As an expat living and working in Lithuania, you will want to make sure that your healthcare costs are taken care of during your stay in the country. If you are employed, it is likely that you will be covered by the public health insurance scheme, known as the CHIF. However, most expats choose to take out private cover as well, either as top-up or as an alternative policy to avoid any issues with the public healthcare system.
Personalising your health insurance cover
Your employer should register you automatically with the CHIF, but check that this has been done. If you are self-employed, you will need to sign up yourself. Consult the CHIF to find out what you need to do. Your state coverage will also apply to your dependants.
You can also pay expenses out of pocket in the private and the public sector. Remember, however, that costs can escalate rapidly if you have a chronic condition or need to see a specialist.
Check the small print of any private health insurance policy to see whether it covers treatments that you may want to access, such as specialist surgical treatment or more advanced dental care. Lithuania is increasingly becoming a destination for medical tourism, including dental treatment.
Remember to check whether your potential policy covers pre-existing conditions. The definition of a pre-existing condition will vary between insurers. Usually, the term applies to any conditions that present symptoms or for which you have been treated in the last five years. This will normally include any conditions you were diagnosed with over five years ago, but some insurers place different time limits on when the diagnosis must have been given.
You may also want to check whether your policy has a ‘hospitalisation’ clause covering you for occasional hospital visits. You may need to discuss this directly with your insurer, in addition to pre-approval. As mentioned above, Lithuania has provision for medical tourism. Therefore, you may want to look at comparative costs while you are in the country, such as for laser eye surgery.
Take a good look at any potential policy for any cover relating to healthcare that does not apply to you. For example, some policies have provision for maternity care, and if you are not intending to become pregnant, then you may wish to reduce your policy costs by having such options removed.
You may also be able to reduce the cost of your premium through ‘cost sharing’. This is where you and your insurer share the costs of any treatment. You will pay up to an agreed limit, and your provider will cover the rest. Different insurers will have different ways of arranging cost sharing:
Co-pay: where you pay a fixed sum for your treatment and your insurer covers the rest. For instance, if the total cost of your treatment is €85 and your co-pay amount is set at €40, then you will pay €40 and your insurer will pay €45.
Co-insurance: where you pay a fixed percentage of the total cost and your insurer covers the rest. For instance, if your co-insurance is set at 20%, you will pay 20% of €85 and your insurer will cover the remaining 80%.
Deductibles: where you pay the entire amount allowed for all services provided until the deductible is met. For instance, if your policy has a €1,000 annual deductible, you would pay €85 for each visit to your GP for 11 visits (€1000/€85 = 11.8), after which your insurance would pay out to the doctor directly.
You may also need to take a look at whether there is an out-of-pocket maximum that you would be expected to pay after you have met your deductible. Let’s say that your plan above, with a €1000 deductible, also has a co-insurance option of 20% and an out-of-pocket maximum of €1500. You would therefore pay €85 for 11 visits to the doctor under your deductible until it is met. Following this, you would pay €17 for each visit as your 20% coinsurance, until you reach the co-insurance ceiling of €500 (€1,500 minus the deductible of €1,000). At that point, you would pay nothing more for the remainder of the plan year.
It is worth doing the maths, especially if you don’t think that you’ll need to make more than a couple of visits to your GP in any one policy period. For example, if you just want dental check-ups with an occasional filling, it might be worth working out whether one or two out-of-pocket costs might be cheaper than full dental cover.
As so many variables have an effect on the cost of international private medical insurance, it is very difficult to give accurate estimates without knowing the full details of the coverage required. However, as a very rough guide, using a standard profile of a 40-year-old British male with no deductibles, no co-insurance, a middle tier plan/product, all modules included, and worldwide coverage excluding the US, a ballpark price of around £4,000/$5,000 might be expected. Were coverage to be expanded to include the US, then the premium could increase to almost double this amount.