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22-09-2021

Copies of prescriptions should also be kept when receiving treatment in European countries

Iliustracija

Šiauliai Territorial Health Insurance Fund (THIF) receives questions from residents about cross-border healthcare. What should I pay attention to in order to be reimbursed by the THIF after receiving healthcare in the European Union (EU), Iceland, Liechtenstein and Norway?

We would like to remind you that patients themselves can choose a healthcare provider in another country, regardless of whether it is a private or public institution, pay for services and receive compensation in Lithuania. It is important to know that the insured person’s expenses are only reimbursed if a referral was received from a healthcare institution in Lithuania that has entered into an agreement with the THIF before leaving for treatment abroad.

“It is compulsory to have a doctor’s referral before travelling to European countries for treatment. This referral is subject to the same requirements as for treatment in Lithuania: it must include the date of issue and the period of validity, the diagnosis of the illness, the results of the tests carried out under the responsibility of the family doctor or specialist, and information on the treatment used and its effectiveness. If a patient goes abroad for medical treatment without a doctor’s referral, he/she can no longer apply to the HIF for reimbursement of the costs incurred”, - warns Inga Kvedarienė, Head of the Population Services Division of Šiauliai THIF.

In order to receive reimbursement, the insured person or his/her representative must submit to the THIF, no later than one year after the provision of healthcare services, medicines and medical devices or medical aids in the country of treatment: a written application for reimbursement of cross-border healthcare costs; a personal identity document or a certified copy thereof; medical documents or copies thereof, a copy of a referral from a doctor of a Lithuanian healthcare institution contracted with the HIF; copies of documents and prescriptions confirming the prescription of and receipt of reimbursable medicines, medical devices or medical aids; if the insured person was prescribed compensatory medicines or medical aids in Lithuania, copies of Form 3 prescriptions under which the medicines or medical aids were dispensed in the country of treatment; financial documents - invoices, cashier’s cheques, cash receipts and other.

Experts point out that it is very important to have a copy of the prescriptions for the medicines used during treatment abroad when claiming reimbursement, as these are needed to calculate the reimbursement. For example, Šiauliai THIF often receive requests from families for compensation for assisted reproduction, much of which consists of reimbursable medicines. “If families don’t bring their prescriptions, we can’t reimburse them for their medicines, and the reimbursement amount is almost halved. In addition, it is important to know that we compensate for as much as the same service costs in Lithuania, we compensate only for those medicines that are in the pricelist of compensated medicines in our country”, — explains I. Kvedarienė.

According to the expert, medical services in EU countries are usually much more expensive, therefore the funds of the Compulsory Health Insurance Fund (CHIF) reimburse only a part of the incurred costs. The decision on the reimbursement of the insured person’s costs is taken by the cross-border healthcare reimbursement commission set up by the THIF.

It is important to know that the CHIF does not reimburse travel, accommodation, meals, transport costs, as well as patient fees and surcharges paid to a healthcare provider.

The costs of services not included in the lists of healthcare services covered by the CHIF approved by the Lithuanian Minister of Health, as well as the costs of medicines, medical devices and medical aids for outpatient treatment, if not included in the lists approved by the Minister of Health, are also not reimbursed.

Information on reimbursement arrangements for cross-border healthcare in European countries is provided by the National Contact Points for Cross-Border Healthcare. Information on the national contact points for all EU countries can be found here.

As a reminder, cross-border healthcare received in the UK will not be reimbursed once the UK leaves the EU.

Šiauliai Territorial Health Insurance Fund information  

The NHIF invites you:

Your questions are welcome by email [email protected] or phone: local (8 5) 232 2222, international +370 5 232 2222.

Last updated: 03-11-2021

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