Skip to main content
01-08-2025

Additional compulsory health insurance guarantees for seniors

Iliustracija

The state’s senior citizens are keen to take advantage of certain medical services that are paid for exclusively by the state, while others are sometimes overlooked. The Health Insurance Fund reminds them about reimbursable dental prosthetics, medication subsidies, disease prevention, and vaccinations.

Dental prosthetics 

For certain groups of people, including those of retirement age, the health insurance fund covers the cost of dental prosthetics using funds from the Compulsory Health Insurance Fund. Last year, out of almost 76,000 people who took advantage of this opportunity, 83% were seniors. 

“In order to take advantage of reimbursable dental prosthetics, residents should contact the medical institution where they are registered, a dentist, or, with a referral from them, to another healthcare institution that has a contract with the Health Insurance Fund for dental care, a dentist, or a dental specialist. The dentist determines whether the patient is eligible for reimbursable dental prosthetics and assesses the condition of their teeth and mouth. If the person is eligible, the dentist registers them in the system – the patient does not need to fill out any paperwork,” – explains Rasa Savičiūtė, advisor at the Service Reimbursement Division of the National Health Insurance Fund (NHIF). 

Registered residents must contact the healthcare institution of their choice that has a contract with the Health Insurance Fund for dental prosthetics and have dental prosthetics made within 3 years. These services can be received again 3 years after the date of compensation for the prosthetics costs.  

It is important to note that the Health Insurance Fund reimburses the healthcare institution that provided the services for the actual costs of dental prosthetics, but not more than the established compensation amount. Depending on the condition of the teeth, this amount can be up to EUR 670.39 for residents of retirement age or up to EUR 2,062.70 in more complex cases, as determined by a medical council. If the cost of dental prosthetics is higher, the patient pays the remaining amount.

Last year, almost EUR 52 million was allocated from the fund to compensate for dental prosthesis costs, and this year – around EUR 56 million. 

Reimbursable medicines

Last year, nearly 1.3 million people used reimbursable medicines and medical aids (MA), half of whom were aged 65 and over. Therefore, reimbursement of the costs of medicines and MA is also an important guarantee for older people. 

Reimbursable medicines and MA for the treatment of various diseases are included in the lists approved by the Minister of Health. The reimbursable prices of medicines or MA included in these lists can reach 100 percent, i.e., when purchasing them with a prescription, patients usually only pay a co-payment. However, some residents do not have to pay even that. 

“The National Health Insurance Fund uses state budget funds to cover patient co-payments for reimbursable medicines and medical aids purchased by socially vulnerable groups on prescription. These include people aged 75 and over, as well as residents of retirement age who receive less than EUR 450 in insured income per month. In such cases, these residents do not have to pay any additional fees,” explains Miglė Domeikienė, advisor to the Pharmaceuticals Reimbursement Division of the NHIF.

In addition, by purchasing reimbursable medicines with the lowest co-payment, all residents automatically accumulate a medicine co-payment basket. From the beginning of the calendar year to the end of the year, the co-payments paid by the patient are added up. When this amount reaches EUR 59.04, when purchasing other reimbursable medicines with the lowest co-payment, there is no need to pay them until the end of the year.  

Last year, more than half a million patients had their patient co-payments covered by the state budget: 442,000 patients due to age concessions and low income, and almost 97,000 due to having accumulated a co-payment basket. This required more than EUR 35 million. Since 2020, when these measures were introduced, the amount of co-payments covered by the state budget has increased fivefold. 

Verification according to three preventive programs

People of a certain age are invited to undergo regular check-ups under five disease prevention programmes. Seniors can undergo check-ups under three of these programmes – for breast, prostate and colon cancer. To undergo a free check-up, you need to contact the healthcare institution where you are registered.

In 2024, over 156,000 people aged 65 and older underwent preventive check-ups, accounting for 27% of all people who underwent such check-ups last year. This year, the Health Insurance Fund allocated EUR 70 million from its fund for preventive health programs, which is EUR 3 million more than last year.

The Health Insurance Fund reminds us that preventive programs are intended for people who are at the age when the risk of developing the disease is highest. However, anyone who feels unwell should immediately contact their family doctor. The doctor will perform the necessary tests and, if necessary, refer the patient to a specialist for consultation. 

Free vaccinations 

“Seasonal flu poses a greater risk to elderly people. For them, this disease can cause more serious complications, such as pneumonia, exacerbation of heart or respiratory diseases. The likelihood of a person having to be treated in hospital increases. Therefore, people aged 65 and older are considered a risk group and are eligible for free flu vaccinations,” says Agnė Grušeckienė, advisor to the Centrally Procured Pharmaceuticals Division of the NHIF. 

During the last flu season, nearly 138,000 people aged 65 and older were vaccinated. This year, the NHIF signed a contract for 223,000 doses of flu vaccine for nearly EUR 770,000 in fund money. They are intended for the 2025–2026 season. 

Patients in risk groups (people undergoing dialysis, those suffering from cancer, rheumatic diseases, etc.) and residents aged 75 and older are vaccinated with the pneumococcal vaccine free of charge. People in high-risk groups, including those aged 65 and older, can get vaccinated against COVID-19 free of charge.

For reimbursable vaccinations, patients should contact their healthcare provider where they are registered.

The NHIF invites you:

Last updated: 11-08-2025

Related news:

Health budget in 2025: what benefits did we receive?

The right to be informed: what is important to know about reimbursable healthcare

Tens of millions of euros for residents’ health: for whom and how are medication co-payments covered?

Study reveals: a family doctor’s advice determines the decision to get checked

Unexpected ailments during the holidays: where to turn and what to know