Planned treatment in EU Member States

Planned treatment in EU Member States

Planned treatment in EU Member States

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/she is covered by the compulsory healthcare insurance, then with the prior authorization of his/her competent institution (form E112 or portable document S2) he/she 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 for taking decisions on prior authorization. The National Health Insurance Fund (NHIF) issues the portable document S2 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 directly accept invoices issued by foreign healthcare providers. The cost of healthcare provided on the basis of the form E112 or portable document S2 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 for 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 the form E112 or portable document S2, 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 the portable document S2?

The portable document S2 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 authorization 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 authorization 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:

• Conclusion of doctors’ consultation justifying the need to send the patient for certain health care services abroad;

• Extract of medical documents;

• Filled-in special form of referral;

• The letter of foreign health care provider confirming that it accepts form E112 or portable document S2 and that the services are the subject of legislation of the country of treatment. 

What the holder of the portable document should know?

You should provide the document S2 together with an identity document to health care institution. 

Please, note that the portable document S2is 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 the portable document S2 should be covered by the public health insurance institution of the country providing the services. The portable document S2 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.