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17-04-2026

The right to be informed: what is important to know about reimbursable healthcare

Iliustracija

The National Health Insurance Fund receives around half a thousand inquiries every day from residents regarding compulsory health insurance and reimbursable healthcare services. This shows that patients consider it important not only to receive services, but also to know what they are legally entitled to. European Patients' Rights Day also serves as a reminder of one of the most important patient rights — the right to be informed.

When are healthcare services reimbursed?

Patients have the right to receive high-quality healthcare services provided professionally and respectfully, as well as the right to choose a healthcare institution and a doctor. It is also important to know basic conditions: in order to receive services reimbursed by the Compulsory Health Insurance Fund, a person must be covered by compulsory health insurance, have a valid referral (when required), and apply to a healthcare institution that has an agreement with the health insurance fund.

What must healthcare institutions inform patients about?

A patient’s right to choose a healthcare institution can only be properly exercised when they have sufficient information about the services provided. “Patients in healthcare institutions should be informed about which services are reimbursed and the procedure for receiving them, so that they can make the most suitable decisions regarding their health and treatment,” reminds Julija Valienė, advisor at Vilnius Healthcare Provider Supervision Division of the National Health Insurance Fund.

Patients must be clearly informed about service prices and receive information from doctors about their health condition, treatment process, prognosis, and possible risks. This information must be understandable to the patient, and if the patient’s age or health condition limits their ability to understand it, the information must be provided to the patient’s legal representatives.

In addition, healthcare institutions that have agreements with the health insurance fund must publicly display, in visible places and on their websites, which services are covered by the health insurance fund and in which cases treatment measures requiring a patient co-payment may be offered.

What will change in the near future?

This is particularly relevant now, because from May 1, in all healthcare institutions – both public and private – healthcare services paid by the fund will have to be provided to patients without any co-payments. This means that if a service is reimbursed by the health insurance fund, the patient must not pay extra for it.

At the same time, a list of optional additional medical aids will come into effect. If a patient wishes, he/she will be able to choose a more expensive device from the list than the one paid for by the health insurance fund. In that case, the person will pay not the full price of the selected device, but only the difference in price. The doctor will have to clearly explain which reimbursed devices are available at no cost and how they differ from more expensive alternatives. The patient must receive this information in writing and confirm their choice with a signature.

The list of optional more expensive devices includes, for example, endoprostheses (for knee, hip, shoulder, ankle, elbow, and wrist joints), intraocular lenses, hearing implants, devices used in arthroscopic surgeries, robotic surgery equipment sets, and meshes for hernia operations.

What to do if you have questions?

“If patients have questions about the provision of services or the charging of medical aids, it is first recommended to clarify the matter at the healthcare institution itself – at the registration desk or with the treating physician. If that is not sufficient, they should submit a written request to the institution’s administration,” emphasizes Julija Valienė.

If the explanation received is still not satisfactory, patients can turn to the relevant institutions responsible for handling such issues, and for matters related to compulsory health insurance – to the National Health Insurance Fund.

Specialists of the health insurance fund encourage residents to consult in advance if they have doubts, even before receiving services. Consultations are available by phone, email, and via social networks.

The NHIF invites you:

Last updated: 12-05-2026

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