Employee and family members in different countries
Family members of a person living and working in Estonia who live in another EU member state
If a person comes to live and work in Estonia (his/her social tax is received and he/she is provided health insurance by Estonia) but that person’s dependent family members remain living in another EU member state where they have no health insurance, then this worker can apply for a form E109/S1 from the Estonian Health Insurance Fund for the members of his/her family.
In order to grant health insurance to family members in their state of residence on the basis of the form E109/S1, the following steps must be taken:
1. The worker submits an application available on our website to the Estonian Health Insurance Fund, listing the family members who need the form.
2. After checking the existence of health insurance and residence data, the Health Insurance Fund forwards the forms to the family members who should then submit these to the health insurance establishment of their state of residence, where the forms will be registered.
3. The family members who have received the form E109/S1 from the Estonian Health Insurance Fund will also be issued the European Health Insurance Card by the Estonian Health Insurance Fund. More about European Health Insurance Card.
Example: Pawel from Poland started working in Estonia and also has health insurance here, but his family stayed in Poland. His wife Marta lives in Poland, but does not work there. If Pawel worked in Poland, then Marta would be entitled to health insurance there; as a result, Marta has the right to get health insurance on the basis of the European Union regulation No 883/2004 as a dependent spouse of a person working in a European Union member state. For this, Pawel must turn to the Estonian Health Insurance Fund and apply for a form E109/S1. The form E109/S1will be sent to Marta who must submit it to the Polish health insurance establishment, who will then register the form. If Marta wants to travel to another EU member state, she must carry the European health insurance with her in proof of her right to receive necessary health care there; she can order it from the Estonian Health Insurance Fund.
Family members of a person working in another EU member state living in Estonia
If a person goes to work in another EU member state (his/her social insurance contributions will be paid to the other country and he/she will receive health insurance from another EU country) but his/her dependent family members stay in Estonia, then the family members are provided insurance by the Estonian Health Insurance Fund after the registration of a standard certificate issued by the new state of employment. For this, the worker must apply for a form E109 or S1 from a competent authority of the state of employment, which must then be delivered to the Estonian Health Insurance Fund. The family members are provided with insurance cover after the registration of the form. The Estonian Health Insurance Fund also sends a written notification about this to the family members.
According to the Health Insurance Act, the following persons are considered dependent family members:
· Persons with up to five years left until attaining retirement age who are maintained by their spouses who are insured persons;
· Spouse of an insured person caring for at least one child of under the age of 8 or an 8-year-old child until his/her graduation from the first year of school, or at least three children under the age of 16, and whose spouse is insured as a worker in a EU member state.
Persons insured on the basis of the form E109 or S1 shall get a European Health Insurance Card from the establishment where the working person is insured at. You can read more on the benefits received on the basis of the European Health Insurance Card on our website.
Example: Toomas started working in Finland and has health insurance there. His wife, Maarika, lives in Estonia. Maarika is not working, but she is caring for a couple of children under 5 years of age. As a result, she is entitled to get health insurance pursuant to the European Union regulation no 883/2004 as a dependent spouse of a person working in a European Union member state. For this, Toomas must contact the competent authority in Finland KELA, and apply for either a form E109 or S1. The form E109 or S1 must be delivered to the Estonian Health Insurance Fund along with the application available at our website.
The Health Insurance Fund registers the form and sends a written notification about it to the person. If Maarika wishes to travel to another EU member state, then she should carry the European Health Insurance Card with her in proof of her right to receive necessary medical care while being in another member state. She can order the card from KELA.