Necessary healthcare services in EU Member States

Necessary healthcare services in EU Member States

Necessary healthcare services in EU Member States

In accordance with European Union legislation people covered by public health insurance in one member state are entitled to receive the 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. In the United Kingdom the right mentioned above will be valid until 31st December 2020 due to Brexit.

To avail of this right, you should apply for the 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 the Compulsory Health Insurance in Lithuania should have an EHIC and carry it with them when travelling abroad.

What is the European Health Insurance Card? 

European Health Insurance Card is a document which certifies that the holder is entitled to receive the 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 the compulsory health insurance in Lithuania.

How can I apply for European Health Insurance Card? 

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

The European Health Insurance Card is issued only at the request of the insured or his/her attorney. It can be requested by e-mail sending the application form signed by the qualified signature, by regular post, electronically via E-Government Gateway or, personally 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.

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 authorized 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 with the application form should present: 

• 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 2 months until 18 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 European Health Insurance Card? 

The European Health Insurance Card gives an 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 for this care in advance. To arrange for kidney dialysis while you are away, contact the renal unit in the country you wish to travel before you trip.

You have a right to use your European Health Insurance Card for routine maternity care while you are away as well. However, if you are going to another country specifically to have your baby, you need the form  E112  or portable document S2.

It is important to be aware, that European Health Insurance Card gives an access to reduced-cost or free medical treatment from state healthcare providers and allows you to be treated on the same conditions 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 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 being provided free of charge at home country might not be free in another country.

Inappropriate use (abusive or fraudulent) of 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 cases when the person being not insured by the compulsory health insurance uses the EHIC in other countries.  

What should I do if I go abroad without a card? 

If your card is lost or stolen while you are abroad you should contact the Territorial Health Insurance Fund and apply for the Certificate Provisionally Replacing the EHIC Members of your family can do this on your behalf as well as the healthcare provider. The Certificate issued by the THIF will be sent to the healthcare institution by fax or regular post. The Certificate will give you a right to receive healthcare services under the same conditions as European Health Insurance Card until you return home.

How do I claim a refund for necessary healthcare? 

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 the 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 document: 

• Your identity document; 

• Copies of medical documentation, prescription; 

• Original document proving that you have covered the cost of healthcare services (financial documents); 

• The completed application form which will be provided at the Territorial Health Insurance Fund after examination of your provided documents.

You have right to choose between the following methods of reimbursement:

• Reimbursement at current prices for the healthcare services provided in the EU country (including the United Kingdom until 31st December 2020);

• Reimbursement at prices approved by the legislation of the Republic of Lithuania when reimbursement do not exceed the actual costs.

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.