Expat insurance and health insurance in Latvia

Latvia’s public health insurance is run by a single state body, the National Health Service (Nacionālais veselības dienests, NVD), supervised by the Ministry of Health. The NVD manages the sector’s public funds, signs agreements with care providers and sets reimbursement rates. Unlike Estonia (Tervisekassa) or Lithuania (VLK), whose funding relies on a dedicated social contribution based on wages, Latvia switched in the mid-2000s to a model close to a National Health Service: the system is funded mainly by general taxation, with the NVD budget voted each year by Parliament and channelled through the Ministry of Finance.

Since 2017, an additional share of the mandatory social contribution (VSAOI, Valsts sociālās apdrošināšanas obligātās iemaksas — overall rate of 34.09% of gross salary, split between 23.59% borne by the employer and 10.50% by the employee) has been specifically earmarked for funding care, in addition to the 3.47 points that fund sick/maternity daily allowances. A health-funding law passed in 2018 provides, in principle, for reserving access to a full care basket to people who have contributed to the VSAOI or who fall under an exempt category (children, retirees, registered jobseekers, pregnant women, notably), with other residents entitled only to a minimal basket limited to emergencies, general medicine, pregnancy follow-up and certain conditions. This two-tier distinction has however never been applied to date: its entry into force has been postponed several times, most recently at the end of November 2025 (postponed to July 2026), with the Ministry of Health now suggesting the outright abandonment of this two-basket approach in favour of a single basket for anyone declaring residence or activity in Latvia. In practice, all residents therefore continue to enjoy equivalent access to the public system, regardless of actual VSAOI payment.

The care basket covers family medicine, referred specialist consultations and hospitalisation within the contracted network, subject to modest co-payments: about €2 per GP consultation (€1 for people aged 65 and over), €4 for a specialist consultation, and a daily rate of €10 from the second day of hospitalisation. Children under 18 are generally exempt. Adult dental care, however, is not covered by Latvian public insurance and remains at the patient’s expense, unless private supplementary insurance applies.

• EU citizen: no visa required, entry with a valid national ID card or passport, Latvia being a Schengen area member since 21 December 2007.
• Stay of more than 90 days: request for an EU citizen registration certificate (reģistrācijas apliecība) from the Office of Citizenship and Migration Affairs (Pilsonības un migrācijas lietu pārvalde, PMLP), within 90 days of entering the territory; a personal identity number (personas kods) is issued on that occasion.
• Enrolment in the public system: automatic for any employee once declared by the employer and once the mandatory social contribution is paid (VSAOI, 34.09% of gross salary), of which 4.47 points relate to health.
• Self-employed: registration and direct payment of the VSAOI, on a base subject to a quarterly floor (€2,220 in the first quarter of 2026, lower monthly base thereafter according to the schedule in force with the tax authority, VID).
• Resident with no activity and outside an exempt category: the 2018 law theoretically provides for restricted access to a minimal care basket, but since this distinction has never come into force to date (postponement to July 2026 at the earliest), access to the public system remains in practice equivalent to that of contributors; private health insurance is nonetheless still recommended as a precaution during the administrative transition period.
• No enrolment or European coverage: care is billed in full by the facility, public or private, at a rate not publicly disclosed in a uniform way.
• Student: the EHIC is sufficient for a temporary stay (e.g. Erasmus); beyond that, supplementary student insurance or local enrolment remains recommended.
• Seconded employee : up to 24 months (extendable), stays affiliated with the French scheme via form A1, exempt from Latvian VSAOI.
• Retiree: form S1 from their French pension fund before departure, for cover by the NVD with no new own contribution to pay.

No individual fine is provided for as such in case of non-enrolment, but the employer has a legal obligation to declare their employee to the tax authority (VID); for expatriates themselves, the risk remains primarily financial, with no help from the French embassy in case of uncovered care.

Since Latvia has been an EU member since 1 May 2004, there is no classic bilateral agreement with France: coordination runs through EU regulations 883/2004 and 987/2009, as with other member states. The country has also been a Schengen area member since 21 December 2007 and a eurozone member since 1 January 2014, the second of the three Baltic states to adopt it, after Estonia (2011) and before Lithuania (2015).

• Temporary stay: the EHIC grants the same coverage as a local insured person at providers under contract with the NVD, on presentation of the card and an ID document; if the card is forgotten or lost, a provisional replacement certificate (PRC), valid 3 months, gives the same rights.
• Secondment: form A1, stay on the French scheme for up to 24 months (extendable), exempt from Latvian VSAOI.
• Long-term move: enrolment in the public system via the VSAOI (paid by the employer for an employee, or directly for a self-employed person); form S1 for a retiree, covered by the NVD with no new own contribution.
• The EHIC covers neither repatriation, nor planned care, nor a long-term move; on return, a stay not covered in advance may be reimbursed retroactively via form S3125, according to rates charged by the Latvian institution or the provisions of French legislation.

1. Before departure: notify French agencies of your departure (CPAM, CAF, France Travail, pension funds).
2. Seconded employee: request form A1 from your French fund before departure.
3. Retiree: request form S1 from your pension fund before departure.
4. Before departure or on arrival: request the EHIC to cover the transition period.
5. On arrival, for a stay over 90 days: request the EU citizen registration certificate from the PMLP, within 90 days of entering the territory.
6. Employee: check with your employer that the VSAOI (34.09%) is declared and paid from the signing of the employment contract.
7. Self-employed: register with the tax authority (VID) and pay the VSAOI according to the schedule in force.
8. Register with the roll of French nationals living abroad (French embassy in Riga).