Estonia has a mandatory solidary health insurance system, which is funded from the social tax, paid on the income of the workforce. If a person does not fit under the conditions to get the automatic insurance; then they can sign a voluntary insurance contract as per the law. Although most of the healthcare services are covered by the Health Insurance Fund, some services are not fully covered.
Health Insurance Fund covers healthcare services which are included in the health insurance package. Patients have to partially cover some of the expenses (such as prescriptions) themselves. The list of services, their price and conditions of payment are updated annually, and can be found in the Regulation of Health Care Services. Some of the completely or partially covered procedures and services include, for example:
- doctor’s or nurses visit
- diagnostic analyses
- medical procedures
- dental care for insured person under 19 years of age
You can find a full list of health services provided by the Health Insurance Fund in the Regulation of Health Care Services.
Under Health Insurance Act, the insurance coverage extends to:
- persons working on the basis of an employment contract or contract under the law of obligations for more than one month
- person registered at the Estonian Unemployment Insurance Fund socially insured persons
- public servants
- persons who are members of management or supervisory board of a legal entity
- persons under the age of 19
- persons studying at educational institutions (e.g., full-time students)
- conscripts
- pregnant women
- persons with partial or no work ability
- persons receiving state pension granted in Estonia
- and other groups defined by the law
Persons who do not belong to the abovementioned groups of insured people can sign a voluntary insurance contract with the Health Insurance Fund. In that case, the person pays the insurance premiums themselves.
Every person in the territory of Estonia has the right to receive emergency care in situations where postponement of care or failure to provide care may cause the death or permanent damage to the health, regardless of whether they are insured.