System of compulsory health insurance: what to do if insurance is terminated?
Health insurance funds are often contacted by people who find out that their compulsory health insurance has been terminated. People ask what to do in this case. Specialists from the National Health Insurance Fund remind you that insurance can be terminated if you do not pay compulsory health insurance contributions on time or if you pay less than the prescribed amount. In this case, the contribution or the missing part of it must be paid immediately.
The right to free medical treatment is inseparable from the obligation to pay compulsory health insurance (CHI) contributions every month. The collection of these contributions is managed by SODRA and the fees collected are transferred into the Compulsory Health Insurance Fund (CHIF). The Fund finances healthcare, provided by both public and private medical institutions in Lithuania, for all insured people. People, who pay or who have CHI contributions paid for them, do not have to pay for healthcare services for which treatment institutions have concluded contracts with the health insurance funds.
Compulsory health insurance is based on the principles of universality and solidarity. Universality means that all citizens of our country are obliged to pay health insurance contributions and that every person who pays them becomes an insured person. Solidarity means that everyone contributes to the best of his or her abilities, i.e. absolutely everyone contributes to the health insurance scheme, but some people contribute more and others contribute less, depending on their income. However, in case of an insured event, regardless of the level of contributions paid, everyone has the right to receive necessary healthcare services that are paid for by CHIF.
This ensures universal health coverage and that all citizens receive healthcare they need. If the principles of universality and solidarity were not applied, both expensive and routine medical services would simply be unavailable for most people.
CHI contribution of a current month must be paid up to the last day of that month. It happens that incorrect personal details, amount or contribution code are provided when making the payment. In such cases, although CHI contributions have been paid, they may not be accounted for and CHI will be interrupted.
If a person receives reimbursable healthcare services, medicines or medical aids when their insurance ends, debts for both CHI contributions and cost of the services provided is calculated.
If CHI is stopped and the patient received, for example, a specialist’s consultation, the amount owed would not be very high. However, if more healthcare services or more complex services and reimbursed medicines are provided, the cost could be several hundred or even several thousand euros. Surgeries, treatment of oncological and other chronic diseases are particularly expensive. A simple way to avoid this is to pay your CHI contributions on time.
All CHI contributions are paid into settlement accounts of SODRA. You can find out what the contribution codes are and how to pay them on the SODRA website or by calling SODRA Information Centre. You can also check whether you have a CHI contribution debt on the website of the institution: www.sodra.lt/pasitikrink.
It is convenient to check, whether you are insured, on the website of the national health insurance funds.
(Piktochart photo)
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