Healthcare Reimbursement in Latvia: Who Reimburses What Depending on Your Situation

CLEISS’s list of social security agreements mentions no bilateral convention between France and Latvia: the European coordination regulations, applicable in the 27 EU States and the European Economic Area, govern the situation. They lift residence conditions, add up periods of activity and organise posting. A French national is treated in Latvia under Latvian rules, with forms issued by their French fund: EHIC, A1, S1.

The concepts of reimbursement base and out-of-pocket cost help compare contracts. How the system works is presented on the page on the healthcare system in Latvia.

The employee on a local contract is covered by the National Health Service: the NVD indicates that EU citizens who work in Latvia, as employees or self-employed, receive State-funded care together with their family. The social contributions include 1% for healthcare and 3.47% for sickness and maternity cash benefits (CLEISS). They choose a family doctor. See the glossary entry on the local contract.

The posted employee sent by a French employer stays affiliated to the French scheme for up to 24 months with the A1 form, without registering with Latvian insurance (europa.eu). If they live in Latvia, they can ask their French fund for an S1 form to receive State-funded care, to be registered with the NVD; their family members are covered without contributions if the local fund treats them as dependants (CLEISS). They can also ask their French fund to reimburse care on presentation of invoices with the S3125 form, at Latvian or French rates. Sick leave certified in Latvia is declared within 48 hours to the French fund and the employer. See posted worker or expatriate and the glossary entry on the posted worker.

The self-employed person pays their own contributions at the total rate of 31.07%, of which 1% for healthcare, on a base between €9,360 and €105,300 per year (CLEISS); they are covered like an EU citizen who works in Latvia (NVD). The digital nomad who works for a foreign client without setting up comes first under the rule of the country of activity, to be confirmed with their home scheme.

The student on a temporary stay uses their EHIC with contracted providers; a long stay means checking their status with the NVD. Before the age of 30, the Caisse des Français de l’Étranger (CFE, the voluntary social security fund for French nationals abroad) offers its youth offer. See student insurance abroad.

The retiree who receives only a French pension and settles permanently in Latvia without working there requests the S1 form from their pension fund, preferably before leaving (CLEISS). The S1 is valid only once registered with the NVD, which refuses it if the person is insured in Latvia (NVD). No contribution to the local scheme is withheld; a contribution of 3.2% on the basic pension and 4.2% on the supplementary pension is levied on general scheme pensions when tax residence is outside France, and 7.1% for the self-employed. The retiree stays covered in France.

The spouse and children follow the holder’s status: the employee’s family, individual S1 for the retiree’s dependants, or their own insurance. Children under 18 receive the full package and covered dental care (CLEISS). See expat family insurance and the guide on retiree health insurance abroad.

The Caisse des Français de l’Étranger lets you keep the French scheme on top of the local scheme; the member pays both the country’s mandatory scheme and the CFE, which spares them waiting periods and the loss of pension quarters on returning (ameli.fr, the website of the French Assurance Maladie, the national health insurance). The CFE’s main offer covers GP consultations, medicines, tests, hospitalisation, maternity, dental care, emergency transport and vaccines, including stays of less than three months in France (CFE).

• Waiting period: immediate cover if you join before departure or within three months of settling in; beyond that, a three-month wait for under-45s and six months for over-45s (CFE, exact age to be confirmed with the fund).
• Maternity: the date of conception must be after joining or being attached as a dependant (CFE).
• Return to France: no waiting period for the member (CFE); they open their entitlement with the S1106 form (ameli.fr). See CFE reimbursements and the page on returning to France.

International health insurance with first-euro cover reimburses actual costs within its ceilings, after any deductible, waiting periods and exclusions. It usefully complements the Latvian scheme on adults’ dentistry, optical care and patient charges, and opens direct access to private providers. Contracts are compared on the annual ceiling, the coverage area and the handling of pre-existing conditions.

The tourist uses their EHIC (EVAK) with a provider approved by the NVD; under third-party payment, they pay only the share remaining at their expense, and a GP is consulted before a specialist, except for a paediatrician, gynaecologist or ophthalmologist (CLEISS). Without an EHIC, the S3125 form lets you request reimbursement on your return. France Diplomatie also recommends an assistance contract covering hospitalisation and repatriation. See long-stay travel insurance.

• Consultation: €2 for a GP, €1 from age 65, €4 for a specialist; no charge for under-18s and for pregnancy (CLEISS).
• Hospitalisation: €10 per day from the second day, €7 for nursing care and oncology, cap of €355 per hospital stay; charge of €2 to €35 per procedure and €7 for a day hospital (CLEISS).
• Medicines: 100%, 75% or 50% of the reference price depending on the condition, annual cap of €14,228.72 (CLEISS).
• Dental: at the adult’s expense; covered for under-18s (CLEISS).
• Optical: glasses outside the patient charge cap and with no cover described by CLEISS; a supplementary contract is worth considering.
• Maternity: pregnancy care with no charge and up to 70 days after childbirth; leave of 112 days, of which 56 before the birth, paid at 80% of the average wage (CLEISS); a CFE member must have conceived after joining.

The reimbursement guide and the page on expat health insurance give benchmarks; Expavy helps you weigh these options against your situation.