Dental prosthetics

Dental prosthesis is a dental prosthesis service that restores a patient's lost teeth in an effort to restore full-fledged biting function. Currently, the established budget procedure for the provision of dental prosthetic services and reimbursement of expenses from the Compulsory Health Insurance Fund (CHIF) is in force. Under this procedure, the following categories of insured persons with compulsory health insurance (CHI) are entitled to dental prosthetics reimbursed from the CHIF budget:

• persons who have reached retirement age;
• children under 18;
• persons recognized as incapable of work or partially able to work in accordance with the procedure established by the Law on Social Integration of the Disabled of the Republic of Lithuania;
• individuals who have been treated for oncological disease of the mouth, face, and jaw.

In order to receive dental prosthetic services, individuals must apply to the medical institution to which they are admitted (the medical institution must have a contract with the territorial health insurance fund (THIF). Or to another personal health care institution that is licensed to provide dental care (assistance) services and has a contract with the THIF for the provision and payment of dental care (assistance) services. During the consultation the dentist (or, in rare and more complex cases, the medical council) has determined the right and validity of the dental prosthesis and assessed the condition of the teeth, dentures and oral condition is suitable for dental prosthetics (medical and preventive procedures performed, sanitary cavity, sealed carious teeth, etc.), - must enter data into the Electronic Health Services and Cooperation Infrastructure Information System. (ESPBI) and fill in form No. E025 "Description of outpatient visit" and online referral form No. E027 "Referral for consultation, examination, treatment" and register the person on the same day in the Dental Prosthetics Subsystem of the Queue and Inventory Management Information System (EVIS DP).

Thus, all data is processed and recorded electronically on site, and the person does not have to make any additional requests to the medical institution or the THIF to write and submit. During the consultation, the person is immediately informed about the acquisition or non-acquisition of the right to receive reimbursable dental prosthesis services. The institution must issue an information notice confirming this.

A person eligible for reimbursable dental prosthesis services and registered with EVIS DP must select and apply to a medical facility that has a contract for dental prosthetic services with any THIF. The costs of providing dental prosthetic services are paid to the institution that provided the services. If the medical institution does not have a contract for these services with the THIF, then dental prosthetic services will not be reimbursed and the person will have to pay for them at his own expense. Dental prosthetic services will have to be provided within 3 years from the acquisition of this right - registration of a person in the EVIS DP subsystem. Re-reimbursed dental prosthesis services will be available to the patient no earlier than 3 years from the date of reimbursement of dental prosthetic services.

For more information, click here (in Lithuanian).