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European Health Insurance Card guarantees - only for insured persons

Date

2021 11 11

Rating
1
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After receiving the European Health Insurance Card (EHIC), residents often do not pay attention or forget that only insured persons in Lithuania can use this card. Uninsured cardholders who have received emergency medical care in other European countries and paid for by the Lithuanian Compulsory Health Insurance Fund (CHIF) may be faced with an unpleasant surprise - a call for compensation.

Many Lithuanians already know that it is useful to have an EHIC when visiting or studying in other European Union countries, Norway, Iceland, Liechtenstein and Switzerland. Holders of this card who have an illness or injury may receive the necessary emergency medical care paid for by the CHIF if they are presented at the medical institutions of the above-mentioned countries.

„European health insurance cards are issued free of charge, but only to those who have compulsory health insurance. Whether a person is insured is checked by health insurance funds before this card is issued. However, later the validity of the insurance becomes the responsibility of the cardholder and he/she must be aware that he/she loses the right to use the EHIC if he/she becomes uninsured in Lithuania. In this case, the card cannot be presented to medical institutions in any country, even if the validity period indicated on it has not yet expired,“ says Martyna Langė, Head of the Law Division of the Vilnius territorial health insurance fund (THIF).

Compulsory health insurance (CHI) is only valid if the CHI contribution is paid monthly. If neither the employer nor the resident pays the contribution for at least one month and the person is not insured at the expense of the state, the insurance is terminated. In the event of such interruption, the EHIC shall not be issued to the resident. However, if at that time a person uses a card previously issued to him or her to receive the necessary assistance in a medical institution in another European country, he or she must later repay the funds paid for this assistance from the CHIF.

„The cost of emergency medical treatment provided to holders of a EHIC shall be borne primarily by the health insurance fund of the European country which granted it or its equivalent. This institution then applies to the Lithuanian health insurance fund for reimbursement of treatment costs with CHIF funds. THIF, when paying these costs, finds out if the person is insured. If the person was not insured in Lithuania while receiving services abroad, the damage caused by the cardholder to the CHIF is considered to be the cost of treatment,” explained M. Langė.

In the event of damage, health insurance funds of the CHIF shall, first of all, inform the person in writing, stating how it can be compensated. Upon receipt of such a call, it is important to compensate by transferring the money to the health insurance fund’s account specified therein. If the damage is more than EUR 300, it can be paid in installments under a contract with the health insurance fund, and the lesser damage must be reimbursed in full immediately. If the claim is not reimbursed voluntarily within 20 working days, the indemnity is not agreed upon or the documents proving that the person was insured at the time of granting the necessary assistance was insured, the recovery of damage is initiated.

According to the Vilnius THIF, slightly less than half of those who have received a call on the damage they have caused in this way reimburse it to the CHIF voluntarily, while others have to be sued. However, almost all people in this situation are surprised to learn how the damage occurred and say that they did not pay attention to the most important condition for using the EHIC - the cardholder must be insured with CHI in Lithuania when receiving medical services in other European countries.

Residents will be able to protect themselves from this unpleasant situation if they check that the compulsory health insurance is valid before going abroad. Particular attention should be paid to people who have graduated from school or completed studies, changed jobs or the nature of their work before traveling, as this is the context in which insurance status often changes and this is not taken into account. At first glance, the cost of negligence can be high - for example, health care services provided in Germany in 2019 to a person who illegally submitted an EHIC cost over EUR 50 thousand. Last year, the average of the CHIF damage to the Vilnius THIF recovered from EHIC holders was about 450 euros per person.

Information of the Vilnius Territorial Health Insurance Fund 

The NHIF invites you:

Your questions are welcome by email info@vlk.lt or phone: local (8 5) 232 2222, international +370 5 232 2222.