Healthcare System in Lithuania: Health Insurance Funds, Family Doctor, Hospitals, Emergencies and Vaccinations

CLEISS describes a mixed system funded by mandatory health insurance and the State budget. Most establishments are non-profit and belong to the central government, through the Ministry of Health, or to the municipalities. Primary care is organised by the municipalities, and the National Health Insurance Fund reimburses the costs through five territorial funds. The private sector plays an important role, particularly in dentistry, through practices under contract with social security.

France Diplomatie points out that an insurance or assistance contract covering all medical costs, including surgery, hospitalisation and repatriation, is necessary for anyone not covered locally, as the embassy does not bear these costs. For reimbursements by situation, see the page on healthcare reimbursement in Lithuania.

Insured people are those who pay the mandatory health insurance contribution, or for whom a third party pays it (CLEISS). People insured by the State include retirees, the unemployed, women on maternity leave, under-18s, students and recipients of social benefits. Sodra, which collects the contribution, specifies that a person is insured in only one EU State at a time: the one where they live, work and pay their taxes.

• Employee: contribution of 6.98% of salary; their entitlement to benefits in kind opens with no minimum affiliation period (CLEISS).
• Self-employed: health contribution of 6.98% with a monthly minimum revised each year, due even with no income (CLEISS); insurance is valid only if the current month’s contribution has been paid (Sodra).
• Retiree from another State: France Diplomatie indicates that, for a long-term stay, the S1 form is requested from the French fund, then registered with a Lithuanian regional health insurance fund.
• Temporary stay: the European Health Insurance Card, called ESDK in Lithuanian, is obtained at least 15 days before departure; a provisional replacement certificate valid for three months has the same effect (France Diplomatie, CLEISS).

Everyone must choose a contracted general practitioner, and CLEISS stresses that the insured person has free choice of doctor at every level of the health system. Free specialist care requires a referral from the GP; for non-urgent care, only the dermatovenereologist and the psychiatrist can be consulted without a referral.

• General practitioner: the consultation is covered on presentation of the European Health Insurance Card and an identity document (CLEISS).
• Specialist or hospital: a referral from a GP to a specialist or contracted hospital is covered.
• Dentist: most dentists are private and charge their fees; public health centres may offer free care to under-18s or partial support, with materials generally remaining at the patient’s expense (CLEISS).
• Sick leave: the employer pays the first two days and Sodra from the third day, with a daily amount between a minimum and a ceiling revised each year (CLEISS).

112 covers medical emergencies, the police and the fire service (France Diplomatie). The French embassy in Vilnius publishes a list of recommended clinics and hospitals, which France Diplomatie’s useful contacts page does not reproduce; it is worth consulting it on arrival and identifying the public establishment closest to your home. Contracted hospitals treat insured people under their territorial fund.

For a non-emergency hospital stay, the GP refers you to the establishment and care is covered according to the fund’s rules; CLEISS does not detail any hospital daily charge. Finally, France Diplomatie reminds that Vilnius lies about 45 km from the Ostrovets plant: the Lithuanian authorities advise keeping iodine tablets, available at pharmacies and free for residents.

Reimbursable medicines appear on a list set according to efficacy, safety, pharmaco-economic evaluation and budgetary impact for the fund (CLEISS). Subsidised prescription medicines are covered at 50% or 100% of the reference price, with the patient paying the difference between that price and the selling price (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 Lithuania and never buying medicines from street vendors.

Dental care falls mostly within the private sector; the CLEISS profile does not detail any reimbursement rate. Public health centres may offer free care to under-18s, but materials generally remain payable. Optical care is not described by CLEISS; it falls under supplementary cover or expat health insurance.

People receiving long-term social services pay a share set according to age, level of disability and household income (CLEISS). The contracted private sector and the independent private sector coexist: before a consultation, it is worth checking that the practice or clinic has a contract with one of the five territorial funds, failing which fees are billed to the patient (CLEISS). Supplementary insurance is assessed on the annual ceiling, the coverage area, the treatment of pre-existing conditions and evacuation, criteria detailed in the reimbursement guide. 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, rabies for young children or rural stays, and tick-borne encephalitis, depending on the conditions of stay.

• Tick-borne encephalitis: transmitted mainly by ticks in spring and summer, with no specific treatment; vaccination is strongly recommended for walks in the forest, as many cases are reported every year.
• Protection against ticks: light-coloured covering clothing, skin repellent and a body check after a walk in a rural or wooded area.
• Civil protection alerts: the LT72 application gives instructions in case of an alert, natural disaster or fire.

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.