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26-10-2021

Health insurance funds comment on applications for rehabilitation after COVID-19: where and when?

Iliustracija

With growing numbers of hospitalised coronavirus patients, more and more of those that have already recovered also need medical or mental rehabilitation. Health insurance funds give tips on things to know to have the rehabilitation costs reimbursed from the Compulsory Health Insurance Fund (CHIF).

According to experts of the National Health Insurance Fund under the Ministry of Health (NHIF), people that have recovered from COVID-19 and experience side-effects should not hesitate and see a doctor. 

“Inpatient and outpatient medical and mental rehabilitation services can be reimbursed from CHIF funds no later than 3 or, in certain cases, 6 months after hospitalisation.” says Rimantė Venclovienė, Head Expert of the Services Management Division of the NHIF.

She also says that outpatient or inpatient medical rehabilitation can be prescribed for patients, whose COVID-19 cases resulted in pneumonia or post-Covid syndrome with residual effects no later than in 3 months after hospital treatment. This applies, e.g. for people with dyspnoea, fatigue, weakness, pain syndrome, and other persisting symptoms.

Meanwhile, patients that experience post-Covid syndrome with residual neuropsychiatric symptoms (fatigue, sleep disorders, difficulty to focus, impaired memory, etc.), can apply for medical or psychosocial rehabilitation, reimbursed from the CHIF funds, no later than in 6 months after discharge from the hospital.  This also applies for people with severe disruptions in activities, behaviour, and social adaptation.

Venclovienė emphasizes that in all cases patients seeking for rehabilitation services, reimbursed from the CHIF funds, should address their family doctor or a treating physician, if he patient is still in hospital. If needed, they will prescribe a referral to a physical medicine and rehabilitation (PMR) doctor or psychiatrist. Patients can address a primary care psychiatrist even without a referral from a family doctor. A psychiatrist or an PMR doctor will assess the degree and severity of the patient's biopsychosocial dysfunction, make the decision regarding the need for rehabilitation and inform the patient of the further course of treatment.

“Patients can benefit from 20-25 first-stage outpatient rehabilitation measures: occupational therapy, physiotherapy, physiotherapy or massage. In more severe cases, based on PMR doctor’s recommendations, a family doctor or a treating physician, can prescribe a referral for a reimbursed inpatient or outpatient rehabilitation. Meanwhile, a doctor psychiatrist can prescribe a referral for psychosocial rehabilitation, which is also possible as an outpatient or inpatient service. Thus, the type of medical assistance, needed by a patient in each specific case, can be determined only by a doctor.” emphasizes the expert.

It should be noted that both inpatient and outpatient rehabilitation services can be provided at the patient’s chosen medical institution, i.e. where it would be most convenient for the patient. However, to have these services reimbursed, the patient must not only be covered by the compulsory health insurance, but the chosen medical institution must have an agreement with the Territorial Health Insurance Fund.

According to health insurance funds, from the period between the beginning of this year and September (inclusive), rehabilitation services were provided for nearly 4 thousand recovered coronavirus patients. These services were reimbursed with 2.5 million Eur from the CHIF funds.

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: 23-11-2021

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