Healthcare System in Latvia: National Health Service, Family Doctor, Hospitals, Emergencies and Vaccinations

According to CLEISS, the National Health Service (Nacionālais veselības dienests, NVD), a public body under the Ministry of Health, buys care from public and private providers by contract. The ministry handles planning and regulation, and local authorities own most primary and secondary care establishments. The system is funded mainly by taxation (CLEISS).

France Diplomatie points out that without adequate cover, access to care can be refused, even in a life-threatening emergency, and that a contract covering all care, including surgery, hospitalisation and repatriation, is necessary for anyone not covered locally; the embassy does not bear these costs. For reimbursements by situation, see the page on healthcare reimbursement in Latvia.

Cover applies to people who reside permanently in Latvia (CLEISS). Contributors and 21 categories of State-insured people, including children, retirees and people with disabilities, are entitled to the full package; people who work without contributing get a minimal package (emergencies, family doctor, maternity, psychiatry, infectious diseases and medicines) and can join through a voluntary annual payment (CLEISS).

• European employee or self-employed person: the NVD indicates that citizens of the EU, the European Economic Area and Switzerland who work in Latvia, as employees or self-employed, are covered together with their family.
• Foreign national holding a permanent residence permit: they are among the beneficiaries of State-funded care; other residents can obtain paid care according to the establishment’s price list (NVD).
• Insured in another State: the S1 form is necessary to receive State-funded care; it is requested from the authority of the country of insurance and is valid only once registered with the NVD. Registration is refused if the person is insured in Latvia, through employment or a pension (NVD).
• Temporary stay: the European Health Insurance Card, called EVAK in Latvian, is requested at least 15 days before departure; a provisional replacement certificate valid for three months has the same effect (France Diplomatie, CLEISS).

Primary care is provided mainly by family doctors, and by paediatricians for under-18s. The patient registers with the doctor of their choice and can change at any time, but a doctor may refuse a patient from outside their area once they reach 1,800 adult patients or 800 children (CLEISS). A patient referred by their family doctor freely chooses their outpatient or hospital provider. Children, pregnant women and patients with certain conditions (cancer, diabetes, HIV) see specialists directly.

• Family doctor consultation: €2, or €1 from age 65; €4 with a specialist; no charge for under-18s and for pregnancy (CLEISS).
• Specialist: a GP is consulted before a specialist, except for a paediatrician, a gynaecologist or an ophthalmologist (CLEISS).
• Procedures: patient charge of €2 to €35 per examination or surgical procedure, and €7 for a day hospital (CLEISS).
• Home visit: the cost may be higher (CLEISS).

112 covers emergencies, 110 the police and 113 the ambulance (France Diplomatie); the 112 Latvija application gives emergency instructions, with some functions in English. France Diplomatie’s useful contacts page does not list any hospitals; the French embassy in Riga can advise on suitable establishments. Outside emergencies, admission to hospital requires a medical prescription, in a contracted establishment (CLEISS).

The hospital daily charge is €10 per day from the second day in most hospitals, €7 per day for nursing care and oncology, and it is capped at €355 per hospital stay; it is not due for children or for a pregnancy-related hospital stay (CLEISS). Patient charges for outpatient and hospital care are capped at €570 per year, excluding medicines, glasses and dental.

The NVD sets the positive list of reimbursable medicines according to clinical criteria (severity of the disease, therapeutic value) and economic criteria (budgetary impact, cost-effectiveness) (CLEISS). Reimbursement is 100%, 75% or 50% of the reference price depending on the condition, with a flat charge of about €0.71 for products reimbursed at 100%, and the annual cap is €14,228.72 per patient over twelve months (CLEISS).

France Diplomatie advises taking only the medicines you need, in their original packaging, with a prescription stating the international non-proprietary name, checking that they are permitted in Latvia and never buying medicines from street vendors.

Dental care falls under primary care and requires no referral; the NVD funds only that of under-18s. Adults pay fees and materials themselves, or go through private insurance (CLEISS). Glasses are also excluded from the patient charge cap; optical care falls under supplementary cover or expat health insurance.

Long-term care, accommodation during a day hospital stay and services outside the list are paid directly by the patient, unless exempt (CLEISS). For a full health budget, the guide on budgeting for health abroad offers a method.

France Diplomatie recommends bringing French vaccinations up to date (diphtheria, tetanus, polio, whooping cough, measles) and mentions hepatitis A, typhoid, hepatitis B for frequent or long stays, rabies for young children or rural stays and tick-borne encephalitis, depending on the conditions of stay.

• Tick-borne encephalitis: transmitted mainly by bites in spring and summer, with no specific treatment; prevention relies on protection against bites and vaccination for stays in rural or wooded areas.
• Lyme disease: treated with antibiotics, the better the earlier they are started; see a doctor after a rash around a bite.
• Sea and ice: avoid swimming in the Baltic in a storm, in particular at Kolka, and do not walk on the frozen public waters of Riga.

A doctor or an international vaccination centre specifies the boosters before departure. To complement this with first-euro insurance, Expavy helps you compare contracts according to status and budget.