Medical care

In the health care system, the first contact that a person with a health concern has is with their family physician or family nurse.

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 health insured citizen of Estonia has a family physician. Insured persons can choose their 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 or the Health Insurance Fund. After that, submit an application (pdf, 113 kB, in Estonian) directly to the chosen family physician to be included in their practice list.

If there is no vacancies in the practice list of the family physician, you will receive a response within 7 days. To those who have not chosen their own family physician, one will be appointed by the Health Board on the basis of their place of residence in the population register.

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 Health insurance and family physician
  • by calling the customer service phone number of the Health Insurance Board at (+372) 669 6630.

Information about family physicians::

In case of minor 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.

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.

Read more about specialised medical care from the website of the Health Insurance Fund.

Dental care

  • Dental care is free of charge for persons under the age of 19. Free dental care is provided only by doctors who have concluded the contract for financing medical treatment with the Health Insurance Fund.
  • As of July 1, 2017, the Health Insurance Fund will reimburse dental care to adults with health insurance up to 30 euro per year. The benefit can be used only at the dentists who have concluded the contract for financing medical treatment with the Health Insurance Fund. The benefit applies to essential dental care services.
  • As of July 1, 2017, the dental care benefit is up to 85 euros per year for
    • pregnant women and mothers of children under one year of age
    • old age pensioners
    • persons receiving pension for incapacity for work
    • persons with partial or no work ability
    • persons over 63 years of age
    • persons with increased need for dental care. The benefit can be used only at the dentists who have concluded the contract for financing medical treatment with the Health Insurance Fund. The benefit applies to essential dental care services.

NB! The Health Insurance Fund will pay the adult dental care benefit for the dental care services provided before July 1, 2017, in case the application for the benefit is submitted no later than 1 October 2017.

  • Once every three years, the Health Insurance Fund compensates old-age and disability pensioners, health insured persons over the age of 63 and persons with partial or no ability to work for dentures in the amount of 260 euros. The procedure for payment of denture benefit will not change before 2018. From January 1, 2018, the form of the benefit will change. Then you will no longer have to file an application for a denture benefit, the benefit will be taken into account at the time of payment to the dentist.

Read more about benefits for dental care and dentures from the website of the Health Insurance Fund.

Both health insured and uninsured adults have no right to receive free dental care, only emergency care that is provided for them in situations where the postponement of care or failure to provide care may cause the death or permanent damage to the health of the person requiring care. Whether the services provided can be regarded as emergency care is decided by the dentist.

If you have any questions, call the client line of the Health Insurance Fund at (+372) 669 6630 or write an e-mail to info@haigekassa.ee.

Last amended: 17-07-2017 00:00 | Compiled by: Health Insurance Fund