Compensation

Provided the person had no European health insurance card when getting health care in another Member State, the local health care institution has the right to submit the invoice to the patient which should be paid at the site.

The original invoice and the document certifying the payment should be retained, as on the basis of the latter compensation could be applied for from the Estonian Health Insurance Fund. The Health Insurance Fund processes only previously paid invoices. In arrival to Estonia submit the original checks together with the document certifying the payment and filled application (you find the application form on the website of the Health Insurance Fund) to the local department of Health Insurance Fund (if going there personally) or send by mail to the address:

Estonian Health Insurance Fund
International relations department
Lembitu 10
10114 Tallinn

Attention!

In case of Spain there is an exception. Estonian Health Insurance Fund reimburses the costs that occured in Spain on the basis of § 25.7 of EC regulation 987/2009. According to this, the costs of healthcare provided for Estonian insured persons in Spain will be reimbursed on the basis of the reference prices in the list of health services of the health insurance fund established by a regulation of the Government of the Republic. For comparing the health services provided to you, please fill in the questionnaire for applying for the reimbursement of health care costs in Spain.

The Estonian Health Insurance Fund sends the original invoices and the document proving the payment to the competent institution of the state having provided health care (except Spain). The institution of another state decides on the basis of its legislation, whether and within which scope the expenses are covered (the patients co-payment, private doctor expenses etc. are not subject to refund). Information is forwarded to the Estonian Health Insurance Fund and within 15 days from the receipt of the positive response the Health Insurance Fund makes the payment to the patients bank account in euros.

The above provided scheme should be followed also in case health care was received in the country where the patient should first fully pay the specific sum (e.g. medicines in many countries). When the person has not managed to apply for the compensation from the local health insurance fund of the country, he/she could do it through the Estonian Health Insurance Fund when returning to Estonia. As the inquiry is made to another country, the procedure takes 2-3 months or longer in average.