Personal health insurance
There is nothing more precious than good health. To prevent unexpected illness, toothache, seasonal illness or accidents from wasting your energy and finances unnecessarily, choose ERGO health insurance.
Health insurance for private individuals
Personal health insurance will give you the opportunity to be treated in the health care facilities of your choice, purchase medicines, visit a dentist, use rehabilitation services without thinking much about the costs, because they will be covered by us.
If you are insured by your employer, you are covered by the terms and conditions of employee health insurance.
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 can we insure against?
All insured events.
In the event of health problems, the personal health insurance will reimburse the following services, depending on the chosen insurance coverage:
- outpatient treatment;
- day surgery;
- inpatient treatment;
- treatment of serious diseases;
- rehabilitation treatment following in-patient treatment of an injury;
- dental treatment, oral hygiene;
- preventive health examination and vaccination.
Outpatient treatment.
In case of outpatient treatment, the following services are paid:
- services, consultations and examinations for health disorders, including cases of exacerbation of chronic diseases, when the disease was established during the period of insurance coverage;
- health disorders and chronic diseases that were diagnosed before the insurance contract came into force are not covered;
- consultations of a psychiatrist, psychiatrist-psychotherapist (up to 5 times during the insurance period), after the psychiatrist has diagnosed the disease and prescribed treatment.
Day surgery.
In case of day surgery, the following services are paid:
- medical aids prescribed by a physician and used in a hospital, medicinal products, care products and premiums for the tools used during surgery, excluding tissue substitutes/bolts/plates/screw/studs, implants, suturing sets, prostheses;
- services prescribed by a physician, provided in a health care facility or at the home of the insured person: injections, infusions (excluding the cost of medicinal substances), wound dressings, blood sampling, etc.
Inpatient treatment.
In case of inpatient treatment, the following services provided in a public in-patient healthcare facility are paid:
- comfort (single or double ward);
- medical aids, medicinal products, care products prescribed by a physician and used in a hospital.
Treatment of serious diseases.
In case of serious diseases, the following services are paid:
- outpatient treatment: physician’s services, diagnostic tests, nurses’ services;
- inpatient treatment;
- medicines and orthopedic technical means for treatment of serious diseases, according to a physician’s prescription;
- after the appointment of the attending physician, we will pay for outpatient and/or inpatient rehabilitation services.
Rehabilitation treatment following in-patient treatment of an injury.
- after an injury treated in an inpatient facility, when more than 24 hours have been spent there, we will pay for medically justified outpatient and/or inpatient rehabilitation treatment upon appointment by the attending physician;
- injuries that were diagnosed before the insurance contract came into force are not covered.
Paid rehabilitation services:
- consultations of a physiotherapist, occupational therapist, speech therapist;
- physiotherapy treatments;
- physical therapy individual and group classes in the hall and in the water;
- water and mud treatments;
- manual therapy sessions;
- therapeutic massages.
Dental treatment, oral hygiene.
In case of dental treatment and oral hygiene, the following services are paid:
- consultations of a dentist, dental specialist and oral hygienist;
- removal of dental concretions, plaque cleaning;
- fluoride applications;
- endodontic, periodontal, therapeutic and surgical treatment of dental diseases, diseases of the mouth, its mucous membrane and jaw, anesthesia, X-ray examination.
Preventive health examination and vaccination.
In case of preventive health examination, the following services are paid:
- mandatory health examination according to the nature of the work;
- tests carried out at the request of the insured person;
- consultations and research carried out in accordance with the preventive programmes of the Republic of Lithuania, as well as preventive programs drawn up and approved in the health care facility;
- preventive physician’s consultations and examinations, which are necessary to regularly monitor the health status of the insured person suffering from a chronic disease or after performed operations.
In case of vaccination, the following services are paid:
- a physician’s consultation regarding vaccination;
- vaccines and vaccinations chosen by the insured or prescribed by a physician.
What can we insure against?
In the event of health problems, the personal health insurance will reimburse the following services, depending on the chosen insurance coverage:
- outpatient treatment;
- day surgery;
- inpatient treatment;
- treatment of serious diseases;
- rehabilitation treatment following in-patient treatment of an injury;
- dental treatment, oral hygiene;
- preventive health examination and vaccination.
In case of outpatient treatment, the following services are paid:
- services, consultations and examinations for health disorders, including cases of exacerbation of chronic diseases, when the disease was established during the period of insurance coverage;
- health disorders and chronic diseases that were diagnosed before the insurance contract came into force are not covered;
- consultations of a psychiatrist, psychiatrist-psychotherapist (up to 5 times during the insurance period), after the psychiatrist has diagnosed the disease and prescribed treatment.
