What does Compulsory health insurance guarantee?

Compulsory health insurance (CHI) guarantees that the cost of healthcare services, reimbursable medicines, medical aids, orthopaedic technical equipment, etc provided to all insured persons is paid for by the Health insurance funds from the Compulsory Health Insurance Fund (CHIF) budget. Health insurance funds pay directly to medical institutions, pharmacies and orthopaedic companies.

It is important to know that you do not have to pay for the services if you apply to a medical institution that has a contract with the territorial health insurance fund (THIF) for the provision and compensation of healthcare services. Information on healthcare institutions having contracts with health insurance funds can be found here.

Most of the healthcare services are free for the insured people. Cost-sharing applies to some kinds of healthcare: for instance, dental services and pharmaceuticals for out-patient treatment. Minister of Health approved the negative list of healthcare services. These services are financed entirely from the patient's own resources according to a set price list.

In order to get free healthcare services, people insured with the CHI in Lithuania must choose a primary healthcare institution and register to the list to the family doctor. The insured person is entitled to choose a primary healthcare institution and practitioner as well as secondary and tertiary healthcare institution and practitioner. Services provided by family doctor are free of charge. If family doctor decides that specialised out-patient services or hospitalisation is needed, he will issue the referral. In case of emergency, in-patient and specialised out-patient healthcare services are provided free of charge without the referral.

Remember that people who are not insured by the CHI must pay the full cost of medical services (excluding emergency medical care provided to the residents).