appointment, for questions about JSIS
(reimbursement of medical expenses, direct billing, prior authorisation, etc).
You can access on presentation of the pensioner’s badge at the reception of the building:
from Monday to Friday : in the morning, from 9h30 to 13h00
As before, this reception area is equipped with a printer and a letterbox for any correspondence relating
to the sickness insurance.
Luxemburg settlement office
European Commission
Krankenkasse (PMO)
DRB B1/061
L – 2920 Luxembourg
Ispra settlement office
Commissione delle Comunità Europee
Uffiicio di liquidazione (PMO)
Centro Comune di Ricerca T.P. 740
I – 21020 ISPRA (Varese)
Italy