International agreements

Persons insured with compulsory health insurance, the rights and obligations of insured persons in the performance of compulsory health insurance shall be established by the Law on Health Insurance of the Republic of Lithuania (hereinafter - LHI). LHI defines the set of persons covered by compulsory health insurance: citizens of the Republic of Lithuania and foreigners permanently or temporarily residing in Lithuania and having the relevant legal status established by the LHI are covered by compulsory health insurance. All participants of the Lithuanian compulsory health insurance system are obliged to pay (or have to pay) compulsory health insurance contributions from the date of granting the insured status in the amount set by the LHI on a monthly basis. Compulsory health insurance contributions are paid by the state for insured persons residing in Lithuania who fall into the list of socially vulnerable categories established by the LHI.

The Republic of Lithuania has signed bilateral international agreements that regulate the issues of payment for health care or health insurance:

• The Agreement between the Republic of Lithuania and the Republic of Belarus on Social Security and the Agreement between the Republic of Lithuania and Ukraine on Social Security provide that persons receiving a pension under the legislation of one or both Contracting Parties are subject to health insurance (medical care) rights acts. Taking into account these agreements, the LHI stipulates that persons permanently or temporarily residing in the Republic of Lithuania who receive any type of pension under international agreements of the Republic of Lithuania and for whom the application of legal acts of the Republic of Lithuania regulating health insurance is enshrined in such international agreements, are insured with the compulsory health insurance at the expense of the state.
• The Government of the Republic of Lithuania and the Government of the Russian Federation signed agreement on the procedure for providing social guarantees to military pensioners of the Russian Federation permanently residing in the Republic of Lithuania. Under this agreement, military pensioners of the Russian Federation and their family members are provided with medical assistance in medical institutions of the Republic of Lithuania, and the costs of this assistance are covered by the Russian Federation. In implementing this agreement, the Ministry of Health of the Republic of Lithuania and the Ministry of Defense of the Russian Federation signed an agreement on the procedure for reimbursement of medical services for military pensioners of the Russian Federation permanently residing in the Republic of Lithuania (hereinafter referred to as the Agreement).

Pursuant to the Agreement, the NHIF and the Social Security Division of the Embassy of the Russian Federation in the Republic of Lithuania (hereinafter referred to as Embassy) shall annually coordinate:

1) the amount of funds received by the NHIF from the Embassy in the previous calendar year for healthcare services provided to military pensioners of the Russian Federation permanently residing in Lithuania;
2) the amount allocated for the payment of health care services of one Russian military pensioner permanently residing in the Republic of Lithuania in the current calendar year. Under the Agreement, the annual amount paid by the Russian Embassy is equal to the amount of the state budget contribution to the budget of the Compulsory Health Insurance Fund for one calendar year for one insured person. According to the 2021 Law on the Approval of Financial Indicators of the State Budget and Municipal Budgets, in the year 2021, the amount of the state budget contribution to the budget of the Compulsory Health Insurance Fund is 6.98 per cent of the amount of the 12 minimum monthly salaries of the previous year and amounts to EUR 464.9 per one person insured with state funds.

Useful links:

• Agreement between the Republic of Lithuania and the Republic of Belarus on social security
• Agreement between the Republic of Lithuania and Ukraine on Social Security
• The Government of the Republic of Lithuania and the Government of the Russian Federation signed a 1993 agreement on the procedure for providing social guarantees to military pensioners of the Russian Federation permanently residing in the Republic of Lithuania.

2012 The Ministry of Health of the Republic of Lithuania, the Ministry of Social Affairs of the Republic of Estonia and the Ministry of Health of the Republic of Latvia (hereinafter referred to as Partners), intending to improve the availability of innovative and expensive medicines in the Baltic States, rationally use available human and financial resources and reduce public expenditure on medicinal products and medicinal devices and to ensure the exchange of information between the competent authorities of the Baltic States, have signed a Partnership Agreement on the joint procurement of medicinal products and medicinal devices and the lending of centrally purchased medicinal products and medicinal devices (hereinafter referred to as the Partnership agreement).

The Partnership agreement regulates the co-operation of the competent institutions of the Baltic States in the joint implementation of centralized procurement procedures for medicinal products or medical devices: preparation and coordination of documentation, decision-making, dispute resolution. It has been established that the competent authorities of the Partners participate in a joint working group, which discusses the need for future joint procurements, their scope and selects the lead partner for a specific procurement, which obliges to procure on behalf of the Partners. The procurement can be made jointly by all Partners or only by two Partners, so each procurement is agreed separately.

Under the Partnership agreement, the Partners have the opportunity to lend to each other centrally procured medicinal products or medicinal devices, if necessary.

In accordance with the Partnership agreement, in the year 2017, Lithuania and Latvia successfully completed a joint purchase of a pneumococcal polysaccharide conjugate vaccine for children under 2 years of age. The National Health Insurance Fund under the Ministry of Health was the lead partner in this procurement, responsible for carrying out the procurement procedures. The vaccine was purchased with a price 15% lower than it would be if the Partners have purchased the vaccine separately. In this way, the countries saved more than EUR 1.4 million. (Lithuania - EUR 825 thousand ).

Using the Partnership Agreement, Lithuania, Latvia and Estonia plan to jointly procure a rotavirus vaccine for the immunization of infants. The Partners are currently negotiating the terms of purchase. Once the conditions and aspects necessary for the procurement procedures have been agreed, the joint procurement of rotavirus vaccine in the Baltic States will take place. It is planned that Estonia will become the lead partner of this joint procurement.