BDAR

National Health Insurance Fund about MRI: don’t hurry to pay when it is not necessary

Date

2021 06 14

Rating
1
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The residents often ask the National Health Insurance Fund (NHIF) to explain whether they have to pay for disposable special clothes and other disposable materials used for magnetic resonance imaging (MRI) and for the copy of radiologic examination images. The answer of the specialists is unambiguous: the persons, who have compulsory health insurance (CHI) and doctor’s referral do not have to pay additionally neither for the examination nor for the disposable clothes – the latter are not necessary. The patients also do not have to pay for the image copy if the doctor indicated its necessity in the referral.

According to the specialists, the patients should know first of all that the expensive examinations and procedures covered by the Compulsory Health Insurance Fund (CHIF) are performed to the persons, who have the referral of the specialist doctor and not the general practitioner. The referral may be issued by the specialist doctor, who is providing the specialised outpatient services of the second or third level that are covered by CHIF.

“Thus, if the patient, who has the doctor’s referral for MRI, comes to the medical institution, with which the National Health Insurance Fund has contract for provision and payment of services from CHIF, the patient does not need to pay neither for the examination nor for necessary medical aids or substances. According to the practice, usually supposedly necessary disposable special clothes ae offered to people for certain price, of course. However, they are not necessary and the patient has he righto refuse them,” – says Mrs. Žydrunė Baigienė, advisor of the Department of Expertise and Control of Services of the NHIF. She reminds that the outpatient has the right to choose a medical institution, where outpatient services could be provided, while the referring doctor has to inform about the institutions, where certain service is provided. No specific institution or specialist can be indicated in the referral.

If the referring doctor decides that s/he needs the copy of radiologic examination images, s/he should state this in the referral. The specialist, who has performed the examination, shall submit the copy together with the description of the radiologic examination to the referring doctor. In such a case, the patient does not need to pay for the image copy.

However, if the doctor does not ask for the copy of examination images in the referral and the patient wants to get it, the medical institution may issue the copy for extra price.

The specialists of the National Health Insurance Fund advise: if you have the referral for MRI, you should check, first of all, whether the medical institution where you are planning to get this service has a contract with the territorial health insurance fund. This may be done on the website of the NHIF, column e-services.

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.