Estonia

Healthcare system

Estonia’s health care system is built on the principle of compulsory solidarity-based insurance and the general availability of services provided by the private providers. The management and supervision of health care system and development of health policy is under the scope of the Ministry of Social Affairs and its agencies. Medical care is divided into three levels: Primary or family medical care, specialized medical care and nursing care. Emergency care is provided on outpatient basis (by the emergency medical care) and in specialized care by departments of emergency medicine.

All health care providers are independent entities operating under private law. The Estonian Health Insurance Fund acts as a single purchaser, compensating all contracted providers according to a payment system.  Family physicians operate as private entrepreneurs or salaried employees of private companies owned by family doctors or local municipalities. Most hospitals are either limited liability companies owned by local governments or foundations established by the state, municipalities or other public agencies. The remaining few are privately owned.

Accessing care

You can obtain medically necessary treatment by presenting the European Health Insurance Card (EHIC), when you are temporarily staying in Estonia. Medically necessary treatment refers to treatment that cannot wait for your return home. You may need such treatment in case of acute illness or accident. You can also receive treatment related to pregnancy and childbirth or to a chronic illness. The need for treatment must emerge during the course of your stay. If your illness requires regular treatment while you are temporarily staying abroad, agree with the treatment provider beforehand on the arrangement of treatment. Treatments that need to be arranged in advance include, for example, dialysis, oxygen therapy, specialised care of asthma and chemotherapy as well as echocardiography in chronic autoimmune diseases.

With European Health Insurance Card you will receive medically necessary treatment on the same terms and at the same price as the locals. It is advisable to carry copies of your European Health Insurance Card with you, along with the card itself. If you didn’t have your EHIC with you or it was not accepted, and you were required to pay all the costs of treatment yourself, you might be able to apply for reimbursement from Kela retrospectively.

In case of sudden illness in Estonia, turn to a health care provider who has an agreement with Eesti Haigekassa (Estonian Health Insurance Fund- EHIF). You can search for these health care providers on this website (in Estonian). When you show your valid European Health Insurance Card, EHIF will pay the costs of necessary medical care directly to the place of treatment. The patient is required to pay deductible (for visit, bed-day, co-payment of pharmaceuticals, translation costs etc.) according to local rates.

In addition to national and municipal services, EHIF also covers the costs of necessary medical care in private hospitals, which have an agreement with EHIF for those medical services.

Estonia also has private doctors, clinics and hospitals that do not have agreements with EHIF. If you seek treatment at such a place, you will be required to pay full price and you will not receive reimbursement in Estonia.

The 1182 web service has a dentist search, doctor service search, personal doctor search, and a private clinic search in English as well as several other searches that you can use to find a healthcare service provider in Estonia. The website of the Eesti Haigekassa also has a search engine for healthcare providers (in Estonian).

Sudden illness

Doctor

In need of a doctor, you should contact a doctor (perearst) who has an agreement with EHIF. Visiting a general practitioner is free of charge in this case if the doctor considers care to be medically necessary and you have a valid EHIC card. You will be asked to fill out a questionnaire, which will form the basis for the assessment.

Seeing a specialist requires a referral from a general practitioner (with the exception of gynaecologists, ophthalmologists, dermatologists, venereologists, psychiatrists and trauma surgeons whom you can see without a referral). When you show your valid European Health Insurance Card and identity card, you will only need to pay a patient fee in this case if the doctor considers care to be medically necessary. A patient’s fee for specialised medical care should not be asked in case the patient is referred to another specialist  within the same hospital, from pregnant women, from children under the age of 2 or in case of urgent medical care followed by an in-patient treatment.

If you do not have the European Health Insurance Card with you, ask your doctor to provide a receipt and a breakdown of treatment together with the invoice (in Estonia, treatment procedures are often marked on the invoice). You can use these documents to apply for reimbursement after returning to Finland.

Dentist

The Health Insurance Fund pays benefits for dental care and dentures. The dentist must have a contract with the Estonian Health Insurance Fund. Free dental care is available for children and young people under the age of 19, and for people in need for emergency care when postponing or not providing aid could cause death or permanent injury to the patient.

Medication

Show your European Health Insurance Card and identity card when collecting your medicines prescribed by a contract doctor. Specific medicines approved by EHIF will be reimbursed. The level of reimbursement mainly depends on the severity of the illness.

You can buy medicines in Estonia also with an electronic prescription that your doctor wrote in Finland. Before purchasing medication, you must give your consent in the My Kanta service to your prescription data being handed over to a pharmacy in another country. You can purchase the medication by showing your passport or official identity card in the pharmacy. Note, however, that not all medicines can be purchased with an electronic prescription abroad. Check the restrictions on the  Kanta.fi website. You can claim reimbursement from Kela afterwards.

Hospital treatment

A doctor’s referral is usually required for hospital treatment. In urgent cases, you can go straight to the Emergency Medical Center. Show your valid European Health Insurance Card and identity card at the hospital. Ambulance transport is free. Only domestic emergency air ambulance transport is free of charge.

Read more about suddenly falling ill in Europe.

Read more about reimbursement of costs of treatment abroad.

Useful websites

If you wish to travel to Estonia for the purpose of using healthcare services, you can find general information on our site concerning seeking treatment abroad. Some useful sources of information are also listed below. You should direct your questions about healthcare in Estonia to the Estonian contact point.

Eesti Haigekassa has more information about dental benefits and services on their website (in Estonian).

Quality and safety of treatment

The Government of Estonia has set the quality requirements for healthcare services and established a supervision system in order to inspect the operation of healthcare service providers. The most important rules related to patient safety are based on the Health Services Organisation Act and the Law of Obligations Act. Malpractices are not systematically registered in Estonia, but the country’s health insurance institute regularly performs clinical audits at the healthcare service providers. In case of malpractice, the party providing the treatment is liable to compensate the patient for the mental and physical damage caused by the provided service.

The treatment provided in Estonia is supervised by the EHIF, the Health Board of Estonia and an expert committee on quality of health services. More information concerning the quality and supervision of treatment provided in Estonia can be found on the website of the National Contact Point of Estonia.

In the event of treatment injuries, the legislation and patient insurance of the country providing the treatment is always applied. In case you are unhappy with the treatment you received, you should primarily try to sort the matter out with the treatment provider. The national contact point can help you with finding the right authority if you wish to make a complaint.