LA Issues — Part 4: Your Health Coverage
- Sumeet Thakkar
- 3 days ago
- 4 min read
Maja Vuckovic-Krcmar, Sumeet Thakkar, Sunil Kumar, Mahbuba Abdulloeva, Lejla Sultanovic, Aminata Ongoiba, Helen Conefrey
€44.5 million in surplus — a utilisation rate of just 55% - an over-cautious approach which compromises access to quality healthcare
This is the 4th in a series of USHU newsletters on Local Agent issues. Part 1 (April) covered salary methodology and arrears. Part 2 covered the issue related to fairer salary comparator for LA. Part 3 was about the LA Provident Fund. This edition focuses on the LA Medical scheme — the Complementary Sickness Insurance Scheme (CSISLA) that covers your medical costs. |
Your medical scheme: €44.5 million — and only 55 cents of every euro comes back to you
The LA Medical scheme held total assets of €44.5 million as of 31 December 2025 — up from €41 million a year earlier and €37.5 million at end-2023. Of the current total, €40 million is in the DG BUDG-managed investment portfolio and €4.8 million in a liquidity account for short-term reimbursements.
The scheme’s utilisation rate is just 55% - this should stop every affiliated member in their tracks. That means for every euro contributed by you and your employer, only 55 cents is returned in reimbursements. The other 45 cents remain and are accumulated in the fund.
To put this in context: even the LA Provident Fund — where almost nobody withdraws their funds until the end of their contract — has a utilisation rate of 58%. Your medical insurance returns less of what you put into it than your savings fund does. That is the visible face of a scheme that systematically under-reimburses its members.
Every euro sitting in that surplus is a euro that could have reimbursed for a dental visit, covered a hospital bill at real-world prices, or funded post-retirement coverage for a colleague who paid into the scheme for decades.
For 88% of you, LA Medical is not a complement — it is your frontline, your primary source of health coverage
Nearly 1,000 colleagues responded to the December 2025 LA Medical survey. The message was overwhelming: we want improvements to the LA Medical Scheme
88% work in countries where the local health system is either poor or absent — LA Medical is their primary coverage, not a complement
Over 45% identified post-retirement medical coverage as their top priority
66% say the current level of reimbursement has limited their ability to access quality medical care
54% say the maximum reimbursable amounts are outdated and do not reflect actual costs
74% were unaware they could request direct billing or a salary advance for medical expenses
51% did not know about the possibility to extend affiliation after retirement
Only 8% believe the current post-employment rules should remain unchanged
The concrete win: ceiling updates in 2026
The EEAS administration initially took the position that updating maximum reimbursable amounts required reopening the full legal decision — effectively linking routine maintenance to a years-long reform process.
After sustained pressure from USHU and like-minded OSPs, management committed to advance ceiling updates during 2026 as a stopgap measure, outside the formal social dialogue. This is a tangible improvement, an immediate gain for every LA Medical member. |
More commitments secured
Direct billing and salary advances: A note will be issued to all Heads of Delegation and Heads of Administration — because 74% of you did not know these options exist (for your ready reference: https://eudelguide.eeas.europa.eu/policy/13000 )
Quarterly newsletter: The EEAS administration will launch a regular update on LA Medical scheme developments
Chronic condition prescriptions: Examination of a simplified prescription renewal process for colleagues on long-term medication (blood pressure, diabetes, thyroid) — an annual prescription instead of every three to six months.
Where does your retired colleague go?
In many countries of assignment, private medical insurance is impossible to obtain at retirement age. The current rules allow you to extend your LA Medical affiliation for a maximum of 3.5 years after leaving where you pay both employer and employee contributions — and half of you did not know this option existed.
Think about what that means for a colleague in Sub-Saharan Africa, South Asia, or Central Asia who retires after 30 years of service. They will have paid into the scheme for three decades. They leave. And 3.5 years later, they are on their own — in a country where the public health system may not function at all or be totally inadequate.
The €44.5 million surplus makes a proper post-retirement scheme not just desirable, but fundable — without any increase in contributions from active members.
USHU is pushing to discuss a workable approach to make this happen. To get more benefit from the LA Medical
Improvements that USHU will continue to fight for :
Post-retirement medical coverage and ending the discrimination between staff under the old and new decisions remain the headline items for the 2027 social dialogue.
USHU resonates the voice of 45% colleagues who participated in the survey and favoured a better post-retirement coverage – LA preferences cannot be ignored! The accumulated surplus of €44.5 million must be actively deployed to improve your coverage — not held indefinitely pending a legal review.
USHU fights for the rights of all staff categories and prides itself on knowing your needs well after more than 15 years at the service of EU DEL colleagues.
Join USHU and join a knowledgeable organisation that achieves results on your behalf.
Join us now: https://www.ushu.eu/membership
Make sure your voice is heard — contact USHU with your proposals and issues:
USHU stands ready to raise your issues with EEAS and Commission Management
Your elected members on the CLP-HU and the EEAS Staff Committee will keep asking the right questions
Comments