In case of day surgery, the following services are paid:
- medical aids prescribed by a physician and used in a hospital, medicinal products, care products and premiums for the tools used during surgery, excluding tissue substitutes/bolts/plates/screw/studs, implants, suturing sets, prostheses;
- services prescribed by a physician, provided in a health care facility or at the home of the insured person: injections, infusions (excluding the cost of medicinal substances), wound dressings, blood sampling, etc.
In case of inpatient treatment, the following services provided in a public in-patient healthcare facility are paid:
- comfort (single or double ward);
- medical aids, medicinal products, care products prescribed by a physician and used in a hospital.
In case of serious diseases, the following services are paid:
- outpatient treatment: physician’s services, diagnostic tests, nurses’ services;
- inpatient treatment;
- medicines and orthopedic technical means for treatment of serious diseases, according to a physician’s prescription;
- after the appointment of the attending physician, we will pay for outpatient and/or inpatient rehabilitation services.
- after an injury treated in an inpatient facility, when more than 24 hours have been spent there, we will pay for medically justified outpatient and/or inpatient rehabilitation treatment upon appointment by the attending physician;
- injuries that were diagnosed before the insurance contract came into force are not covered.
Paid rehabilitation services:
- consultations of a physiotherapist, occupational therapist, speech therapist;
- physiotherapy treatments;
- physical therapy individual and group classes in the hall and in the water;
- water and mud treatments;
- manual therapy sessions;
- therapeutic massages.
In case of dental treatment and oral hygiene, the following services are paid:
- consultations of a dentist, dental specialist and oral hygienist;
- removal of dental concretions, plaque cleaning;
- fluoride applications;
- endodontic, periodontal, therapeutic and surgical treatment of dental diseases, diseases of the mouth, its mucous membrane and jaw, anesthesia, X-ray examination.
In case of preventive health examination, the following services are paid:
- mandatory health examination according to the nature of the work;
- tests carried out at the request of the insured person;
- consultations and research carried out in accordance with the preventive programmes of the Republic of Lithuania, as well as preventive programs drawn up and approved in the health care facility;
- preventive physician’s consultations and examinations, which are necessary to regularly monitor the health status of the insured person suffering from a chronic disease or after performed operations.
In case of vaccination, the following services are paid:
- a physician’s consultation regarding vaccination;
- vaccines and vaccinations chosen by the insured or prescribed by a physician.
What can we insure against?
Travel insurance.
Travel insurance coverage is valid:
- worldwide, except for USA, Canada, Australia, Belarus, Russia.
Accident insurance.
Accident insurance coverage is valid:
- worldwide.
What can we insure against?
Travel insurance coverage is valid:
- worldwide, except for USA, Canada, Australia, Belarus, Russia.
Accident insurance coverage is valid:
- worldwide.
Why to choose ERGO insurance?
You will be able to choose the desired public or private treatment facility, physician-specialist and, if necessary, quickly receive high-quality services.
Every day will be filled with the satisfaction of knowing that you and your loved ones have been well cared for.
We all know that a sudden illness does not wait. Treatment will be provided to you as quickly as possible.
Insurance coverage for inpatient treatment and treatment of serious diseases will also apply to you in Latvia and Estonia.
How to use personal health insurance and receive a compensation?
A large part of treatment services is paid for by the State (doctor’s consultations, tests).
If you need urgent assistance and you cannot wait for the services provided by the State, you can contact any private medical institution, pay for the services with your own funds and apply for a compensation from ERGO.
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 here.
- After receiving the necessary documents, we will transfer the payment to you within 2-3 working days.
ERGO mobile health app
The ERGO mobile app is the easiest and fastest way to apply for reimbursement of health insurance costs.
In the mobile app, you may:
- make a claim for reimbursement of expenses;
- check the limits of the sums insured under health insurance.
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.
Frequently asked questions about personal health insurance
The cost of personal health insurance depends on the chosen option. The minimum annual insurance premium is EUR 240. We will determine the price of private health insurance after reviewing your insurance application.
The health insurance we offer covers serious diseases such as cancer, bacterial meningitis, myocardial infarction, aplastic anemia, stroke, active tuberculosis, kidney failure, etc. We will pay for treatment and surgery services provided by the best specialists in the Baltic States.
The following dental treatment and oral hygiene services are covered if they have been chosen:
- consultation of a dentist, dental specialist and oral hygienist;
- removal of dental concretions, plaque cleaning;
- fluoride application;
- endodontic, periodontal, therapeutic and surgical treatment of dental diseases, diseases of the mouth, its mucous membranes and the jaw, anesthesia, X-ray examination.
According to the current legal acts of the Republic of Lithuania, personal income tax relief does not apply to personal health insurance premiums.
Health insurance is valid in the Baltic States.
You can fill out and submit a request online, which will be discussed with our consultant.
