10 questions and 10 answers about EHIC

The EHIC is a document certifying the right of the insured to receive necessary healthcare services paid from the Compulsory health insurance fund (hereinafter - CHIF) budget during a temporary stay in the European Union (EU), European Economic Area (EEA) countries, Switzerland and the United Kingdom under the same conditions and at the same cost as people insured in those countries.

The card is valid only in the listed European countries:

EU Member States: Ireland, Austria, Belgium, Bulgaria, Czech Republic, Denmark, Estonia, Greece, Spain, Italy, Cyprus, Croatia, Latvia, Poland, Lithuania, Luxembourg, Malta, the Netherlands, Portugal, France, Romania, Slovakia, Slovenia, Finland, Sweden, Hungary, Germany.

EEA member countries: Liechtenstein, Iceland, Norway.

Other countries: Switzerland, the United Kingdom.

Citizens of the listed European countries use the EHIC issued in the country where they are insured by social (compulsory) health insurance (hereinafter - CHI) when there is an urgent need for healthcare in another European country.

The card is issued by the institution implementing the compulsory health insurance of the respective country (in Lithuania - territorial health insurance funds or THIFs). EHIC is useful when emergency medical care services are needed upon temporary stay in Lithuania (for insured persons from other European countries) or when necessary medical care is provided to a person insured in Lithuania in another European country.

The EHIC together with the insured person's identity document must be submitted to the healthcare institution providing necessary healthcare services.

If you are insured by the CHI in Lithuania, the EHIC can be obtained by applying to the Territorial Health Insurance Fund (THIF).The application can be submitted personally or through an authorized person, by post, online (temporarily available only in Lithuanian language on the website of the National Health Insurance Fund). The application form and its electronic version can be found on the National Health Insurance Fund (hereinafter - NHIF) and THIF websites. It is most convenient to order the EHIC by filling in the electronic application form.

EHIC is also issued to the children. The application for a child under the age of 16 shall be completed and submitted to the THIF by one of the parents (adoptive parents), guardian (custodian), a representative of the social care institution, together with documents confirming the appointment as guardian (custodian) or representation documents, or official copies of these documents and the identity document of the representative.

The card is issued free of charge upon presentation of the insured person's identity document. The card can also be obtained free of charge in the territory of the Republic of Lithuania by registered mail.

The EHIC is valid from 2 months to 18 years depending on the person’s CHI category which is determined by the Law on Health Insurance (e.g., the EHIC is issued to pensioners for a period of 10 years, to working people - up to 4 years, to students - for one academic year, etc.). However, the EHIC is only valid if its holder is covered by the CHI regardless of the expiry date indicated on the EHIC. If person is no longer insured with the CHI in Lithuania, he or she cannot use the EHIC issued by the THIF.

If a Lithuanian insured person needs necessary healthcare services during a trip abroad, the healthcare services on the basis of the EHIC are provided and paid for in accordance with the scope and tariffs established by legislation of the country of treatment. The invoices submitted directly to the NHIF and THIFs by the foreign medical institution are not accepted and paid. The necessary healthcare services provided to a Lithuanian insured person who has submitted his/her EHIC are paid for by the health insurance fund or another relevant institution of the country of treatment, and later reimbursed by the NHIF.

If any European country has provisions requiring to charge patients for the services in question, the EHIC holder will also have to pay co-payment or cover the cost of the healthcare services. In many European countries, health insurance funds do not cover transport costs if the patient has to be transported to the country where he or she is covered by the compulsory health insurance.

If, for some reason, a Lithuanian insured person still has to pay for the costs of necessary healthcare services provided by a medical institution in a European country after submitting the EHIC, he or she may apply to the THIF at his place of residence for reimbursement. For example, in France, Belgium and Switzerland, it is always necessary to cover the costs of outpatient care at one's own expense.

When applying to the territorial health insurance fund for reimbursement of the costs of necessary medical assistance, it is necessary to submit the originals of the documents confirming the payment and copies of the extracts from the medical documents. More information about reimbursement procedure, you can find in the section „Reimbursement of expense“.

The same procedure for the provision and payment of services also applies to the insured persons from European countries who receive the necessary healthcare services in Lithuania.

The legislation gives the right to receive necessary healthcare services paid from the CHIF budget only in those medical institutions that participate in the national health system of the respective European country. These can be both public and private, so when you visit any healthcare provider, you should always find out if it belongs to the national health system and whether it accepts the EHIC.

The THIFs also do not reimburse patient co-payments and healthcare services that are not covered by public health insurance under the national legislation of the European country of treatment.

The use of EHIC is prohibited if the status of the CHI changes.

When issuing the EHIC, the person signs the commitment not to use the EHIC in case if his/her CHI insurance status changes. If the person who is no longer insured with CHI in Lithuania uses the EHIC issued by THIF, the NHIF is obliged to reimburse the cost of treatment. But after the payment of the bill, the NHIF approaches the person who misused EHIC with request to reimburse the expenditure. 

If a person being not insured with the CHI uses the EHIC, the NHIF must, in accordance with EU law, reimburse the expenditure of the treatment provided. In this case, the budget of the CHIF experiences losses due to the inappropriate use of the EHIC. These losses must be compensated by the person. First of all, the NHIF informs the person about the obligation to indemnify the damage to the fund by himself / herself or to submit the documents confirming the insurance with the CHI. If the person does not provide the requested documents or does not compensate for the determined damage, the NHIF applies to the court.

Voluntary compensation causes less inconvenience than the enforcement of a court judgment. Voluntary indemnification can be done by choosing one of the possible methods: immediately transfer the total amount to the specified account or sign an indemnity agreement and compensate the amount in instalments.

If you have lost your card (or it was stolen), contact the police for a certificate of loss. In case of loss of a valid card and without a certificate issued by the police about the loss of this document, a new card is issued only after paying 15 EUR for the replacement of a lost (or damaged) card.

It should be known that the scope of the medical care varies in European countries, so it is worth considering additional insurance. For example, supplementary travel insurance may cover the cost of transportation in the event of illness (repatriation), the cost of additional patient-selected services that are not covered by that country's public (compulsory) health insurance system.