Medical care and treatment abroad
Persons who are insured by the Health Insurance Fund 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.
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 need medical help and 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, the UK.
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. NB! The application and original documents must be submitted to a customer service office of the Health Insurance Fund or sent by mail to Lastekodu 48, Tallinn 10144, Estonia.
You need to apply for prior authorisation to receive reimbursement for planned treatment abroad from the Health Insurance Fund in the following two cases:
- If you wish to travel abroad to receive a health service which cannot be provided in Estonia, but has been medically prescribed for you and is proven to be effective. In this case, you need to present an application for prior authorisation for provision of planned treatment abroad (available also in customer service offices)to the Health Insurance Fund prior to traveling abroad. The Estonian Health Insurance Fund will make a decision whether or not to finance the treatment on the basis of a decision made by a medical board. The patient is responsible for covering their own contribution as well as travel expenses, administration and office costs, and accommodation outside the hospital.
- If you wish to receive reimbursement for the costs of a planned health service provided in a Member State of the EU. The authorisation is granted if the necessary treatment is considered one of the benefits provided for in the legislation of the Member State of residence of the person and this health service cannot be provided for the person within a medically justified term, given the status of health of the person and the possible progress of the disease.
Application may be submitted::
- to a customer service office of the Health Insurance Fund.
- by mail to Eesti Haigekassa, Lastekodu 48, Tallinn 10144, Estonia.
- via e-mail. NB! As the application includes sensitive personal data, you should let the Health Insurance Fund know of your desire to send the data by mail and agree with them on which data should be encrypted by sending an e-mail at email@example.com.
To see a doctor in a foreign country, you need a referral from a medical specialist.
Read more about planned treatment abroad from 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 can also fill in the application in the customer service offices of the Health Insurance Fund. NB! You have to submit the application and original documents to a customer service office of the Health Insurance Board or send them by mail to Lastekodu 48, Tallinn 10144, Estonia.
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.