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30-05-2023

The health insurance funds remind: rehabilitation services are available all year round

Iliustracija

Each year, most of the inpatient medical rehabilitation services paid for by the Compulsory Health Insurance Fund (CHIF) are provided in summer. Specialists from the National Health Insurance Fund (NHIF) remind patients that rehabilitation facilities are not for recreation, but for treatment, and services are provided regardless of the season.

“Every year, between May and August, the number of parents wishing to send their children to sanatoriums increases. As a result, queues often form at some rehabilitation facilities. For example, last summer, 42% of all inpatient rehabilitation services were provided to children, and twice as many children received them in the warm season than at other times. However, rehabilitation is not provided when it is convenient for the patient, but when treatment is really needed. Sanatoriums are not for recreation - both children and adults are sent there in presence of serious illnesses all year round”, says Rimantė Venclovienė, Advisor to the Services Management Division of the NHIF.

The specialist points out that rehabilitation services are available for patients having chronic diseases, after major surgeries, illnesses and injuries. However, rehabilitation is not prescribed to some patients at all due to medical contraindications. A patient should therefore first contact his/her family doctor or an attending doctor in the inpatient unit, who may be able to issue a referral for a consultation with a doctor of physical medicine and rehabilitation. In each individual case, this doctor determines the need for rehabilitation, its duration and whether rehabilitation services should be provided in the outpatient or in the inpatient unit. It depends on the patient’s condition, the severity of the disease and the impairment of biopsychosocial functions.

“It’s important to know that adults can receive one course of inpatient rehabilitation for the same condition per calendar year. There is no such limitation for children: if there are indications, they can receive inpatient rehabilitation services for the same illness several times a year”, emphasizes R. Venclovienė.

Children up to 8 years old can be accompanied by a carer to inpatient rehabilitation facilities. If a child is over 8 years old, a carer can only accompany the child if he or she is disabled or if a consillium of doctors determines the need for care. In these cases, Compulsory Health Insurance Fund pays not only for child’s rehabilitation services, but also for caregiver's accommodation and meals. It is important to remember that only one caregiver can accompany children from the same family at a time.

The doctor referring the patient for rehabilitation must explain what rehabilitation services he needs and tell him what treatment institutions provide necessary services. However, the patient has the right to choose a rehabilitation facility by himself. We always recommend to choose the facility with the shortest queue for rehabilitation. This can be found in the interactive search for rehabilitation facilities for children and adults  on the website of the Health Insurance Fund. The number of available places is updated every business day, so you can always find the latest information.

Once a doctor has prescribed rehabilitative treatment, the patient does not need to take care of any documents. The referral is issued electronically by a doctor of physical medicine and rehabilitation and the patient only needs to contact the rehabilitation facility of his/her choice by phone to arrange the date of arrival. Upon arrival at the rehabilitation facility, the patient will only need to provide a proof of identity.

To ensure that rehabilitation services are available to those patients who need them most, the Health Insurance Fund reminds that since January of the last year, some inpatient rehabilitation services have been provided and paid for on a priority basis. Therefore, patients who have suffered a heart attack, stroke, injuries or who are after oncological surgeries or endoprosthesis, as well as children and patients with extremely serious health conditions, must be admitted first to a rehabilitation facility.

(Freepik photo)

The NHIF invites you:

Last updated: 09-08-2023

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