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Examinations that can be prescribed by a GP with no additional payments

Date

2022 07 21

Rating
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Patients ask the health insurance funds of the primary level examinations that can be ensured by healthcare institutions offering GP services that are not subject to any additional payments. The experts of the national health insurance funds are kindly reminding that if an examination is really needed and is prescribed by a GP, the examination will be covered by the Compulsory Health Insurance Fund (CHIF).

A GP prescribing an examination must follow the GP Medical Standard and ensure that patients, covered with a compulsory health insurance, receive CHIF-covered services with no additional payments.

Thus, insured patients addressing the healthcare institutions they are registered with and receiving GP-prescribed examinations, established in the GP Medical Standard, do not have to pay for these examinations as they are covered by the health insurance funds from the CHIF funds.

Healthcare institutions that have signed service provision and funding agreements with the territorial health insurance fund (THIF), are paid for a full service, while examinations make an integral part of healthcare services.

GP prescribes examinations in case of a need to diagnose illnesses, conditions or health disorders that fall under a GP competence and then makes an assessment of the result obtained. Examinations are prescribed not only in case of a need to substantiate a diagnosis, to adjust a treatment started, and evaluate its effectiveness.

Examinations that can be prescribed by a GP:

  • a general blood test, performed on a regular basis once every two years;
  • blood glucose establishment and general urine test, performed on a regular basis once every two years, and since the age of 65 – once a year;
  • glucose tolerance test;
  • albumin/creatinine ratio in urine;
  • C-reactive protein and ESR (inflammation indices);
  • biochemical blood tests: creatinine, potassium, sodium, ALT, AST, ALP, bilirubin, TSH, uric acid;
  • lipid metabolism examination (lipidogram);
  • blood cholesterol level testing, performed on a regular basis once a year for adult patients, and for children - in case of indications;
  • PSA (for patients after radical treatment of prostate cancer);
  • pulse oximetry, spirometry;
  • co-program, enterobiasis testing;
  • gynaecological smear from the vagina and cervix;
  • electrocardiogram (ECG), performed on a regular basis once a year for adult patients, and for children - in case of indications.

It’s important to remember that patients that have been prescribed treatment with oral anticoagulants with the active substance (Warfarinum, Acenocoumarolum) have their blood clotting tests 12 times per year covered by the health insurance funds. The health insurance funds also cover glycosylated haemoglobin test 4 times a year for patients with diabetes. In order to evade complications, this test should be conducted every three months.

Blood tests, performed before planned surgery – establishment of the ratio between post-thrombotic time (PT) and the international normalization ratio (INR), establishment of activated partial thromboplastin time (APTT), establishment of the blood group according to ABO antigens and rhesus factor.

Tests are also prescribed in cases, when patients take part at NHIF-covered preventive programmes regarding breast, cervical, prostate, colon cancer, and cardiovascular diseases.

Patients can also have a preventive check-up once a year. In such case, the GP must measure the blood pressure, weight, height, prescribe an electrocardiogram, check the blood cholesterol, conduct an oral examination, and for women - conduct a breast examination and palpation. Patients also undergo an eye check-up.

Moreover, during the examination, a GP should measure the patient’s eye pressure, as a higher eye pressure might indicate the onset of glaucoma. Medication for glaucoma is reimbursed and an early diagnosis could help control the disease. However, failure to follow the treatment might eventually result in a vision loss.

Once every two years, as a preventive measure, adults can undergo a general blood and urine test, and also a blood glucose test. Patients above 65 years old can undergo this testing every year.

Information of Šiauliai Territorial Health Insurance Fund

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The NHIF invites you:

Your questions are welcome by email [email protected] or phone: local (8 5) 232 2222, international +370 5 232 222