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Necessary healthcare services in European Union

In accordance with European Union legislation people covered by public health insurance in one member state are entitled to receive state-provided medically necessary healthcare during their temporary stay in any of the EU member states. The costs of these services will be covered by public health insurance. This also applies to visits to Iceland, Norway, Liechtenstein and Switzerland

​To avail of this right, you should apply for a free European Health Insurance Card, which allows you to access necessary state-provided health care while visiting or temporarily staying in these countries. Everyone who is insured by Compulsory Health Insurance in Lithuania should have an EHIC and carry it with them when travelling abroad.

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What is the European Health In​​surance Card?

 

European Health Insurance Card is a document which certifies that the holder is entitled to receive state-provided medically necessary healthcare during a temporary stay in any of the EU countries, Iceland, Lichtenstein, Norway and Switzerland, under the same conditions and at the same cost (free in some countries) as people insured in that country.

 

Lithuanian Territorial Health Insurance Funds issue EHICs free of charge to people insured by compulsory health insurance in Lithuania

 

How can I apply for a European Health Insurance Card?

 

Applying for the European Health Insurance Card is easy. Even if you don't have any plans to travel in the near future, it is always a good idea to get one.

 

The European Health Insurance Card is issued only at the request of the insured. It can be requested by fax, Internet, personally or through a representative at Territorial Health Insurance Funds. The application form can be found on the websites of the National Health Insurance Fund (NHIF) and Territorial Health Insurance Funds: (http://www.vlk.lt/vlk/lt/?page=info&id=1053)

 

The European Health Insurance Card will be issued within 14 days of the request being registered at the THIF. The card is issued by the Territorial Health Insurance Fund to which the request has been presented.

The European Health Insurance Card must be issued to the person concerned or by an authorised attorney, because the cardholder has to sign a commitment not to use the card after the expiry of his entitlement.

 

In order to get the card, the holder should present the Territorial Health Insurance Fund:

- Identity document (passport or identity card);

- The child's birth certificate or passport (if the card is ordered for child).

If another person collects the card, he must submit his identity document, a copy of the identity document of the person to whom the card is issued as well as a power of  attorney to collect the card executed in accordance with terms and conditions endorsed by the Civil Code of the Republic of Lithuania. The power of attorney is only necessary if the personal data of the person collecting the  card was not indicated in the application form.

 

How long is the card valid for?

 

The validity period of a European Health Insurance Card is from 1 month to 6 years and depends on a person's compulsory health insurance category which is determined by the Law on Health Insurance.

 

After expiry of the validity period of the card a new European Health Insurance Card will be issued. A new application must be submitted to the Territorial Health Insurance Fund.

 

How to renew a card?

 

At the request of the insured person the European Health Insurance Card can be replaced by the end (at the end) of the validity period of the old card or in case of changes of personal details indicated in the old card.

 

What is covered by the European Health Insurance Card?

 

The European Health Insurance Card gives access to any state-provided medical treatment that becomes necessary during your stay because of either illness or an accident. It includes treatment of a chronic or pre-existing medical condition that becomes necessary during your visit.

If you require kidney dialysis or oxygen therapy you have to make arrangements in advance for this care. To arrange for kidney dialysis while you are away, contact the renal unit in the country you wish to travel before you trip.

 

Your European Health Insurance Card should cover you for routine maternity care while you are away. However, if you are going to another country specifically to have your baby, you will need an E112 form.

 

It is important to be aware, that the European Health Insurance Card gives access to reduced-cost or free medical treatment from state healthcare providers and allows you to be treated on the same basis as a resident of the country you are visiting i.e. you may have to pay a patient contribution (co-payment).

 

Information about necessary healthcare services for European Health Insurance Card holders in different countries can be found on the website of the European Commission: http://ec.europa.eu/social/main.jsp?catId=1021&langId=en

 

Remember to check that your European Health Insurance Card is still valid before you travel!

 

 

 

 

What is not covered by the European Health Insurance Card?

 

  • The European Health Insurance Card is not a substitute or replacement for private travel insurance. You should always take out an appropriate private policy in addition to carrying your card.
  • It will not cover the costs of private healthcare or services that are not part of the state healthcare system.
  • It will not cover the costs of being repatriated to Lithuania.
  • It will not allow you to go abroad specifically to receive treatment (including going abroad to give birth).
  • It does not guarantee free services. As each country's healthcare system is different, services that cost nothing at home might not be free in another country.

 

Inappropriate use (abusive or fraudulent) of the European Health Insurance Card

 

If you are no longer insured with the Compulsory Health Insurance in Lithuania you cannot use the THIF-issued European Health Insurance Card even if the validity period of this card has not expired. Territorial Health Insurance Fund will seek reimbursement of the costs from the cardholder in the case of card misuse the.

 

 What to do if I go abroad without a card?

 

If your card is lost or stolen while you're abroad you should contact the Territorial Health Insurance Fund and apply for a Provisional Replacement Certificate (PRC). Members of your family can do this on your behalf if necessary. The PRC will provide you with the same cover as an European Health Insurance Card until you return home.

 

If leave Lithuania without your European Health Insurance Card and treatment becomes medically necessary during your visit, you may be issued with a PRC as well. At your request the PRC will be sent directly to the place of treatment.

 

 

Compensation

How do I claim a refund?

Some European health systems expect you to pay your bill when you are treated and then claim a refund using your European Health Insurance Card. Try to apply for your refund before you return home.

If you actually paid all the costs for state-provided necessary treatment keep all your receipts and any paperwork (make copies if necessary). You may need them to apply for a refund or reimbursement.

In order to get a refund of your expenses contact the Territorial Health Insurance Fund and provide the following:

  • Your identity document;
  • The copies of medical documentation, prescription;
  • Original document proving that you have covered the cost of healthcare services;
  • The completed application form; the application form will be provided at the Territorial Health Insurance Fund after examination of the provided documents.

