Right to health care after relocation to another EU Member State

Entitlement document is  required, when the person resides in the another EU Member State than he/she is covered by the social insurance.

Entitlement document is also used by retired persons, who live in another EU Member State.

The NHIF issues entitlement documents to the persons insured by the compulsory health insurance in the Republic of Lithuania.

The persons insured in the Republic of Lithuania have the right to entitlement document, provided they have declared their departure from the Republic of Lithuania in accordance with the Law on Declaration of the Place of residence as well insured persons of the Republic of Lithuania residing in another EU country who are not considered to have changed their place of residence  in accordance with the procedure established by this Law:

• 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 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;
• unemployed persons of working age who have the minimum statutory period of pension social insurance required to receive a state social insurance old-age pension, or who have acquired no less than 30 years of pension social insurance period required to receive a state social insurance old-age pension by 31 December 2017;
• the family members of persons listed above, if they are not entitled to 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 NHIF:

• completed application to issue the document confirming the right to healthcare in the EU country of residence (Application Form);
• personal identity document (or a copy thereof, if the application is submitted by regular post or electronically;
• document certifying the right to live in the EU Member State if the person is not an EU citizen or has no citizenship;
• copies of documents proving that the person resided in another EU country (ies) before the declared departure, if entitlement document is requested to be issued retroactively;
• copies of documents confirming insurance periods acquired in other EU country (ies), if the insured person of the Republic of Lithuania is receiving pensions under the legislation of both Lithuania and one or more EU countries."
• if the application for the insured is completed and submitted by his representative, a written consent confirming the right to represent the insured is submitted with the application.

If the data is not sufficient to make a decision on issuing the entitlement document, the employee of the NHIF applies to:

• Vilnius Division of the State Social Insurance Fund Board under the Ministry of Social Security and Labor requesting confirmation that the person is subject to the social insurance legislation of the Republic of Lithuania (document A1 or another document) and that his work experience in the Republic of Lithuania or in another EU country is sufficient;
• the institution of the EU country of residence of the insured person for confirmation of information about the right of the insured or his/her family members to receive benefits in kind under the legal acts of the EU country of residence;
• the institution of the EU country or the insured person for providing additional information.

In all cases, the SED S072 is issued to the person, however, if the person requests a paper form, the document S1 is issued in addition.
 

The SED S072 issued by the NHIF is sent electronically to the institution of the place of residence of the insured person indicated in the application. If the person indicates in the application that he/she wishes to receive a paper form, the document S1 is delivered or sent to the person in the manner indicated in the application.

Paper form of the entitlement document issued by the NHIF 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 funds of the EU Member State of residence, health insurance or social insurance authority, or some other authority performing respective functions.

When the entitlement document is registered  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 services provided shall be covered by the authority, where the entitlement document  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 NHIF.

The validity of the entitlement document may be terminated by:

• the NHIF if it learns that the person has lost the status of person insured with the 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 the entitlement document was registered (e.g., the person ceases to reside in certain country or gets employed there) or having received a request from the person to mediate in the termination of the entitlement document (Application form) 
• the authority of the EU Member State of residence if it learns that the person has been insured by the 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 the entitlement document 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 the entitlement document. Entitlement documents are registered in the NHIF.

When the entitlement document is registered, the 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 NHIF. Afterwards, the competent authority that has issued the entitlement document shall reimburse the expenses to Lithuania.

If the insured person of another EU Member State moved to the Republic of Lithuania without having previously applied for the issuance of the entitlement document it is possible to apply to the NHIF with a request for mediation (Application form). The NHIF will apply to the competent institution of the EU Member State where the person is covered by the social insurance for the issuance of that document.