Employee health insurance at the company’s expense
ERGO health insurance for the company’s employees is an effective incentive tool that provides the opportunity to use health care and wellness services by paying for them with insurance funds. If you have any questions, we will help you choose the most suitable insurance for your company.
Employee health insurance
ERGO health insurance provides the opportunity to use health care services, receive a physician’s consultations and undergo prescribed tests in both public and private medical institutions throughout Lithuania, as well as purchase medicines or use other health promotion services.
We care not only about people’s physical health, but also about their emotional well-being, which is why we were one of the first in the health insurance market to introduce a separate limit for psychological consultations. Emotional health is a new service which, if selected, will pay for consultations with a psychologist or psychotherapist without a physician’s appointment.
Professional customer service
We take care of you, so you can always easily reach us by calling the short telephone number 1887.
Quick claim settlement
With our mobile app, you can quickly and conveniently fill out a claim for compensation.
Possibility to choose
You will be able to choose the scope of insurance coverage according to your needs.
What services are compensated by ERGO?
Additional health insurance for employees
All services
In the event of health problems, the personal health insurance will reimburse the following services, depending on the chosen insurance coverage:
- outpatient treatment;
- inpatient treatment in public and private medical institutions;
- preventive examination, prenatal care and vaccination;
- optics;
- vitamins, food supplements, non-prescription medicines;
- critical illnesses;
- rehabilitation treatment;
- dentistry services;
- medical services;
- emotional health;
- prescription medicines and orthopedic technical devices.
Important: this is the broadest insurance option, each valid insurance scope may differ from the insurance coverage described here or mentioned in the Rules.
Outpatient treatment
In case of outpatient treatment, the following services are paid:
- consultations of a general practitioner in a health care facility and home visits;
- consultations and examinations of other medical specialists;
- consultations of a psychiatrist, psychiatrist-psychotherapist (up to 10 times during the insurance period), after the psychiatrist has diagnosed the disease and prescribed treatment;
- Remote medical consultations.
Inpatient treatment
In case of inpatient treatment, the following services are paid:
- comfort (single or double ward);
- consultations of medical specialists and their diagnostic and therapeutic treatments;
- diagnostic tests prescribed by a physician;
- nursing services by a physician’s appointment;
- medical aids prescribed by a physician and used in an inpatient facility, medicinal products, care products, orthopedic equipment.
Preventive examination, prenatal care and vaccination
In case of preventive examination, prenatal care and vaccination, the following services are paid:
- according to the nature of the work, a health examination is mandatory in accordance with the law;
- tests carried out at the request of the insured person;
- tests that are not necessary and medically justified in a specific clinical situation;
- psychotherapeutic treatment (a physician’s appointment is not necessary);
- comfort services (single or double ward) during pregnancy, childbirth and postnatal care;
- pregnant women’s examinations, a physician’s consultations and tests prescribed by them to monitor the course of pregnancy (laboratory, instrumental);
- diagnosis of pregnancy complications (a physician’s consultations and tests);
- childbirth care (services of nurses and physicians during childbirth (including a premium for a pre-selected physician or midwife of the same medical institution), painkillers, birth-inducing drugs, lard, vacuum aid device);
- a physician’s consultations regarding vaccinations and vaccines chosen by the insured person or prescribed by the physician and vaccination.
Optics
Paid optical services:
- glasses selection and production service;
- frames for glasses are purchased together with corrective lenses (glass, plastic, photochromic, progressive);
- corrective lenses (glass, plastic, photochromic, progressive);
- contact lenses (lenses);
- eye lenses used during surgery;
- myopia and hyperopia vision correction surgeries.
Vitamins, food supplements, non-prescription medicines
The following products purchased in pharmacies or e-pharmacies are paid:
- food supplements and vitamins;
- non-prescription medicinal products.
Rehabilitation treatment
In case of rehabilitation treatment, the following services are paid:
- consultations of a physiotherapist, occupational therapist, speech therapist;
- physiotherapy sessions;
- individual and group physical therapy classes in the hall and in the water;
- water and mud treatments;
- manual therapy sessions;
- therapeutic massages.
