In Estonia, the sickness fund Eesti Haigekassa (Estonian Health Insurance Fund- EHIF) will pay the costs of medical care directly to the place of treatment and the patient will only pay the deductible when seeking treatment. The place of treatment must have an agreement with EHIF. In addition to national and municipal services, EHIF also covers the costs of medical care in private hospitals, which have an agreement with EHIF.
Estonia also has private doctors, clinics and hospitals that do not have agreements with EHIF. If you seek treatment at such a place, you will be required to pay full price and you will not receive reimbursement in Estonia. If you do not have the European Health Insurance Card with you, you can request a temporary certificate to replace it from Kela or via Eesti Haigekassa.
Contact a doctor (perearst) who has an agreement with EHIF. Visiting a general practitioner is free of charge in this case. Precondition is that the need for health care has arisen during your stay in Estonia and the need for health services is justified on medical grounds. The doctor must also consider the presumed duration of your stay when he desides about the treatment to be given.
Seeing a specialist requires a referral from a general practitioner (with the exception of gynaecologists, ophthalmologists, dermatologists, venereologists, psychiatrists and trauma surgeons whom you can see without a referral). When you show your valid European Health Insurance Card and identity card, you will only need to pay a maximum patient fee of € 5. The price is the same for house calls from general practitioners. A patient’s fee for specialised medical care should not be asked in case the patient is referred to another specialist within the same hospital, from pregnant women, from children under the age of 2 or in case of urgent medical care followed by an in-patient treatment.
If you do not have the European Health Insurance Card with you, ask your doctor to provide a receipt and a breakdown of treatment together with the invoice (in Estonia, treatment procedures are often marked on the invoice). You can use these documents to apply for reimbursement after returning to Finland.
At the dentist, a patient will usually be liable for all costs. The exception is patients under the age of 19, for whom treatment is free when it is necessary. In case of an emergency, necessary tooth removal is free for adults. The dentist must have an agreement with EHIF and you must present your European Health Insurance Card.
Show your European Health Insurance Card and identity card when collecting your medicines prescribed by a contract doctor. Specific medicines approved by EHIF will be reimbursed. The level of reimbursement mainly depends on the severity of the illness. Reimbursement is calculated according to reference prices, price agreements or sale prices.
When your medicine is reimbursed by 50 %, you will pay a deductible of € 3.19 plus 50 % of the reference price as well as any portion of the price that exceeds the reference price. The sickness fund of Estonia will reimburse you by 50 % of the portion exceeding the deductible of € 3.19 and up to the reference price, however, no more than € 12.79 per prescription. You will be liable for all other costs.
When your medicine is reimbursed by 75 %, you will pay a deductible of € 1.27 per prescription plus 25 % of the portion that exceeds the deductible.
When your medicine is reimbursed by 90 %, you will pay a deductible of € 1.27 per prescription plus 10 % of the reference price as well as any portion of the price that exceeds the reference price. The sickness fund of Estonia will reimburse you by 90 % of the portion exceeding the deductible and up to the reference price. You will be liable for all other costs.
If your medicine is reimbursed by 100 %, you will pay a deductible of € 1.27 per prescription plus the portion that exceeds the reference price. The sickness fund of Estonia will reimburse you for the entire difference between the deductible and reference price.
A doctor’s referral is usually required for hospital treatment. In urgent cases, you can go straight to the Emergency Medical Center. Show your valid European Health Insurance Card and identity card at the hospital, in which case the treatment will cost a maximum of € 2.50 per day. The fee will be collected for the first 10 days of illness, i.e. up to a maximum of € 25. Treatment is free for patients under the age of 19, intensive care patients and pregnant women.
Ambulance transport is free in urgent cases. Only domestic emergency air ambulance transport is free of charge.
If you are required to pay full price
If you are required to pay full price for public healthcare treatment that should have been covered by the European Health Insurance Card, you can apply for reimbursement retrospectively. You can apply for reimbursement from EHIF or from Kela on form SV 128.
Most hospitals in Estonia are either limited liability companies owned by a municipality or foundations set up by the government, municipalities or local governmental bodies. Companies providing personal doctor services can only offer general practitioner and healthcare services.
You can look for a hospital in Estonia by browsing the list on the Estonian contact point’s website that lists the largest hospitals in Estonia. The hospitals also have several specialists. A corresponding list can be found on the website of the Eesti Haigekassa (Estonian Health Insurance Fund) (in Estonian).
The 1182 web service has a dentist search, doctor service search, personal doctor search, and private clinic search in English as well as several other searches that you can use to find a healthcare service provider in Estonia.
Practices and costs related to treatment
When seeking treatment from a specialist in Estonia, you will usually require a referral from a general practitioner (See under ‘Doctor‘). Please contact the place of treatment in advance to verify whether a referral from a general practitioner in Estonia is required or if a referral from a doctor operating in Finland is acceptable.
The website of the Eesti Haigekassa also has hintalista (Haigekassa) provided in the country. In order to receive a specific cost estimate, however, you should contact the place of treatment directly. If necessary, you can request assistance from the National Contact Point of Estonia.
Quality and patient safety
The Government of Estonia has set the quality requirements for healthcare services and established a supervision system in order to inspect the operation of healthcare service providers. The most important rules related to patient safety are based on the Health Services Organisation Act and the Law of Obligations Act.
The treatment provided in Estonia is supervised by EHIF, the Health Board of Estonia and an expert committee on quality of health services. More information concerning the quality and supervision of treatment provided in Estonia can be found on the website of the National Contact Point of Estonia.
Malpractices are not systematically registered in Estonia, but the country’s health insurance institute regularly performs clinical audits at the healthcare service providers. In case of malpractice, the party providing the treatment is liable to compensate the patient for the mental and physical damage caused by the provided service.
If you feel that your rights as a patient have been neglected, you can file a complaint with the healthcare service provider, the Health Board of Estonia, the EHIF or the expert committee on quality of health services.