Health insurance
ERGO Life Insurance SE expects to become your partner in creating the employee motivation system in your company, and would like to introduce to you an efficient and long-term motivation tool, viz. the health insurance of employees.
The health insurance of employees is more than a salary, a one-time bonus or a possibility to use a new car of the company offered to the employee. The health insurance facilitates in developing a mutual sustainable confidence link: the employee will value you for the motivating working environment and you will value the employee for loyalty.
We hope that our extensive experience accumulated in the area of health insurance, our competence gained in consulting companies as well as staff qualifications will meet the needs of your company.
DESCRIPTION OF HEALTH INSURANCE SERVICES
They have different scopes of services, compensation ceilings and insured sums.
You may select the services and their ceilings. Health insurance shall be valid in the territory of the Republic of Lithuania.
The total insured sum for outpatient and inpatient services (standard conditions) during the insurance year may be LTL 5,000, LTL 10,000, LTL 20,000 or LTL 40,000.
Outpatient treatment
Physician’s services
Physician’s (general practitioner’s, specialist doctor’s) consulting, home visits; surgical manipulations; outpatient surgery services provided at the daytime inpatient department (in observance of surgery (scheduled or unscheduled) and nursing (excluding meals) for up to 24 hours in a daytime inpatient department as specified in Order No V-45 of the Minister of Health of 17 January 2008). The number of surgeries shall not be limited.
Nursing services and procedures: Injections, infusions, wound redressing and other services prescribed by a doctor;
Diagnostic tests Compensation for diagnostic tests shall be paid only with a doctor’s prescription and their extent shall be determined by the treating doctor;
Compensation shall be paid for the following laboratory tests: clinical, biological, biochemical, immune, hormone, bacteriological; histological; functional; X-ray; ultrasound and instrumental tests.
Medicines, medical aids and orthopaedic appliances
Compensation shall be paid for medicines, medical aids and orthopaedic appliances according to the treating doctor’s prescription.
Rehabilitation treatment
Compensation shall be paid for medically based services prescribed by the treating doctor: Exercise therapy procedures, physical activity exercises, therapeutic massage (manual therapy) procedures.
Inpatient treatment
Compensation shall be paid for health care services provided in a public or private health care establishment (depending upon the selected insurance option), paid services, comfort services (stay in a one-bed or double-bed ward), additional care, medicines.
Dental treatment
Compensation shall be paid for dental treatment, X-ray examination, and oral hygiene. The contract may also include prosthesis.
Preventive treatment
Vaccination – preventive vaccination from flue, tick-born viral encephalitis, Hepatitis A and B.
Preventive health examination. The insured person shall be free to select a medical institution and tests.
Optics
Compensation shall be paid for glasses or lenses.
Health promotion services
Compensated expenses: physical activity exercises in sports clubs (aerobics, fitness, trainers, yoga, tennis, squash), water treatment (pool, different water baths), massages (manual therapy sessions) in sports clubs, sanatoria, SPA centres or rehabilitation centres.
Other services
Paid services provided in health care institutions: doctors’ consulting, treatment, diagnostic tests, surgery, nursing, rehabilitation, preventive treatment. All treatment services, excluding uninsured events.
PROCEDURE OF VISITING MEDICAL INSTITUTIONS
The insured person may visit any (private or public) health care institution in Lithuania which is licensed to engage in such activities of the provision of health care services.
The insurer shall recommend visiting those health institutions with which the insurance company has concluded a cooperation agreement (an updated list of these institutions is provided on the internet website: www.ergo.lt). In such case the payment for the provided health insurance services shall be made directly to the health care institution.