 

According to EU legislation costs will be reimbursed to the person concerned in accordance with the reimbursement rates administered by the institution of the country of treatment. Therefore, please, note that there may be a delay in reimbursing you until all the information  about the reimbursable amount is received from the European country, where you received the healthcare services.

If you wish to be reimbursed up to the level of costs that would have been assumed by the Territorial Health Insurance Fund if such treatment had been provided in Lithuania, please indicate this in the application form.

 

Planned treatment in European Union

European Union regulations determine that if a person insured by public (compulsory) health insurance in one member state cannot get the needed healthcare services in the country in which he is covered by compulsory healthare insurance, then with the prior authorisation of his competent institution (form E112 or portable document S2) he can travel to another country of the European Union, Iceland, Norway, Liechtenstein, or Switzerland and get the appropriate healthcare services in one of these countries.

 

There is a special Commission at the Ministry of Health of the Republic of Lithuania responsible to for taking decisions on prior authorisation. The National Health Insurance Fund (NHIF) issues the form E112 within 5 days after the Commission has taken positive decision to send the patient for examinations/consultation/treatment/ abroad.

 

Form E 112 (portable document S2) is a document certifying that the holder is entitled to receive certain state-provided healthcare services in any of the European Union member states, Iceland, Lichtenstein, Norway or Switzerland, under the same conditions and at the same cost (free in some countries) as people insured in that country.

 

Please note that the NHIF and the Territorial Health Insurance Funds do not accept invoices issued by foreign healthcare providers. The cost of healthcare provided on the basis of form E112 should be covered by the local public health insurance institution of the country providing the services according to its national legislation and rates and the patient should pay co-payments. The patient's co-payments as well as expenses paid accommodation and transportation expenses will not be reimbursed from the Compulsory Health Insurance Fund's budget.

 

So, in order to receive health care abroad on the basis of form E112, first of all you should find out if the public health insurance covers the costs of healthcare you needed as well as if healthcare provider belongs to the country's national health system.

 

Who is entitled to receive form E112?

 

The form E112 is issued by the NHIF for patients insured by the compulsory health insurance in Lithuania who are referred for treatment into other European Union member states, Iceland, Norway, Liechtenstein and Switzerland in accordance to the procedure approved by the Order of the Minister of Health No. V-729 dated 16th August 2010 (Official Gazette, 2010, Nr. 99-5162).

http://www3.lrs.lt/pls/inter3/dokpaieska.showdoc_l?p_id=379698&p_query=&p_tr2=2

 

Who is responsible to take the decision on prior authorisation to send the patient for treatment abroad?

 

The Commission on decisions on patient examination, consultation and treatment abroad, acting at the Ministry of Health of republic of Lithuania is responsible to take the decision on prior authorisation to send the patient for examination, consultation or treatment abroad. The commission notifies the patient about its decision.

 

The Commission shall take a decision to send the patient to examine, consult and (or) treat abroad after it receives following documents from the university clinics or hospitals running the university clinics:

 

  1. Conclusion of doctors consultation justifying the need to send the patient for certain health care services abroad;
  2. Extract of medical documents;
  3. Filled-in special form of referral;
  4. The letter of foreign health care provider confirming that it accepts form E112 and that the services are the subject of legislation of the country of treatment.

 

What the holder of form E112 should know

 

You should provide the form E112 together with an identity document to health care institution.

 

Please note that the form E 112 is not a guarantee letter insuring that the cost of healthcare services will be assumed by the Lithuania compulsory health insurance. In accordance with the regulation (EC) 883/2004 of European Parliament and of the Council the cost of the treatment provided on the basis of form E 112 should be covered by the public health insurance institution of the country providing the services. The form E112 gives you an access to state-provided healthcare under the same conditions and at the same cost as people insured in the country of treatment. You will have to pay the same patient fees or co-payments, if any are approved by the legislation of country providing the healthcare services.

 

In case you have actually borne the cost of the treatment keep all receipts and any paperwork (make copies if necessary). You may need them if you' are applying for a refund or reimbursement.

In order to get the refund of your expense turn to the Territorial Health Insurance Fund and provide the following:

  • Your identity document;
  • The copies of medical documentation, prescription;
  • Original document proving that you have covered the cost of healthcare services;
  • The filled in application form; an application form will be provided at the Territorial Health Insurance Fund after the examination of the provided documents.

 

According to the EU legislation the costs shall be reimbursed in accordance with the reimbursement rates administered by the institution of country of treatment. Thereby, please, note that reimbursement may be delayed because of the compensation will be provided only after the information about the reimbursable amount would be receipt from the European country, where healthcare services had been provided.

 

Cross-border healthcare

Rules for receiving cross-border healthcare and reimbursement of these costs are now not always clear or easy to understand. EU countries have until 25 October 2013 to pass their own laws implementing the Directive 2011/24/EU on the application of patients' rights in cross-border healthcare. This directive clarifies the rules on access to healthcare across the European Economic Area (EEA) for all EEA citizens, including reimbursement.

The EU Directive gives the person insured with compulsory health insurance in Lithuania a right to access healthcare services in another EEA country as long as the treatment is medically necessary and is also available in Lithuania ( the cost of treatment are covered from the budget of Compulsory Health Insurance Fund). It covers treatment in both state-run hospitals and by private service providers.

In order to get cross border healthcare you will have to pay the costs. You can claim reimbursement when you return to Lithuania, up to the amount the treatment would have cost in Lithuania. For more information and to ensure you don't have any difficulties when claiming back your money, contact the Lithuanian territorial health insurance fund before making any arrangements abroad.​

Modified: 2014-02-14
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