Citizens of Lithuania who live and legally work in another European Union country, Iceland, Norway, Liechtenstein, Switzerland or the United Kingdom, are covered by social health insurance only in the country where they work, that is, where they pay taxes. However, upon arrival in Lithuania, they can also receive medical services paid for by the state. The most important thing is to take care of the necessary documents in advance in a country where a person is covered by social health insurance.
European Health Insurance Card – for essential help
“People covered by social insurance in other European countries should order a European health insurance card or a certificate temporarily replacing it in their country of insurance before going to Lithuania.
This card or certificate confirming the person’s insurance must be issued by a competent institution of the country where he works, such as the health insurance fund, social insurance or another institution,” says Justina Izotovė, adviser to the Resident Services Department of the Vilnius territorial health insurance fund.
The representative of the health fund reminds that the European Health Insurance Card (ESID) is useful when you need the help of a doctor after an acute illness or injury in Lithuania.
In order for this assistance to be provided on the basis of ESDK, and its costs to be reimbursed by the country that issued the card, it is necessary to apply to those Lithuanian medical institutions that have a contract with the health insurance fund. In these medical facilities, upon presentation of an ESDK or a certificate and an identity document, such assistance is provided so that the patient does not have to return to the country where he lives and is covered by social health insurance ahead of time due to medical reasons.
ESDK or a certificate and an identity document must also be presented at the pharmacy when the ESDK holder purchases compensatory drugs or medical aid products according to a prescription issued by a doctor in providing emergency assistance. Then you only need to pay the patient premium at the pharmacy.
The data available from the health insurance funds show that the majority of ESDK holders in Lithuania receive consultations from medical specialists, emergency medical assistance services, and also receive treatment while lying in hospitals. Medical services on the basis of ESDK are provided mainly to insured persons of Germany, Great Britain, Norway, as well as Latvia, Sweden, and Ireland.
Document S2 – for planned treatment
“It happens that a Lithuanian citizen covered by social health insurance in another European country, taking into account his state of health and the course of his illness, due to some circumstances cannot receive the necessary planned health care services there in time and wishes to receive them in Lithuania. Then such an insured person should apply to the competent institution of his country of insurance for the issuance of document S2”, explains J. Izotovė, another possibility to receive compensated medical services in Lithuania.
Holders of document S2 covered by social health insurance abroad in Lithuania can receive medical services paid for by health insurance funds in medical institutions that have a contract with the health insurance fund. In these cases, patients themselves have to pay only for services from the list of paid services approved by the Minister of Health (for example, for acupuncture and manual therapy, cosmetic surgery operations, cosmetic or cosmetology procedures by a dermatologist, etc.), as well as patient premiums, transportation, etc. expenses.
The representative of the health insurance fund points out that, when going to Lithuania to receive planned medical services according to document S2, it is useful to coordinate the time of service provision with the Lithuanian medical institution in advance. Upon arrival at the treatment facility, you must present your identity document and document S2.
According to the data of health insurance funds, services are mostly used by people insured in Latvia and the United Kingdom on the basis of document S2 in Lithuania. Last year, for the services provided in Lithuania to the insured persons of these countries according to the S2 document, the State Sickness Fund submitted invoices for payment of 3.2 million to the inquiry services. euros. Most patients use the services of transplants, expensive blood tests, specialist doctor consultations and day surgery.
Reimbursement of cross-border health care costs
Insured persons from the countries of the European Union, Iceland, Liechtenstein and Norway (not insured persons from Switzerland and the United Kingdom) can also receive cross-border health care services in Lithuania. In this case, patients who have received medical services in a public or private medical institution in Lithuania and paid for them with their own funds can apply to the competent institution of the country where they are covered by social health insurance for reimbursement of expenses according to the procedures and conditions of that country.
In each of these European countries, the costs of cross-border health care are reimbursed differently for the insured. For example, in some places, a patient must obtain prior authorization from the competent institution of his country of insurance before going to another country for treatment or examination in this way.
Therefore, when planning to receive cross-border health care services in Lithuania, it is necessary to look into their compensation procedure in the country where a person lives and is covered by health insurance. Such information can be provided by the National Contact Center for Cross-border Healthcare of the country of insurance.
Information of the Vilnius Territorial Hospital Fund
2024-08-19 07:05:43