Dentistry services
In case of dental treatment, oral hygiene, prosthetics, the following services are paid:
- consultations of a dentist, dental specialist and oral hygienist, consultations on dental prosthetics, implantation and orthodontic treatment;
- removal of dental concretions, plaque cleaning;
- fluoride applications;
- endodontic, periodontal, therapeutic and surgical treatment of dental diseases, mouth, its mucous membrane and jaw diseases, anesthesia, X-ray examination;
- production, restoration and repair of removable and non-removable dental prostheses;
- dental implantation, dental implants, orthodontic treatment, braces, therapeutic aligners for orthodontic treatment, myorelaxation trays, aesthetic filling.
Medical services
Paid medical services:
- services provided in healthcare facilities: a physician’s consultations, diagnostic tests, surgeries, nursing services, rehabilitation treatment, prenatal care, prevention, vaccination, psychotherapeutic treatment;
- services purchased in pharmacies/e-pharmacies, stores/e-stores of orthopedic technical devices: medicinal products, food supplements, medical aids, orthopedic technical devices;
- in optical stores/e-optical stores: contact lenses (lenses), corrective lenses, and frames purchased together with corrective lenses, safety glasses, glasses selection and production services, eyeglass care products (solutions for contact lenses and liquid cleaners for eyeglass lenses), eye lenses used during surgery;
- dental treatment services: dental treatment, oral hygiene, prosthetics, implantation, orthodontic treatment, braces, therapeutic caps for orthodontic treatment, myorelaxation caps, aesthetic filling;
- in health care institutions: physiotherapy sessions, occupational therapy sessions, halotherapy, physiotherapy classes, water and mud treatments, manual therapy sessions, therapeutic massages.
Medical services do not require a physician’s appointment/prescription/referral.
Emotional health
Paid emotional health services:
- a psychiatrist consultations;
- a psychiatrist-psychotherapist consultations;
- a psychologist-psychotherapist consultations;
- a medical psychologist, psychologist consultations.
A physician’s appointment is not necessary.
Prescription medicines and technical orthopedic devices
Paid medicines and technical orthopedic devices:
- prescription medicinal products;
- orthopedic technical devices purchased in stores/e-stores of orthopedic technical devices and/or pharmacies/e-pharmacies, orthopedic inserts, orthopedic socks and compensatory equipment, elastic and compression socks.
Additional health insurance for employees
Why to choose ERGO insurance?
The opportunity to take better care of your health will ensure a better well-being of employees and higher work efficiency. Additional insurance also promotes employee loyalty.
Taking care of your employees will have a positive impact on your company’s image.
Your employees will be able to choose the desired public or private medical institution, specialist physician and receive services quickly and in a high quality manner.
Health insurance-reimbursed treatment services will allow employees to return to work faster after illness, which will reduce the number of days off.
How to use health insurance and receive a compensation?
Your employees may choose the desired public or private medical institution, specialist physician and receive services quickly and in a high quality manner. For your convenience, we provide a list of medical institutions where you can receive the State-paid services. Going to these medical institutions for medical consultations or tests can save your insurance funds and allocate them to other higher expenses.
How to apply for a compensation of claims?
- Keep a record of your doctor’s appointment, prescription or referral for tests and treatments, documents of payment for the provided services and provide them to us as soon as possible.
- You can submit documents quickly and conveniently using the ERGO mobile app, My ERGO self-service portal.
- You can also submit a request by e-mail sveikatos_zalos@ergo.lt after additionally completing the application for reimbursement of expenses, which is available in Self service portal.
- After receiving the necessary documents, we will transfer the payment to you within 2-3 working days.
ERGO mobile health app for companies
We invite you to use the ERGO mobile app – it is the most convenient way to apply for reimbursement of health insurance costs. In the mobile app, you will be able:
- make claims for reimbursement of expenses;
- check the health insurance limits;
- read the policy information;
- see the reimbursed services, the necessary documents;
- view the electronic health insurance card.
How to log in and use the app:
- first, log om to your account on the smart phone via e-banking. Later, you can log in using a quick identification method: PIN code, fingerprint and face recognition function, depending on the capabilities of your device;
- by selecting the SUBMIT menu item, you will register a request for reimbursement of expenses;
- when registering an insurance benefit for the first time, enter your contact details, select the limit from which you wish to receive reimbursement;
- attach documents (e.g. cheque, invoice, medical record, etc.) or their photos;
- make sure the details you provide are correct;
- familiarise yourself with the policy rules and submit an application;
- we will process the submitted application within 2-3 working days and contact you by e-mail.