Expat insurance and health insurance in Lithuania

The Lithuanian healthcare system relies on a single national fund, the Valstybinė ligonių kasa (VLK), under the Ministry of Health, which funds and coordinates the mandatory health insurance scheme (PSD, privalomasis sveikatos draudimas). The VLK relies on five territorial funds (teritorinės ligonių kasos) — Vilnius, Kaunas, Klaipėda, Šiauliai and Panevėžys — which contract with public and private providers in their area and pay them for care given to insured people. The benefits basket covers primary care and emergencies, specialist consultations, hospitalisation in contracted facilities, part of dental care (free for under-18s and students), and medicines and medical devices on the positive list, reimbursed at a variable rate (generally between 50% and 100% depending on the condition, with exemption for certain categories such as low-income retirees or people with disabilities).

A Lithuanian quirk worth understanding: there's no standalone health contribution like the Polish NFZ or the Slovenian ZZZS. Since the 2019 reform that unified social contributions, the health-maternity contribution (6.98% for the VLK's care component, 1.99% for daily allowances, 1.81% for maternity, i.e. 10.78% in total) is one component of the single Sodra social contribution, deducted at 19.5% of the employee's gross salary — with the employer paying, for its part, only a residual contribution (1.77% for an open-ended contract, 2.49% for a fixed-term contract, plus marginal contributions to the guarantee and long-term employment funds). A self-employed person with a declared activity (individuali veikla) contributes at the same rates on a base of 90% of their taxable income; a person with no job or activity must self-insure (savarankiškai apsidraudę) via a minimum contribution of 6.98% of the Lithuanian monthly minimum wage, i.e. 80.48 € per month in 2026 (based on 1,153 €).

Emergencies (number 112) are accessible to any VLK insured person or holder of a valid EHIC. The country's largest university hospital centre, Santaros klinikos, is in Vilnius; it exists alongside a network of private clinics, whether or not contracted with the VLK.

• EU citizen: no visa required, free movement with a valid passport or ID card, Lithuania having been part of the Schengen area since 21 December 2007.
• Residence certificate with the migration department (Migracijos departamentas): for any stay over 90 days, apply, via the MIGRIS portal or in person, for a certificate confirming an EU/EEA citizen's right of residence, valid for up to 5 years, on proof of a reason for stay (employment, self-employment, studies, family reunification or sufficient resources) and health cover.
• VLK registration: automatic for any employee as soon as the employer registers them, with the health-maternity contribution (10.78%, of which 6.98% for the care component) deducted along with the rest of the single Sodra social contribution (19.5% in total) directly from gross salary.
• Self-employed: direct registration and contribution with Sodra, on a base of 90% of declared taxable income; a person with no activity or job must self-insure with a minimum contribution of 6.98% of the monthly minimum wage (80.48 €/month in 2026), with no option for a lasting suspension.
• Without registration or European cover: care is billed in full by the facility, public or private, at a rate that varies by facility and isn't published uniformly.
• Student: the EHIC (ESDK) is enough for a temporary stay (e.g. Erasmus); beyond that, local VLK registration or a student insurance plan is still recommended during the administrative transition period.
• Seconded employee : up to 24 months (extendable), stays on the French scheme via form A1, exempt from local registration.
• Retiree: form S1 with their French pension fund before departure, for coverage by the VLK with no new contribution of their own to pay.

No individual fine is provided for as such in case of failure to register, but the employer has a legal duty to register their employee with Sodra; for the expat themselves, the risk is above all financial, with no help from the French embassy for uncovered care.

As Lithuania has been an EU member since 1 May 2004, there's no classic bilateral agreement with France: coordination runs through EU regulations 883/2004 and 987/2009, as for other member states. Lithuania has also been part of the Schengen area since 21 December 2007 and of the eurozone since 1 January 2015, the last of the three Baltic states (after Estonia in 2011 and Latvia in 2014) to adopt it.

• Temporary stay: the EHIC (ESDK in Lithuania) grants the same cover as a local insured person at VLK-contracted providers, on presentation of the card and an ID document; if the card is forgotten or lost, a provisional replacement certificate (PRC), valid for 3 months, grants the same rights.
• Secondment: form A1, stay on the French scheme for up to 24 months (extendable), exempt from local registration.
• Long-term move: automatic VLK registration via the single Sodra social contribution (deducted by the employer for an employee, paid directly for a self-employed person); form S1 for a retiree, covered by the VLK with no new contribution of their own.
• 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, per the rates charged by the Lithuanian institution or the provisions of French law.

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 (ESDK) to cover the transition period.
5. On arrival, for a stay of more than 90 days: apply for the residence certificate with the migration department (Migracijos departamentas), via the MIGRIS portal or in person.
6. Employee: check with your employer that you're registered with Sodra and that the single social contribution is deducted as soon as the employment contract is signed.
7. Self-employed: register and contribute directly with Sodra, including minimum self-insurance if you have no activity.
8. Register with the roll of French nationals living abroad (French embassy in Vilnius).