If you are living and working in the Baltic state of Lithuania and suffer from a chronic health condition, what choices do you have when it comes to healthcare? How effective is the Lithuanian healthcare system when it comes to managing such diseases? We will look at some of your options below.
How does the Lithuanian healthcare system work?
You will be entitled to register with public healthcare (Health Insurance Fund/CHIF) if you are a citizen of the Republic of Lithuania or a foreign national permanently residing there.
If you are an EU national with a chronic condition and are resident in Lithuania, you will be entitled to treatment under the national healthcare system. This is as a result of reciprocal healthcare agreements with your home nation. You will also be able to use your European Health Insurance Card (EHIC). If you are a card holder, you can apply for medical care directly with your GP, as long as the practice has an agreement with the local teritorinė ligonių kasa (Territorial Health Insurance Fund/THIF).
You will be able to access healthcare services provided in private, public and municipal healthcare institutions if you are not insured under the national scheme, but you will have to pay out of pocket.
The Lithuanian healthcare system and chronic illnesses
According to the WHO, the Lithuanian population suffers from a high burden of disease, including cardiovascular diseases, lung cancer, musculoskeletal problems (including lower back and neck pain), and mental health issues. Heart diseases and strokes are the leading causes of death in the country.
According to the European Health Interview Survey (EHIS), nearly three in ten people live with hypertension in Lithuania.
Chronic illness in the country is a prioritised area of healthcare, and some provision is made for patients with chronic diseases.
The WHO reports that efforts to strengthen the role of primary care, particularly in disease prevention, have been underway for over a decade. There have been incentivised services and expanding programmes for prevention and treatment of major chronic diseases. Specialist nursing positions in diabetes and cardiac care for chronic patient groups have also been introduced.
In the 2000s, the government set up a chronic non-communicable disease (NCD) research programme, targeting cardiovascular diseases, cancer and diabetes. Its goal was to provide insights into the management of morbidity and mortality from chronic diseases.
The Lithuanian Health System Development Dimensions (2011–2020) has set out a strategic direction for health promotion, disease prevention and the reduction of morbidity and mortality. This aims to improve health management and financing, in addition to patient access and quality and safety of care. A further goal is the creation of a financing mechanism for the integration of nursing and social care. This seeks to pilot an integrated primary care model based on case management, and the integration of public health services under the aegis of primary care services.
The WHO says that there are indications that the focus on chronic disease management in primary care has led to a reduction in avoidable hospitalisation rates. Lithuania has seen a fall in rates for congestive heart failure (CHF), asthma, and chronic obstructive pulmonary disease (COPD). Since 2013, over a hundred new diagnostic and treatment protocols have been developed, with a focus on cardiovascular diseases, as well as 20 types of cancers, paediatrics and trauma care. These are currently being piloted in selected hospitals. The organisation reports that hospitalisation rates for chronic diseases have decreased, indicating an improvement in primary care services.
Under the public healthcare scheme, if you suffer from a chronic condition, you will be entitled to treatment at primary and secondary level. You may have to make a small co-payment, but much of your treatment will be free at the point of delivery. You will also be eligible for 80% coverage of any medication for chronic diseases.
If you are engaging with the public healthcare system in Lithuania, therefore, and you have a chronic condition, you will find that there has been a substantial focus on chronic illnesses in recent years. You may, however, find that this is balanced by standards that are not commensurate with healthcare levels elsewhere in Europe. Nonetheless, the country has been making considerable efforts to improve the quality of its healthcare.
Applying for disability/sickness benefits
A disability pension (social insurance) is paid for an assessed loss of working capacity of at least 45%. The required coverage period increases with age: at least two months of social security contributions, if you are younger than 22, and this increases by two months a year from the ages of 23 to 38. It then increases by six months a year from the ages of 39 to 63, until you reach 15 years of contributions.
To be eligible for sickness benefits, you must have made at least three months of contributions in the last 12 months, or at least six months of contributions in the last 24 months. 80% of your average income, during three consecutive calendar months before your incapacity, will be paid from the third to the seventh day of incapacity. Your employer will pay 80% to 100% of your average earnings for the first two days.
Private cover for chronic illnesses
Due to the limitations of public sector healthcare in Lithuania, many expats choose to take out private health insurance, particularly if they have an existing chronic condition. You should check with your insurer to see whether they cover pre-existing conditions, as some providers do not.
Private healthcare is held to be of a good standard in the country. Vilnius, for instance, has two asthma clinics. There has been little specific provision for diabetics under the public system, and you may prefer to seek treatment in the private sector for this condition. If you suffer from hypertension, provision is more extensive. Santaros Klinikos, for example, provides vascular advice.