Visit and in-patient fees

Visit or in-patient fee

Fee in 2015

Visit to a family doctor

Free

Home visit by a family doctor

Up to 5 euro *
* No visit fee may be charged from pregnant women whose pregnancy has been determined by a doctor and from insured persons under two years of age. The visit fee per home visit can be a maximum of 5 euro regardless of the number of insured persons attended to during the home visit.

Visit to a specialised doctor (incl. dentist)

Up to 5 euro

In-patient fee in hospital

Up to 2.5 euro per day

A maximum of 25 euro per period in hospital

In-patient fee in the case of nursing care

9.20 euro per day

Benefit rates

Dental care benefit

Benefit in 2015

Person aged 19-62

No right to any benefit, but emergency care is free of charge

Recipient of pension for old age or incapacity

for work or persons aged at least 63 

19.18 euro per year

Pregnant woman

28.77 per year 

Mother of a child under 1 year of age

28.77 per year 

Person with an increased need for dental care services as a result of health services

provided to them

28.77 per year  

Dentures benefit

 

Recipient of pension for old age or incapacity for work or persons aged at least 63

255.65 euros per three years  

Supplementary benefit for medicinal products before 01.01.2015

Individual expenditure on medicinal products with a discount per calendar year

The Health Insurance Fund compensates

Less than 384 euro

No supplementary benefit for medicinal products.

384–640 euro

50% of the share exceeding 384 euro, i.e. 128 euro.

640–1300 euros

For amounts ranging from 384–640 euro, 50%, i.e. 128 euro, and, in addition, 75% of the share exceeding 649 euro, i.e. up to 495 euro.

More than 1300 euros

No supplementary benefit is paid for amounts exceeding 1300 euro. In such cases, the rate of the supplementary benefit for medicinal products is 623 euro.

Supplementary benefit for medicinal products after 01.01.2015:

Individual expenditur on medicina product  wit a discount per calendar year The Health Insuranc Fund compensates 
Less than 300 euro

Additional benefit  for medicinal products will not be paid

300 – 500 euro 50% from the part exceeding 300 euro
More than 500 euro 90% from the part exceeding 500 euro, there is no rates per calendar year anymore.
 

Voluntary insurance premium

The insurance premium is calculated on the basis of Estonia’s average monthly gross salary, published by the Statistical Office of the Republic of Estonia, multiplied by 0.13. The amount of the insurance premium is adjusted annually, once the Statistical Office of the Republic Estonia has published Estonia’s average gross salary per calendar month.

 

Insurance premium

The premium in 2015

1 month

130,7 euro

1 quarter year

392,1 euro

1 year

1568,4 euro

Insurance of medical records

Extract from a medical record

Fee in 2014

Up to 0,2 euro per page, starting from page 21.


Cost-sharing in health services

In accordance with the additional conditions set forth in the list of health services

Health services

Cost-sharing in 2015

Function-supporting in-patient medical rehabilitation, 20%.

11,40 euro per 24 hours

In vitro fertilisation (IVF), 30%

179,99 euro (paid by ministry of social affairs)

Induced abortion at the request of the woman (with anaesthesia), 30%

50,97 euro 

Drug-induced abortion, 50%

37,27 euro

In-patient fee of nursing care, 15%

9,20 euro


 In vitro fertilisation

Expenses on medicinal products

Benefit in 2015

The person has incurred expenses of up to 639.12 euro

The whole amount incurred

The person has incurred expenses of more than 639.12 euro

639.12 euro


Cost-sharing in prescriptions with a discount

Discount % for medicinal products

Cost-sharing in 2015

Prescription with a discount rate of 50%

3.19 euro

Prescription with a discount rate of 75% (90%)

1.27 euro

Prescription with a discount rate of 100%

1.27 euro


For prescriptions with 50% reimbursement rate, the maximum reimbursement amount by the EHIF is 12.79 euros.

In case the price agreement/reference price of a prescription drug is lower than the retail price, the patient pays the amount exceeding the price agreement/reference price.