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03-06-2025

Treatment Abroad: When Are Lithuanian Patients Sent to Other Countries and Who Pays?

Iliustracija

Although Lithuania’s healthcare system provides the majority of essential medical services, there are occasions when patients may be referred to other European countries for treatment — offering hope to those whose diagnostic and treatment options have been exhausted in Lithuania.

Medically justified necessity

Patients insured with compulsory health insurance may be sent to other countries of the European Union, as well as to Switzerland, the United Kingdom, Norway, Iceland or Lichtenstein for treatment. A special document is issued confirming that the costs of planned medical services provided abroad will be covered by the Compulsory Health Insurance Fund (CHIF).

“This is not an individual initiative or a desire to seek treatment abroad, but a medically justified necessity. Patients are referred abroad for treatment only when it is not possible to provide required services in Lithuania in a timely manner, or when all options within the country have been exhausted, and the treatment method available abroad could significantly improve patient’s health, prolong life, or help prevent disability,” says Neringa Šafranavičienė, Advisor of the Cross-Border Healthcare Division of the National Health Insurance Fund (NHIF).

The journey begins with the doctor

For planned treatment abroad, the patient is first referred for a consultation at a university or university-affiliated hospital. If a justified need arises, a medical council is convened to assess the possibilities of treatment in Lithuania and potential benefits of receiving treatment abroad.

If the medical council determines that the referral is justified, the hospital contacts a specific foreign medical institution, arranges the details, and obtains a written confirmation of acceptance and treatment cost. All these documents are sent to a special commission at the National Health Insurance Fund (NHIF), which makes the decision regarding the patient’s referral for consultation, examination, or treatment abroad. Upon a positive decision by the commission, the patient is issued a special document, the S2 form.

The entire process – from medical decisions to paperwork – is handled through healthcare institutions, so patients do not need to take care of the formalities themselves.

Most often, expensive and complex services are required

For such planned treatment, patients are referred only to medical institutions that are part of the national healthcare systems in other European countries. Moreover, only those medical services that are covered by the public health insurance of the respective country are reimbursed.

Patients are most often referred abroad to receive expensive and complex inpatient services that, for various reasons, cannot be provided in Lithuania. For example, this may occur when the patient is very young and there is a lack of specific medical expertise in the country or an insufficient number of such cases to develop the necessary competence.

Based on the S2 form, children are often referred to Switzerland for treatment of rare ocular oncological diseases; patients travel to Poland for liver transplants; pregnant women are sent to Sweden when treatment for twin-to-twin transfusion syndrome is needed; and adults are referred to various countries for cancer treatment when effective treatment methods are not available in Lithuania.

“These are not routine cases – each situation is unique, medically assessed, and justified. Services abroad are reimbursed only when they are necessary and can genuinely benefit the patient,” emphasizes N. Šafranavičienė.

Reimbursed treatment costs 

Based on the S2 form, the costs of healthcare services provided in a foreign country are covered by that country’s health insurance institution, and the National Health Insurance Fund (NHIF), upon receiving the invoice, reimburses these costs from the Compulsory Health Insurance Fund (CHIF).

Although patients do not have to pay for treatment, co-payments, such as charges for hospital stays, are not reimbursed from the CHIF. Additionally, paid medical services, patient’s travel, accommodation, transportation, or document translation expenses are not covered.

Half of patients go to Switzerland 

Last year, the National Health Insurance Fund (NHIF) commission made 30 positive decisions regarding planned treatment abroad. Of these, 28 were made at the request of Lithuanian healthcare institutions: 18 cases where timely assistance could not be provided in Lithuania, and 10 cases where all available treatment options in Lithuania had been exhausted. Two additional decisions were made at the request of foreign healthcare institutions – these involved patients who, after receiving emergency care in Germany, could not return to Lithuania due to their health condition and required rehabilitation.

As in previous years, the most common destination for patients was Switzerland – fifteen individuals were sent there for the treatment of malignant eye tumours or congenital anomalies. Additionally, patients were referred to Sweden, Poland, the Netherlands, France, Austria, and Finland.

In total, last year NHIF paid EUR 426,600 for planned treatment of Lithuanian patients abroad.

The NHIF invites you:

Last updated: 17-06-2025

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