According to the legal acts of the European Union (EU), the person insured by social insurance in one EU Member State but residing in another EU Member State, is entitled to healthcare services in the country of residence. The competent institution  of the EU Member State, where the person was insured by social insurance, is responsible for reimbursement of such expenses. In order to exercise this right, the person has to register document S1 issued by his competent institution in the institution of place of residence in the country of residence.

The functions of the competent institution in Lithuania are performed by territorial health insurance fund (THIF).

The countries, where Lithuanian insured may get healthcare services covered from the budget of Compulsory Health Insurance Fund (CHIF) are: EU Member States, European Economic Area countries, Switzerland, and the United Kingdom.

Document S1 issued by the THIF certifies the right of the person insured by compulsory health insurance in the Republic of Lithuania but residing in another EU Member State, to receive healthcare services in the country of residence, the expenses whereof would be reimbursed from the CHIF budget.

Document S1 has replaced certificates E 106, E 109, E 120 or E 121.

Document S1 is needed, when the person resides in the different EU Member State than that he/she is insured with social insurance.

Document S1 is also used by retired persons, who live in another EU Member State.

The THIFs issue documents S1 to the persons insured by compulsory health insurance in the Republic of Lithuania.

The persons insured in the Republic of Lithuania have the right to document S1, provided they have declared their departure from the Republic of Lithuania in accordance with the Law on Declaration of the Place of esidence:

  • the persons, who work in the Republic of Lithuania and pay the compulsory health insurance contributions in accordance with Article 17 of the Law on Health Insurance of the Republic of Lithuania, or for whose behalf these contributions are paid (with the exception of persons specified in points 8, 10, 11 of Article 17 of of the Law on Health Insurance of the Republic of Lithuania);
  • the persons, who receive the state social insurance pension in the Republic of Lithuania or pensions according to the laws of other EU Member States, if the work experience obtained in Lithuania is the biggest and if they are not entitled to the pension under the legal acts of the EU Member State, where they reside;
  • the family members of persons listed above, if they are not entitled to the healthcare under the legislation of the EU Member State of their residence.

The person insured in the Republic of Lithuania has to submit the following documents to the THIF:

  • completed application to issue document S1 (Application Form);
  • personal identity document;
  • document certifying the right to live in the EU Member State if the person is not an EU citizen or has no citizenship.

Document S1 issued by the THIF shall be submitted to the institution of the EU Member State responsible for registration of persons for health care services. These may be territorial health insurance fund of the EU Member State of residence, health insurance or social insurance authority, or some other authority performing respective functions.

When the person registers document S1 in the authority of the EU Member State of residence, that person acquires the right to receive medical services in that country under the same conditions as the persons insured in that country. The expenses of the provided services shall be covered by the authority, where document S1 was registered. Meanwhile, the authority’s expenses shall be reimbursed by the NHIF.

When the person insured in the Republic of Lithuania gets employed in the EU Member State of residence or other Member State, that person has to notify the Lithuanian THIF that has issued document S1 thereof.

The validity of document S1 may be cancelled by:

  • the Lithuanian THIF if it learns that the person has lost the status of person insured with compulsory health insurance in Lithuania or is not entitled any more to receive the healthcare covered from the budget of the CHIF in the EU Member State, where document S1 was registered, because of some other reasons (e.g., the person ceases to reside in certain country or gets employed there);
  • the authority of the EU Member State of residence if it learns that the person has been insured by social insurance in accordance with the legal acts of that EU Member State or has lost the right to healthcare in that EU Member State because of other reasons.

If the person is employed and pays social insurance contributions in another EU Member State, but is residing in the Republic of Lithuania, that person should apply for document S1 to the competent authority of the EU Member State of employment (for example, local health insurance funds, social insurance or other authority). This authority is the only one that may decide to issue document S1 (or equivalent certificate of E form if documents S1 are not issued in that EU country) in accordance with national legal acts. Document S1 has to be registered in any THIF in the Republic of Lithuania.

When the person registers document S1 in the chosen THIF in the Republic of Lithuania, that person acquires the right to healthcare services financed by the CHIF budget and the compensated medicines and medical devices under the same conditions as the persons insured by compulsory health insurance in Lithuania: 

  • when applying to a healthcare institution, a person must present just an identity document,
  • a person can choose an institution providing primary health care services and a family doctor, 
  • the specialized health care or inpatient treatment is provided upon the referral of the family doctor (in case of emergency the referral system is not applicable).

The expenses of the provided healthcare services, compensated medicines and medical aids shall be covered by the THIF. Afterwards, the competent authority that has issued document S1 shall reimburse the expenses to Lithuania.

In order to receive the state-guaranteed medical services smoothly, it is important to submit document S1 to the THIF immediately after arriving to Lithuania.

If the insured person of another EU Member State moved to the Republic of Lithuania without having an S1 document, it is possible to apply to the THIF with a request for mediation. The THIF will apply to the competent institution of the EU Member State where the person is covered by social insurance for the issuance of document S1.

Contacts of Territorial Health Insurance Funds – click here.
Application for mediation regarding issuance of document S1 – click here

Last updated: 21-06-2024