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13-06-2023

It’s not only participants in the prevention programmes who don’t have to pay for the tests they need

Iliustracija

Why are only insured people of a certain age screened according to free disease prevention programmes? What about the rest of the population? This is a question often asked when talking about disease prevention. Health insurance funds emphasize that other insured persons do not have to pay for preventive check-ups as well as for other necessary tests prescribed by a doctor. There is no age limit in this case - other aspects are important.

Various tests are performed to the insured people for free on the basis of five prevention programmes. For example, screening for cardiovascular diseases includes a lipidogram, electrocardiography, glucose and creatinine tests, mammograms for breast cancer, cytology smears for cervical cancer, human papillomavirus tests, prostate-specific antigen test for prostate cancer, a FOB test for colorectal cancer, etc.

“Following international recommendations and evidence-based medicine, people are screened at an age when they are at a particularly high risk to fall ill and screening with certain tests is effective. However, this does not imply that people younger or older than the age at risk are discriminated, i.e. that they are not subject to the same tests when needed. Regardless of age, all insured persons must have all the tests prescribed by a doctor, taking into account patient’s health, complaints, diagnosis, stage of the disease, and applied treatment, compensated by the state,” says Vaida Bernotienė, Advisor to the Population Service Division of the Vilnius Territorial Health Insurance Fund.

The representative of the Health Insurance Fund emphasizes that if a person does not belong to the age group checked according to the preventive programmes, but feels unwell or is worried about his/her health, he/she should immediately contact his/her family doctor. In this case, examination and treatment, carried out on the patient, are covered by the Compulsory Health Insurance Fund, provided that:

  • a person is insured with compulsory health insurance;
  • tests are prescribed by a family doctor or a specialist, depending on the health condition; 
  • a patient visits regarding prescribed tests or procedures with a doctor’s referral;
  • a patient goes to any medical institution (public or private) in the country that has concluded a contract with the health insurance fund for the service specified in the referral; 

What concerns prevention of various diseases, when seeing a family doctor  free of charge once per year on a preventive basis, all insured adult patients should have:

  • blood pressure, weight and height assessed; 
  • electrocardiography prescribed; 
  • amount of cholesterol established; 
  • oral inspection performed;
  • breast inspection and palpation – for women;
  • women over 20 years old – gynaecological inspection, in presence of any indications – cytological smear. 

In addition, all insured adults should have a common blood count performed every second year, a hearing test shall be performed once per year or once per 2 years according to the age, eye pressure shall be measured and peripheral lymph nodes shall be palpated during each preventive check. 

In addition, people over 65 years of age should also have an annual visual acuity check and a general urine test performed, glucose in blood should be tested, and younger adults should have this done every 2 years.

It is reminded that the following age groups are screened according to disease prevention programmes: for cardiovascular diseases - men and women aged 40-60 (inclusive) every 1, 2 or 4 years, for cervical cancer - women aged 25-59 (inclusive) every 3 or 5 years, for breast cancer - women aged 50-69 (inclusive) every 2 years, for prostate cancer - men aged 50-69 (inclusive) every 2 years (from age 45 if a father or brothers had this disease), for colorectal cancer – men and women aged 50-74 every 2 years.

(Piktochart photo)

The NHIF invites you:

Last updated: 09-08-2023

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