This chapter presents information about receiving healthcare services in Latvia.

In what situation can I claim?

The following have the right to receive state-funded healthcare services (veselības aprūpes pakalpojumi):

• citizens and non-citizens of Latvia and their children by the age of 18;
• citizens of the United Kingdom, European Union Member States, European Economic Area countries and Switzerland who live in Latvia and work as employees or self-employed persons, and their family members;
• foreigners with permanent residence permits in Latvia and their children by the age of 18;
• stateless persons who have been granted stateless status in the Republic of Latvia and their children by the age of 18;
• refugees and persons granted alternative status and their children by the age of 18;
• persons who are arrested, detained or sentenced to imprisonment and their children by the age of 18;
• asylum seekers and their children by the age of 18.

Spouses of citizens and non-citizens of Latvia with temporary residence permits in Latvia have the right to receive state-funded childbirth care.

Persons with the right to receive state-funded healthcare services in Latvia also have the right in accordance with set procedures to receive healthcare in another Member State.

What conditions do I need to meet?

Registering with a general practitioner (GP)

The central role in the healthcare system is played by the GP, who delivers essential primary healthcare services and provides overall coordination of your healthcare. You have the right to choose your GP and register on his or her list of patients.

To register with a GP, choose the GP closest to your home, contact him or her and arrange a registration visit at which you and the doctor will conclude a contract on healthcare provision. You can register with a GP also electronically in the e-health portal or latvija.lv.

A doctor's referral

In most cases, you need to obtain a referral from a GP or specialist in order to access state-funded healthcare services. Without a referral you will have either to pay the full-service price out of your own pocket or to pay voluntary health insurance.

Referrals for state-funded healthcare services may be given by doctors who have concluded a contract with the National Health Service.

Without a referral you have the right to receive state-funded emergency medical assistance and consultations with a direct access specialist, for example a gynaecologist, ophthalmologist, paediatrician, endocrinologist (if you have diabetes) and other specialists.

Healthcare when moving within the EU

If you have the right to receive state-funded healthcare services in Latvia, you also have the right to receive healthcare services in another EU/EEA country or Switzerland/UK. You have the right:

• to receive planned healthcare services in another EU/EEA country or Switzerland if such services are unavailable in Latvia and the respective service is included in the range of state-funded healthcare services (confirmed by form S2 'Confirmation of rights to planned medical treatment');
• to receive essential or emergency healthcare in the event of a short-term stay in another EU/EEA country or Switzerland/UK (confirmed by an EHIC - European Health Insurance Card);
• to receive guaranteed healthcare services in another EU/EEA country or Switzerland/UK if the person lives in the respective country or is sent to another country on a short-term work assignment (for a maximum of 12 months) (confirmed by form S1 'Confirmation of rights to receive healthcare');
• to complete treatment already in progress if the person is a retired border zone employee who previously worked as an employee or self-employed person (confirmed by form S3 'Confirmation of rights to healthcare').

The National Health Service rules on issuing the aforementioned documents.

What am I entitled to and how can I claim?

The following are funded from the state budget:

• assistance from emergency medical teams;
• outpatient healthcare (for example healthcare provided by GPs and specialists, services by dentists and dental hygienists for persons up to 18 years and certain other categories of persons, healthcare at home, laboratory and visual diagnostic examinations, etc.);
• inpatient healthcare;
• medications and medical devices purchased by the National Health Service;
• reimbursable medications and medical devices.

More details about which healthcare are not funded from State budget.

In order to receive state-funded treatment from specialists, outpatient treatment or treatment in a hospital, you may have to get on a waiting list. You have the right to apply to the institution with the shortest waiting time. You may choose a place to receive state-funded healthcare services regardless of where you live.

Patient's fees and co-payments

When receiving state-funded healthcare services, you must co-pay a patient's fee. Patient's fees are charged for visits to GPs and specialists, treatment in inpatient day clinics and hospitals as well as for certain diagnostic examinations.

Inpatient facilities have the right to charge also a patient’s fee for surgical operations performed during admission. The maximum amount of a patient’s co-payment in this case is EUR 31.

Children up to 18 years, pregnant women and women in the post-natal period (up to 70 days), 1^st category disabled persons, poor persons as well as other categories of persons are exempted from patient's fees and co-payments.

If you have accrued patient's fees amounting to EUR 570 in a given year, you will be exempted from further patient's fees and co-payment in the respective year (application to National Health Service is required). Based on documents you have submitted confirming payment, regional branches of the National Health Service will issue a statement of exemption from patient's fees.

The total amount of patient's fees for each treatment event in a hospital may not exceed EUR 355.

