Please note that EHIF does not reimburse the costs of necessary medical care outside the European Union (EU) member states, European Economic Area (EEA) countries (Norway, Iceland, Liechtenstein) or Switzerland.
So, if you are planning a trip outside Europe, we recommend taking out travel insurance that would cover not only medical, hospital and first aid costs but also transport costs for repatriating the patient, if necessary. This way you won’t be left without medical assistance in case of unexpected health problem.
- We also recommend that you read the recommendations of the Ministry of Foreign Affairs before going abroad.
Planned treatment outside Europe
In certain cases, EHIF reimburses the costs of planned treatment performed in a foreign country that is not a EU member stare or a EEA country or Switzerland. In such case the insured person must apply for prior authorization from the EHIF to cover the necessary medical expenses.
The expenses of planned treatment outside Europe are reimbursed by EHIF only if the requested health care service (consultation, treatment, study) is not available in Estonia, there are no alternative health care services and the requested service is indicated for the patient. Also, the health care service provided abroad must have proven medical efficacy and the probability of achieving the aim of the service must be at least 50 per cent.
Whether a particular patient's treatment case meets the above criteria is assessed by at least two medical specialists, one of whom is the patient's attending physician (medical specialist, not the family physician). In the event of a positive decision by medical council, EHIF issues a document confirming that EHIF will assume the responsibility for payments (letter of guarantee), and will pay the medical expenses incurred abroad. The patient will bear the visit and deductible fees and travel expenses.
- The terms of reimbursement are set out in the Health Insurance Act (§ 271, subsection 1). You can read more about applying for prior authorization for planned treatment here.