Medicines and Medical Aids
The price list of the compensated medicines is formed in Lithuania two times a year. The purpose is to reduce the prices of the compensated medicines and surcharges paid by the patients. The price list of the compensated medical aids (MA) is formed once in a year.
Not all the purchase expenses of the medicines and MA may be covered from the budget of the Compulsory Health Insurance Fund in Lithuania – only the expenses of the medicines and MA included into the lists approved by the Minister if Health:
- (A) List of diseases and compensated medicines to treat them;
- (C) List of compensated MA.
The medicines used to treat various diseases (for example, oncologic disease, tuberculosis, diabetes mellitus, epilepsy, asthma, schizophrenia, disseminated sclerosis, blood coagulation disorders) are included into list A. They may be prescribed for all the insured persons who have the listed diseases. The basic prices of all the listed medicines are compensated by 100 percent.
Since July 2020, the co-payments paid by the patients for medicines and MA are compensated from the State budget for persons over 75 years old, as well as pensioners and disabled whose income (from pensions, allowances, compensatory benefits, and annuities) are smaller than 100 percent of last year’s amount for minimal consumer needs.
The MA included into list C (nursing tools, various diagnostic stipes, food products of special medical purpose, etc.) may be prescribed to all the insured persons according to the conditions provided in this list. If new MA are entered into list C, the price list of the compensated additional MA is supplemented, if necessary. The doctor is the one to decide about the need for MA. However, the prescriptions for the already used MA may be also issued by nurses. The nurses of general practice, community nurses and diabetes specialist nurses have the right to prescribe the majority of MA appointed by the doctor.
For more information, click here (Lithuanian).
How to avoid overpaying for reimbursable medicines at the pharmacy?
- The pharmacist must display on a computer monitor all medicines with the same active substance from different manufacturers.
- The pharmacist should first offer the reimbursable medicine with the lowest co-payment.
- A basket of premiums is built up each year for the purchase of reimbursed medicines with the lowest co-payment. Once accumulated premiums reach EUR 48.33, the patient does not have to pay for the cheapest medicines afterwards.
- If the pharmacy does not have the medicine with the lowest co-payment available on that day, the pharmacist must order and deliver it: within 2 days in the city and within 4 days in rural areas.
Who is covered by the patient’s premium from state funds?
- From July 2020, the State budget covers the cost of medicines and reimbursed MA for people aged 75 and over.
- The premiums are also covered when prescriptions for reimbursable medicines and MAs are purchased by retired people and disabled people, whose pensions, social assistance pensions, compensation payments, annuities are less than 100% of the current year’s minimum consumption needs.
- From July 2023, the state budget covers the patient’s premium for reimbursable medicines (which are classified as medicines with the lowest premium) for people who have accumulated a basket of premiums.
The patient’s premium paid by these population groups to pharmacies is covered by the state budget of the health insurance funds, so there is no extra cost to residents themselves when picking up reimbursable medicines from pharmacies via e-prescriptions.
Please note: Pharmacies are automatically informed of the accumulated basket of premiums and patients can check their accumulated basket of premiums on E. sveikata.
For more information, click here (Lithuanian).
Last updated: 08-10-2024