There is at least one institution in every EU country that helps people find information on how to obtain medical care abroad. This kind of institution is called national contact point. In Estonia, Estonian Health Insurance Fund performs the functions of a national contact point.
Here, you can see the details of the European Health Insurance Card issued to you and order a replacement certificate.
If you have any questions about health care and health insurance, please contact the Customer Service of the Health Insurance Fund. You will receive an answer within an average of 5 working days, but no later than within 30 calendar days.
Health Insurance Fund can disclose information containing your personal data only when we have verified your identity as a person requesting information or clarification. To verify your identity at information request you can choose between the following options:
- send an e-mail with a digitally signed application to [email protected] (the working languages are Estonian and English)
- send a hand-signed application to by mail: Liivalaia 36, 10132 Tallinn
- visit a Customer Service Office of the Health Insurance Fund and present your personal identification document (the working languages are Estonian, English and Russian)
- call to the Health Insurance Fund infoline +372 669 6630 and identify yourself either with your mobile-ID or with smart-ID (the working languages are Estonian, English and Russian)
European Health Insurance Card
Persons who are insured and temporarily staying in another EU member state have access to the same level of necessary medical care as the insured persons living in that country. However, the need for medical care must have arisen during their stay in that country.
To receive medical care, you need to have your European Health Insurance Card or a replacement certificate with you and present them together with an identity document to a medical institution.
The European Health Insurance Card or its replacement certificate can be ordered through the state portal service Ordering the European Health Insurance Card or its replacement certificate.
European Health Insurance Card gives you the right to receive health services provided by the medical institutions belonging to the national health insurance system.
Required medical care is not free – the patient's deductible expenses (such as visit fee, in-patient fee, etc.) must be paid for according to the tariffs in the country of location. Deductible expenses shall not be compensated for the patient. Also, the card does not cover the transport costs between countries.
In case you have forgotten your European Health Insurance Card at home, but you need medical help and you are insured in Estonia, you need to pay for the bills yourself first and when arriving back to Estonia, you have the right to submit an application for reimbursement of costs to the Health Insurance Fund. Definitely keep all of the original invoices and documents proving payment.
European Health Insurance Card gives you access to required medical care in the following countries: Austria, Belgium, Bulgaria, Croatia, Czech Republic, Cyprus, Denmark, Finland, France, Germany, Greece, Hungary, Spain, Holland, Iceland, Ireland, Italy, Latvia, Liechtenstein, Lithuania, Luxembourg, Malta, Norway, Poland, Portugal, Romania, Slovakia, Slovenia, Sweden, Switzerland.
Estonian insured persons has the right to receive the necessary medical care with the European Health Insurance Card in the UK and the UK insured person has the right to receive the necessary medical care in the EU member states, including Estonia.
You can also turn to the medical institutions of these countries to receive planned treatment and apply for reimbursement of costs from the Health Insurance Fund later. The application and documents must sent by mail to Liivalaia 36, 10132 Tallinn, Estonia or by email to [email protected].
Planned treatment abroad with prior authorisation
You will need to apply for a prior authorisation of the Health Insurance Fund for the financing of health care provided abroad before the provision of the health care service. There are two legal bases for issuing a prior authorisation (you can only choose one at a time):
1. Subsection 271 (1) of the Health Insurance Act
This option is intended for insured persons for whom neither a medically indicated health service nor an alternative health service is available in Estonia. In addition, according to the criteria of the Health Insurance Act, the health service provided abroad must have proven medical efficacy and the probability of achieving the aim of the service must be at least 50%.
2. Article 20 of Regulation (EU) No. 883/2004 of the European Parliament and of the Council
This option is for insured persons for whom a health service provided in Estonia has been medically indicated but it cannot be provided within the medically justified time limit.
Please indicate in your application only one of the grounds corresponding to the reason for the application.
In order to apply for a prior authorisation, please submit the following documents to the Health Insurance Fund:
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Application for prior authorisation for planned treatment abroad;
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Council summary – for the council summary, you should consult your attending physician (specialist doctor, not your family physician).
Documents can be submitted:
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in the customer service offices of the Health Insurance Fund
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via email at [email protected]. Please note! As the documents contain sensitive personal data, they must be encrypted using the DigiDoc4 software. Select ‘Health insurance encryption certificate’ as the addressee and encrypt the document.
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by post – send the hand-signed application by post to Liivalaia 36, Tallinn 10132.
You can read more about planned treatment abroad on the website of the Health Insurance Fund.
Compensation for expenses
Persons who are insured by the Estonian Health Insurance Fund can travel to another Member State of the EU to receive treatment there and apply for financial compensation from the Health Insurance Fund later. This means that the person needs to pay the costs themselves first and apply for financial compensation from the Health Insurance Fund after the service is provided and the necessary documentation is presented.
The Health Insurance Fund pays the compensation according to the price list of health services of the Health Insurance Fund, rather than the foreign price list. The Health Insurance Fund compensates patients according to its price list for:
- a health service or treatment which could also have been provided for them in Estonia at the expense of the Health Insurance Fund;
- medicinal products and medical devices that have been included in the list of discounted medicinal products or compensable medical devices and on which you are entitled to get a discount in Estonia as well.
To receive the benefit, submit an application to the Health Insurance Fund. You have to submit the application and documents to the Health Insurance Fund by mail to Liivalaia 36, 10132 Tallinn, Estonia or by email to [email protected].
NB! If you are going to travel outside the European Union, we recommend you to get travel insurance, as it covers the costs of transnational transport, the amount of cost-sharing, etc. Be sure to also be acquainted with the terms and conditions of the insurance, especially if you are pregnant or have a chronic condition.
Read more about medical care abroad from the website of the Health Insurance Fund.
Medical care when living in another EU country
Posted employees whose social tax is paid to Estonia and the receivers of Estonian pension who go to live in another country of the EU will start to get medical care on the same terms as the insured persons living in that country. The Estonian Health Insurance Fund will cover the costs of their treatments.
To receive medical care in their county of residence, a posted employee or pensioner must acquire a certificate from the Estonian Health Insurance Fund and register themselves with it at the institution providing health insurance benefits in their country of residence. Posted employees must also have a posting certificate (A1/E101 certificate) issued by the Social Insurance Board.
Persons working in several Member States at once need to make sure that their social tax is paid to one Member State only, as a person can only have one country of affiliation. You can determine your country of affiliation at the Social Insurance Board.
More information about medical care in different EU countries:
- Information about medical care in the EU on the website of the European Commission
- Information about medical care on the Your Europe web portal.
Read more about health insurance in the European Union from the website of the Health Insurance Fund.
If you have any questions, call the to Estonian Health Insurance Fund at (+372) 669 6630 or write an e-mail to [email protected].
Forms
Related articles
References
- Healthcare in the EU and elsewhere
- Reimbursement of health care costs in EU
- European health insurance card
- Health insurance when living abroad (Portal Your Europe)
Services
- My personal data in the Health Insurance Fund
- Ordering the European Health Insurance Card or its replacement certificate