Specific treatment abroad
In order to get specific treatment in some other Member State, the permit of the Estonian Health Insurance Fund should be priorly applied for. The Health Insurance Fund covers only the medical expenses of the persons having received the permit.
In case the person submits the invoice or application for refund after the treatment without prior agreement, no medical expenses are covered by the Estonian Health Insurance Fund.
Procedure for exceptional referral to the treatment in the foreign country
The Estonian Health Insurance Fund pays for the treatment provided exceptionally in the foreign country in case the treatment has been indicated for the insured and it is not possible to carry out in Estonia. If the alternative treatment exists in Estonia, the Health Insurance Fund has no right to pay for the treatment in the foreign country. In order to exceptionally refer to the treatment to the foreign country the application in free form, which includes the contact address and phone of the patient and the name and contact data of the doctor, should be submitted to the Health Insurance Fund. The abstract of the medical record and the contact data of the doctor or clinic (mail and e-mail address, fax, phone) having consulted the patient in the foreign country could be added to the application.
The application should be sent to the address:
Estonian Health Insurance Fund
Lembitu 10
Tallinn 10114
After the receipt of the application the Health Insurance Fund turns to the doctors of the relevant specialty to specify the validity of need for treatment. The decision on exceptional referral to treatment to the foreign country is made by the Health Insurance Fund based on the decision of the consilium of local specialist doctors. In case of positive decision the Health Insurance Fund issues the letter of guarantee. In case of negative response the written notice is sent to the insured person together with the statement of grounds of denial of referral to treatment.
The application for exceptional referral to treatment to the foreign country should be submitted as early as possible – 30 days before the planned treatment at the latest. Then the Health Insurance Fund could process the documents of the Health Insurance Fund in time.
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