Benefit and fee rates
Visit and in-patient fees
| Visit or in-patient fee | Fees |
| 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 | 11,05 euro per day |
Benefit rates
| Dental care benefit | Benefits |
| Person aged 19-64 | 40 euro per year |
Recipient of pension for old age or incapacity for work or persons aged at least 63 | 85 euro per year |
| Pregnant woman | 85 euro per year |
| Mother of a child under 1 year of age | 85 euro per year |
Person with an increased need for dental care services as a result of health services provided to them | 85 euro per year |
| Dentures benefit | |
| Recipient of pension for old age or incapacity for work or persons aged at least 63 | 260 euros per three years |
Supplementary benefit for medicinal products
| Individual expenditur on medicina product wit a discount per calendar year | The Health Insuranc Fund compensates |
| Less than 100 euro | Additional benefit for medicinal products will not be paid |
| 100 – 300 euro | 50% from the part exceeding 100 euro |
| More than 300 euro | 90% from the part exceeding 300 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 |
| 1 month | 170,30 euro |
| 1 quarter year | 510,90 euro |
| 1 year | 2043,60 euro |
Cost-sharing in health services
In accordance with the additional conditions set forth in the list of health services
| Health services | Cost-sharing |
| Induced abortion at the request of the woman (with anaesthesia), 30% | 59,60 euro |
| Drug-induced abortion, 50% | 17,67 euro |
| In-patient fee of nursing care, 15% | 21,79 euro |
| Enteral nutrition formula 1000 kcal, 50% | 1,83 euro |
| Oral nutritional supplement 600 kcal, 25% (cost-sharing does not apply in case of inherited metabolic disorder) | 1,64 euro |
| Oral nutritionally complete modular nutritional supplement 600 kcal, 25% (cost-sharing does not apply in case of inherited metabolic disorder) | 9,89 euro |
| Oral modular nutritional supplement for food fortification 600 kcal, 25% (cost-sharing does not apply in case of inherited metabolic disorder) | 2,07 euro |
Cost-sharing in prescriptions with a discount
| Discount % for medicinal products | Cost-sharing |
| Prescription with a discount rate of 50% | 2,50 euro |
| Prescription with a discount rate of 75% (90%) | 2,50 euro |
| Prescription with a discount rate of 100% | 2,50 euro |
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.