Reimbursement of expenses

You may be reimbursed for healthcare which you have received in another EU/EEA country or Switzerland/UK and for which you paid out of your own pocket in the following cases:

1) For essential/emergency healthcare received during a brief visit to an EU/EEA country or Switzerland/UK. The competent institution in the country where the healthcare services were provided determines whether the healthcare expenses are reimbursable and for what amount.

2) For planned healthcare services in an EU/EEA country or Switzerland. Expenses are reimbursed if the healthcare services are included in the range of state-funded services, and the amount of reimbursement is calculated in accordance with rates in force in Latvia. Certain medical services require prior approval, which is granted by the National Health Service.

3) For planned healthcare services in an EU/EEA country or Switzerland, if you have not received healthcare services in the country or from the healthcare service provider indicated on form S2. Expenses are reimbursed if the healthcare services are included in the range of state-funded services, and the amount of reimbursement is calculated in accordance with rates in force in Latvia.

Medical Treatment Risk Fund

If medical treatment has caused harm to your life and health, you have the right to claim compensation for damages and reimbursement of medical expenses. You have the right to seek compensation from the Medical Risk Fund not later than 2 years after the date of discovering the harm, but not later than 3 years after the date the harm was incurred.

Application for services

Apply to the National Health Service to receive:

• an exemption from patient's fees, in case you have accrued patient's fees amounting to EUR 570 in a given year, appending documents confirming payment to the application;
• a European Health Insurance Card;
• S1, S2 or S3 forms;
• prior approval to receive certain healthcare services and reimbursement of expenses for healthcare services received in another EU country.

Apply to the Health Inspectorate to receive:

• compensation from the Medical Treatment Risk Fund, appending documents confirming payment and medical documents to the application.

See your electronical health record or apply for the European Health Insurance Card on the e-health portal or portal latvija.lv. You can also access the electronical health record of your minor child, a person who is under your guardianship, as well as of people who have authorised you to access their electronic health record. If you are registered in the Register of Natural Persons of Latvia, you can access this information using your internet bank, e-signature or e-ID.

Jargon busters

A general practitioner is a primary healthcare doctor who performs preventative check-ups, vaccinations and simple examinations, diagnoses and treats illnesses, and if necessary refers patients to specialists, for further examinations, day clinics or hospitals.

A medical specialist is a doctor specialising in a particular field who on an inpatient (hospital) or outpatient basis performs examinations, diagnoses and treats illnesses, and if necessary refers patients to other specialists, for further examinations, day clinics or hospitals.

The patient's fee is a payment made by the patient for state-funded healthcare services.

Hospitals have the right to charge patients a co-payment in addition to the patient's fee for certain operations performed in the hospital's operating theatre.

Forms you may need to fill in

• Exemptions from patient's fees
• Application for an EHIC
• Application to the Medical Treatment Risk Fund
• Requesting S1 forms, S2 forms and S3 forms from the National Health Service

Know your rights

See the links below for information on state-funded healthcare. These are not European Commission websites and do not reflect the views of the European Commission:

• Information about healthcare services if you live/work in another EU Member State, European Economic Area country or the Swiss Confederation or the UK.

Latvian laws and regulations on the provision of healthcare services:

• Medical Treatment Law
• Health Care Financing Law
• Law on the Rights of Patients
• Cabinet regulations: Procedures for organising and funding healthcare

European Commission publication and website:

• Social security: your rights in other European Union countries

Who do you need to contact?

National Health Service
Cēsu iela 31 k-3 (entrance 6, floors 2, 3 and 4)
Riga, LV-1012, Latvia
Secretariat: +371 67043700
Toll free information number: +371 80001234 (Mon. 8.30-18.30, Tue.-Thu. 8.30-17.00, Fri. 8.30-15.00).
e-mail: nvd@vmnvd.gov.lv
twitter.com/vmnvd

National Health Service regional branches

GPs' consultation number (weekdays 17.00 to 8.00, weekends and public holidays - 24 hours): +371 66016001
e-mail: medkonsultacija@gmail.com

"Skype" (medkonsultacija)

General practices throughout Latvia

State Emergency Medical Service

Laktas iela 8

Riga, LV-1013

Administration: +371 67337000 (8.30- 17.00)

e-mail: nmpd@nmpd.gov.lv

https://twitter.com/NMPdienests

Health Inspectorate
Klijānu iela 7
Riga, LV-1012, Latvia
Information number: +371 67819671
For medical care quality issues: +371 67221244
e-mail: vi@vi.gov.lv
twitter.com/veselibasinspek

Ministry of Health
Brīvības iela 72
Riga, LV-1011, Latvia
Tel.: +371 67876000, Fax +371 67876002
E-mail: vm@vm.gov.lv
twitter.com/veselibasmin

If you have any problems regarding your rights in the European Union, please contact the EU assistance service.