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08-08-2023

Compulsory health insurance for holidays: is it possible?

Iliustracija

The health insurance funds have noticed that some medical institutions misinform expatriates returning to Lithuania for holidays about compulsory health insurance (CHI). A number of Lithuanians who have returned to our country for a short period of time have already come to Panevėžys Territorial Health Insurance Fund (THIF) to take out CHI for one month. All of them claim to have heard about this possibility from their doctors.

“Arriving people live in other European countries. They are insured there, but when they return to Lithuania for holidays, they decide to get treatment in Lithuania. Many applicants are misled by the information and advice they receive in the medical institutions to go to the health insurance fund to take out CHI insurance for the duration of their holiday in this country. On arrival, people are both surprised and annoyed to learn that there is no such option. Expatriates living elsewhere are entitled to either emergency medical care with a European Health Insurance Card issued by their country of residence or to planned services with an S1 or S2 document issued in another country. Treatment is still available under the cross-border healthcare arrangements”, notices Sigita Paulauskienė, the head of Population Service Division of Panevėžys THIF.

The health insurance funds would like to remind Lithuanians living and working in another country of the European Union, as well as in Iceland, Norway, Liechtenstein, Switzerland or the United Kingdom (EU countries), of the details of each of these treatment options, if they are covered by social health insurance in one of the listed countries and are planning to go to another European country, such as Lithuania, for a temporary stay.

European Health Insurance Card and emergency aid

When you leave the country where you live, you must take your European Health Insurance Card or a certificate temporarily replacing it. Both the card and the certificate are issued by the responsible body in the European country where you are insured. Having one of them, if you need emergency medical treatment, the costs will be paid in full or in part by the country that issued the card or certificate, according to the procedures and rates laid down by the legislation of the country of treatment.

Document S1 and planned treatment

If you work in another EU country but live in Lithuania, you should apply for an S1 document from the responsible authority in the country where you work and are covered by social insurance, such as your local health insurance fund, social insurance or other institution. Only this body can decide, in accordance with national legislation, to issue an S1 document. The document must be registered with any Lithuanian territorial health insurance fund in order to be able to receive free treatment in your country, and the treatment will be paid for by the responsible institution in the country that issued the document. S1 is useful for employees on secondment, as well as for workers travelling abroad, pensioners, civil servants and their dependants. Please note that this document can be used by family members of migrant workers who remain in their home country but have acquired the right to healthcare in the country where their family member is currently working (if they are not entitled to healthcare under the legislation of their home country).

Document S2 and planned treatment

Lithuanians who have migrated to an EU country may be sent to another country, such as Lithuania, for specific planned treatment, depending on their health condition and the course of their illness, if they are unable to get the healthcare they need in time in the country where they are insured or live. Before they leave, they must obtain an authorisation from the responsible body in the country where they are insured – a document S2. Once you have presented this document, the healthcare services you receive are free of charge and the costs are covered by the institution that issued the authorisation (S2), according to the rates set by the legislation of the country of treatment. The patient is responsible for paying any patient surcharges or fees, if these are approved by the legislation of the country providing the services.

Reimbursement of cross-border healthcare costs

Insured persons in the EU countries have the right (except Swiss and UK insured persons) to cross-border healthcare in another country, such as Lithuania. Patients can choose their own healthcare facility (both private and public), pay for their services and, on their return, apply for reimbursement to the responsible body in the country where they live and are covered by social security - the local health insurance fund, social security or other institution. Reimbursement of expenses is made to the same extent and in the same order as if the same services had been provided in the country of residence. The amount reimbursed may not exceed the insured person’s actual costs for cross-border healthcare.

Countries have chosen different reimbursement methods for cross-border healthcare. Some countries require the insured person to obtain authorisation from his/her home social security body before travelling abroad to receive health care. For this reason, anyone planning to travel to another country for treatment or examination should first check the reimbursement arrangements for cross-border healthcare in the country where they are insured.

For full details on reimbursement arrangements for cross-border healthcare, visit National Contact Centre of Cross-Border Healthcare. 

Information of Panevėžys Territorial Health Insurance Fund

(Freepik photo)

The NHIF invites you:

Last updated: 18-08-2023

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