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

CLEISS’s list of social security agreements mentions no bilateral convention between France and Lithuania: 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 Lithuania under Lithuanian 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 Lithuania.

The employee on a local contract is compulsorily affiliated to health insurance: their 6.98% contribution opens their entitlement to benefits in kind with no minimum affiliation period, and daily allowances require three months of insurance over the last twelve (CLEISS). The employer pays the first two days of sick leave, then Sodra, the social security body, takes over. They choose a contracted general practitioner. 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 Lithuanian insurance (europa.eu). If they live in Lithuania, they can ask their French fund for an S1 form to register with a regional fund; their family members are covered without contributions if the local fund treats them as dependants under Lithuanian law (CLEISS). They can also ask their French fund to reimburse care on presentation of invoices with the S3125 form, at Lithuanian or French rates. Sick leave certified in Lithuania 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: 6.98% for health with a monthly minimum revised each year, due even with no income, on 90% of declared income after expenses (CLEISS). Sodra specifies that insurance is valid only if the current month’s contribution has been paid. 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 is insured by the State in Lithuania according to CLEISS (students are among the insured people covered); on a temporary stay, they use their EHIC with contracted providers. 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 Lithuania without working there requests the S1 form from their pension fund, preferably before leaving (CLEISS), then registers it with a Lithuanian regional health insurance fund (France Diplomatie, the French foreign ministry). 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: dependants of the employee, individual S1 of the retiree, or their own insurance. Under-18s are insured by the State (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 Lithuanian scheme on dentistry, optical care and the gap on medicines, 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 with a provider under contract with one of the five territorial funds: the GP consultation is covered on presentation of the card and an identity document, as is the referral to a specialist or contracted hospital (CLEISS). Dentists, most often private, charge their fees. Without an EHIC, the S3125 form lets you request reimbursement on your return. See long-stay travel insurance.

• Consultation: GP covered with the EHIC and an identity document; specialist covered on referral from the GP, except the dermatovenereologist and the psychiatrist for non-urgent care (CLEISS).
• Hospitalisation: covered in contracted establishments on referral; CLEISS does not detail any daily charge.
• Medicines: 50% or 100% of the reference price for subsidised medicines; the patient pays the difference with the selling price (CLEISS).
• Dental: essentially private, fees paid by the patient; possibly free for under-18s in a public health centre, materials generally payable (CLEISS).
• Optical: not described in the CLEISS profile; a supplementary contract is worth considering.
• Maternity: women on maternity leave are insured by the State (CLEISS); a CFE member must have conceived after joining (CFE).

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