Healthcare in older age

The elderly are entitled to both ambulatory and stationary medical care, including geriatric medical care. In the event of health issues, one should first contact their family doctor, who will decide whether they need to be treated at home or a hospital.

Dental care and dentures benefit

As of 1 July 2017, old-age pensioners, persons receiving pension for incapacity for work, and the elderly over 63 years of age are eligible for up to 85 euros of benefit for dental care per year. The benefit can only be used at the contractual partners of the Health Insurance Fund.

According to the new procedure, it is no longer necessary to personally apply for the benefit for dental care services after receiving treatment. The respective documents do not need to be submitted to the Health Insurance Fund personally. The amount of dental care benefit is calculated electronically between your dentist and the Health Insurance Fund. In the event that a new type of benefit applies to the service provided by your dentist, the reimbursable amount is deducted from the treatment invoice right at the moment of payment.

The patient shall pay 15% of the price of services. The benefit applies only to essential dental care services. The full price has to be paid for services that are not included in the list of reimbursable services. Service providers are additionally entitled to demand a visit fee of up to 5 euros from their patients (except pregnant women).

The dental care benefit can be used in full within a calendar year, any unused share thereof cannot be transferred to the next year. The calculation of the benefit begins anew at the beginning of each year. The maximum amount of benefit that can be received within a calendar year is 85.

In the event that you have received dental care services in 2017 before 1 July and applied for a monetary compensation of up to 19.18 euros, the benefit you have used so far is deducted from 85 euros.

Dentures benefit

The amount of dentures benefit that can be used over three years is 255.65 euros.

There are two ways of applying for the benefit:

  1. submit a dentures benefit application (pdf, 168 KB, in Estonian) and a document certifying payment for the application of your dentures to the Health Insurance Fund. The Health Insurance Fund shall transfer the benefit to the bank account of the respective health-insured person within 90 days from the receipt of the required documentation by the regional department of the Health Insurance Fund;
  2. submit an application directly to the dental technician – in such a case, the health-insured person shall pay the maker of the dentures only the amount which exceeds 255.65 euros.

NB! As of 1 January 2018, one no longer has to submit an application for a denture benefit following the procedure; all calculations are completed between the dentist and the Health Insurance Fund, which means that the benefit will be deducted from the treatment invoice at the moment of payment for the procedure at the dentist.

In the State Portal in the e-service Dental care benefit and dentures benefit information, you are displayed the data related to your adult dental care benefit and dentures benefit limit.

Technical aids

A technical aid is a product or device which allows preventing the aggravation of an occurred or congenital damage or disability, compensating for functional impairment caused by the damage or disability, improving or maintaining physical and social independence, operational capacity and work ability. Technical aids can be bought or leased on the basis of a personal technical aid card.

The basis for applying for a personal technical aid card is a medical certificate or a need for a technical aid identified by a rehabilitation team. In the case of specific technical aids (such as tibial prostheses, wheelchairs, mobility scooters, etc.), the need for a technical aid can only be identified by a medical specialist or rehabilitation team.

The holder of a valid personal technical aid card who has a valid medical certificate or rehabilitation plan, which include the name or description of the technical aid, may turn to whichever company in Estonia that sells or leases technical aids and has a valid contract with the Social Insurance Board to receive the technical aid.

A person applying for a personal technical aid card for the first time, or a duplicate thereof, must turn to the Social Insurance Board.

Application (pdf, 406 kB, in Estonian) may be submitted:

Upon application by e-mail or mail, a copy of a valid doctor’s certificate or the front page of a rehabilitation plan, which include the respective personal data, and a copy of the page which includes the name or description of the technical aid, must be added to the application.

Upon application at a customer service office, an identity document, a doctor’s certificate or rehabilitation plan, which include the name or description of the technical aid, must be presented.

If you have any questions, call the information line of the Social Insurance Board at 16106 or (+372) 612 1360 or write an e-mail to info@sotsiaalkindlustusamet.ee.

Medical devices

Medical devices are medical technical aids (instruments, apparatus, devices, software, etc.) by means of which illnesses or injuries can be treated or which are used to prevent the aggravation of a particular illness.

The need for a medical device is determined by the attending physician. In the event that you have been diagnosed with a disease the treatment of which requires a medical device that is included in the list of medical devices of the Health Insurance Fund, your attending physician will prepare a digital medical device card for you. Once you have your medical device card, you may go straight to a pharmacy or contact the vendor of your medical device and purchase the medical devices you have been prescribed at reduced cost.

The Health Insurance Fund’s list of medical devices the cost of which is reimbursed can be found on the website of the Health Insurance Fund.

The list of vendors of medical devices and orthoses is available on the website of the Health Insurance Fund.

Medical rehabilitation

Medical rehabilitation is generally carried out in a health care institution, where the chances of rehabilitation as well as the methods of attaining it are mapped out as precisely as possible. Medical rehabilitation is also carried out in sanatoriums.

Physicians shall prepare a sanatorium voucher application for those who require treatment for submission to a regional customer service office of the Social Insurance Board. A regional customer service office of the Social Insurance Board shall issue the sanatorium voucher for disabled children, non-working disabled persons, and non-working pensioners.

Medical rehabilitation includes:

  • physical activation and improvement of tonicity;
  • social activation and communication;
  • corrective gymnastic therapy.

Last amended: 18-06-2017 00:00 | Compiled by: Health Insurance Fund