In accordance with the legal acts of the EU the insured person, who cannot receive timely health care services in the country where he/she resides or is insured by social health insurance, upon receipt of the prior authorisation of his competent institution, may go for the treatment to another EU Member State, Iceland, Norway, Lichtenstein, Switzerland or the United Kingdom. The authorisation shall be granted if the treatment in question is among the benefits provided for by the legislation in the Member State where the person resides and if the healthcare services cannot be provided within a time-limit which is medically reasonable, taking into account patient’s current state of health and the probable course of his illness.

In Lithuania, the decision to refer the person for consultation, treatment and/or examination abroad is made by the special commission acting at the National Health Insurance Fund under the Ministry of Health (NHIF). The NHIF issues portable document S2 upon receipt of information from the commission that the prior authorisation has been approved.

Planned treatment abroad could be funded from the budget of the Compulsory Health Insurance Fund (hereinafter - CHIF) if:

  • relevant or equally effective healthcare service in Lithuania is paid for from the CHIF budget, but due to the patient's health condition and / or course of the disease it cannot be provided to him / her in Lithuania on time
  • if the possibilities of examination and treatment in Lithuania have already been used and the treatment method applied abroad could effectively affect the patient's state of health and prolong the patient's life and / or reduce the disability.

Document S2 is a document certifying the person’s right to receive certain scheduled health care services in the Member States of the EU, European Economic Area, Swiss Confederation and the United Kingdom. When the persons submit this document to a foreign medical institution, the healthcare services are provided, and their expenses are paid in accordance with the legal acts of the respective foreign country – as if the persons had social health insurance of that country. The expenses of health care services provided on the ground of document S2 are covered by the institution of the country providing healthcare services in accordance with the terms, conditions and rates established in the national legal acts of that county. Later the NHIF compensates these expenses.

It should be noted that document S2 is not a guarantee of payment of the expenses from the Compulsory Health Insurance Fund (CHIF) budget. the NHIF does not accept the invoices of foreign medical institutions and does not cover directly the expenses of health care services provided abroad. The expenses of the patient’s co-payments or travel, accommodation and translation expenses shall not be reimbursed from the budget of the CHIF.

The decision to refer the patient for consultations, examinations and/or treatment abroad is made by the commission established by the NHIF director. The Commission notifies the patient and/or his/her representative about the decision in writing within 5 business days.

The Commission makes the decision to refer the patient for consultations, examinations and/or treatment abroad upon receipt of the following documents from the university hospitals or hospitals, where certain university clinics operate:

  • Conclusion of physicians stating the patient’s personal data, clinical diagnosis, the current patients’ health state, applied treatment and its results, needed treatment abroad, justification of the patient’s referral abroad, and preliminary prognosis of recommended treatment
  • the patient’s referral in the established form
  • a letter from the foreign medical institution confirming that the expenses of the treatment will be covered on the ground of document S2 and stating the preliminary cost of it.

Last updated: 28-05-2024