Benefits provided by the Health Insurance Fund

Benefits for temporary incapacity for work is paid based on a certificate of incapacity to work to an employed insured person who, due to a temporary leave from work, loses the income subject to social security tax.

The calculation of incapacity for work benefit does not take account of doctoral student benefits, parental benefit and other benefits paid by the rural municipality, city or creative association and the social security tax paid from them. 

The subcategories of temporary incapacity for work benefit are as follows

  • Sickness benefit is paid on the basis of a certificate of incapacity for work to an insured person who is on a temporary leave from work. More information on different sickness benefits can be found here.
  • Carer’s allowances are paid to an insured person who is nursing a sick child or a family member. More information on benefits can be found here.
  • From 01.04.2022, the maternity allowance changed to the mother's parental allowance. The compensation is paid by the Social Insurance Board.

In addition to temporary incapacity for work benefits, there are many other non-monetary benefits available.

  • Dental care benefit  is granted to adults with health insurance, persons with partial or no work ability, persons with health insurance over 63 years of age, pregnant persons, mothers of children under 1 year of age, persons with increased dental care needs, persons who have registered as unemployed with the Unemployment Insurance Fund, and persons who have received the subsistence benefit within the past two months preceding the month in which they receive dental care. More information on benefits can be found here
  • Denture benefit is granted to persons with health insurance over 63 years of age, persons with partial or no work ability, and persons receiving the old-age pension or the pension for incapacity for work. More information on the terms of compensation.

  • Additional benefit for pharmaceuticals is granted to insured persons who pay for reimbursable prescriptions at least €100 per calendar year. Additional benefit for pharmaceuticals applies to the costs of reimbursable pharmaceuticals. Additional benefit for pharmaceuticals is granted if the conditions for receiving the benefit are met.
  • Reimbursement of pharmaceuticals The EHIF reimburses to a certain extent for prescription medicines, the effectiveness of which has been previously thoroughly assessed and therefore have been included in the list of reimbursed pharmaceuticals. More information on the reimbursement of pharmaceuticals is available here.
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