Latvia

Health systems in transition
Latvia
Table 3.3
Voluntary health insurance contributions and claims, 1997–2005 (real LVL
million, 1997 prices)
1997 1998 1999 2000 2001 2002 2003 2004 2005
Premiums* 3.4 4.3 6.6 7.6 9.4 10.4 13.3 14.2 18.1
Claims* 2.0 2.2 4.2 6.3 7.5 7.9 8.8 9.6 11.1
State budget financing* 111.5 122.5 126.8 136.7 140.5 155.9 172.5 188.5 214.1
VHI claims/budget 1.8 1.8 3.3 4.6 5.3 5.1 5.1 5.1 5.2
financing (%)
User charges (% paid - - - - 8.3 8.6 8.7 8.6
by VHI) 39% 30% 42% 34% -
Source: Latvian Insurers Association, 2007 (data provided in nominal terms).
Notes: * Figures are in real terms (million LVL), deflated by use of the consumer price index,
1997 prices; VHI: Voluntary health insurance
VHI schemes are offered by commercial insurance companies to employer
organizations. There is only one quasi-public insurance company (belonging
to Riga City) that provides coverage for individuals, and this is about to be
privatized.
Each commercial insurance company defines its own insurance schemes
without any external regulation of prices and benefits packages. Insurance
schemes provide a mixture of complementary and supplementary coverage.
They cover those health care services and/or prescription drugs which are not
statutorily financed, such as dentistry for adults, routine health check-ups needed
for specific job security requirements, physiotherapy and massage, rehabilitation
and some types of vaccines (influenza, tick-borne encephalitis, hepatitis). Other
VHI schemes cover only user charges (patient fees and co-payments) imposed
on state budget services. Some schemes cover the cost of specific services, such
as optician services, hearing aids and prosthesis. Generally, voluntary health
insurers exclude from their schemes health conditions and diseases covered
by statutory insurance, such as communicable diseases, STIs, HIV/AIDS,
mental health, substance and alcohol abuse, emergencies and pharmaceuticals.
Plastic surgery, extra uterus fertilization and non-traditional medicine, as well
as hygiene products, are not usually covered by VHI.
Insurance premiums are calculated according to each insurance company’s
tariffs, and are based on age and health status of clients. Premiums can be paid
as lump-sum transfers or by instalments and usually cover one year; however,
insurance contracts signed between the company and the client may include
specific terms and conditions. There are no legal regulations specifically for
health insurance in VHI companies; they conform to the regulations of the
private sector, including solvency controls.
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