In the health care system, the first contact that a person with a health concern has is with their family physician or family nurse.
Here, you can find information on dental care and denture benefits.
Here, you can see the details of the European Health Insurance Card issued to you and order a replacement certificate.
Here, you can see the details of the current account submitted to the Health Insurance Fund.
Family physician
The family physician together with the family nurse:
- diagnoses and treats most diseases;
- monitors child’s progress and persons with chronic conditions;
- performs minor surgical procedures;
- refers patients for tests and takes analyses;
- vaccinates;
- makes home visits, if necessary;
- gives advice on care, injuries or intoxications and in terms of preventive measures to all persons included in their practice list.
Every citizen of the Republic of Estonia and alien staying in Estonia on the basis of a residence permit has the right to register in the practice list of a family physician and change a family physician on the basis of a written application. You can choose your own family physician, in order to do so, find a family physician you wish to start going to. Information about which family physicians closest to your place of residence is available on the website of the Health Board. After that, submit an application directly to the chosen family physician to be included in their practice list.
Being able to speak English is not a requirement for family doctors to practice in Estonia, so you cannot assume that all family doctors will be able to serve you in your own language. However, it is possible if the doctor and patient agree. You can also visit the doctor with a translator or other support person. Most private practices have service available in other languages.
A family physician will give a positive or negative response to a person who has applied for vacancies in the practice. The family physician will inform a person in written form within seven working days from the day the application was presented. In case of refusal, the family physician will indicate the reason for the refusal.
The family nurse has independent appointments where they teach, advise and guide people about the promotion and maintenance of health and prevention of disease. The family nurse provides assistance in the event of illness and organises medical records; also, the role of a nurse is to monitor persons with chronic conditions. If necessary, the family nurse consults with the family physician or refers the person to an appointment with the family physician.
Primary health care is free of charge for health insured persons. Persons without health insurance have to pay for the service of the family physician. For a home visit, the family physician may charge up to 5 euros, regardless of how many patients they will check during the visit. Home visits for pregnant women and children under the age of two are free of charge.
Names of family physicians may be checked:
- at the state portal in the e-service of the Health Insurance Board under My personal data in the Health Insurance Fund
- by calling the customer service phone number of the Health Insurance Board at (+372) 669 6630.
Information about family physicians:
- Phone numbers and addresses are listed on the website of the Health Insurance Fund
- The size of their practice lists and their service areas are available on the website of the Health Board
- For questions, contact customer service phone number at (+372) 669 6630 or
- send an e-mail to [email protected].
In case of concerns, you can also contact the family physician advice line and ask for professional medical advice in Estonian or Russian 24 hours a day. The numbers for the advice line are 1220 and (+372) 634 6630.
E-service of Estonian Health Insurance Fund “My prescriptions” enables a person to see prescribed medicines and prescriptions’ validity. Also you can see information about your additional drug reimbursement. To see prescribed medicines to your underage children, please visit the Health Portal at www.terviseportaal.ee. In the same portal you can also see referrals issued to you and to your children, health records and results of analyses.
Medical specialist
Specialised medical care is out-patient, day or in-patient treatment provided by a medical specialist or a dentist and the health care professionals working together with the dentist.
Out-patient treatment refers to a consultation by a physician, during which the patient is checked, some procedures (such as a blood test, cardiogram, etc.) are performed on site and, if necessary, further treatment is prescribed. The patient does stay in the hospital for any longer.
Day treatment implies that the patient stays in the hospital for longer than just the consultation time but not overnight.
In-patient treatment is provided at the hospital and the patient has to stay there for a night or longer.
Health insured persons have the right to choose their preferred medical specialist and consultation time in any of the medical institutions that have a contract with the Health Insurance Fund.
To see a medical specialist, a referral from the family physician is needed, except for a gynaecologist, dermatologist, eye specialist, pulmonologist or dentist. In the case of traumas, you can also see a surgeon or traumatologist without a referral.
Patients are no longer issued referrals on paper. Instead, the family physician shall forward a digital referral to the medical specialist through the health information system. Digital referrals issued to you are available in the Health Portal at www.terviseportaal.ee. All referrals issued to your children and representatives are also available there.
Read more about specialised medical care from the website of the Health Insurance Fund.
Dental care
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Dental care is free of charge for insured people under 19 years of age. Free dental care is only available in dental care institutions that have concluded a contract with the Health Insurance Fund. You can read more about dental care and orthodontics for children on the website of the Health Insurance Fund.
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All adults with health insurance can use a dental care benefit of 60 euros per year. The patient pays at least 50% of the cost of the services.
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A dental allowance of up to 105 euros per year is available to pregnant people and mothers of children under one year of age, old-age pensioners, people receiving a pension for incapacity for work, people with partial or no work ability, people over 63 years of age, patients with increased dental care needs, unemployed people registered with the Unemployment Insurance Fund, and recipients of the subsistence benefit who have received the subsistence benefit during the two calendar months preceding the month in which they receive dental care. The patient pays at least 12.5% of the cost of the services.
The benefit can only be used in dental care institutions that have concluded a contract with the Health Insurance Fund. The benefit applies to essential dental care services. For all services not included in the list of reimbursable services, the full price must be paid.
The amount of the benefit will be deducted from the medical invoice as soon as it is paid, and you do not need to submit any applications or documents afterwards.
Free adult dental care and orthodontic treatment
On the basis of specific criteria, the Health Insurance Fund guarantees free orthodontic treatment or free dental care for adults only at dental care institutions that have concluded a contract with the Health Insurance Fund.
Emergency dental care
Both insured and uninsured adults have the right to receive emergency dental care free of charge at dental care institutions who have concluded a contract with the Health Insurance Fund. It is provided when delaying or not providing treatment could result in death or permanent damage to the health of the person in need. It is up to the dentist to decide whether the condition is an emergency.
Benefit for dentures
Once every three years, the Health Insurance Fund will reimburse 260 euros of the amount payable for dentures to people receiving the pension for incapacity for work or the old-age pension, people with health insurance who are over 63 years of age, and people with partial or no work ability.
The denture benefit can only be used in dental care institutions that have concluded a contract with the Health Insurance Fund. The amount of the discount will be deducted from the treatment invoice at the moment of payment at the dentist. You do not have to fill in or submit any applications or other documents for the Health Insurance Fund.
You can check the amount of the benefit and the balance on the state portal www.eesti.ee under ‘Dental care benefit and denture benefit information’.
You can read more about the dental care benefit and the denture benefit on the website of the Health Insurance Fund.
For more information, call the Health Insurance Fund at (+372) 669 6630 or send an email to [email protected].
References
- European health insurance card
- Estonian Patient Advocacy Association (EPAA)
- Healthcare in EU (Portal Your Europe)
Services
- Health Portal
- My dental care benefit and denture benefit information
- My personal data in the Health Insurance Fund
- My prescriptions
- Ordering the European Health Insurance Card or its replacement certificate