Benefit and fee rates

Visit and in-patient fees

Visit or in-patient fee

Fees

Visit to a family doctor

Free

Home visit by a family doctor

Up to 5 euro *
* No visit fee may be charged from pregnant women whose pregnancy has been determined by a doctor and from insured persons under two years of age. The visit fee per home visit can be a maximum of 5 euro regardless of the number of insured persons attended to during the home visit.

Visit to a specialised doctor (incl. dentist)

Up to 5 euro

In-patient fee in hospital

Up to 2.5 euro per day

A maximum of 25 euro per period in hospital

In-patient fee in the case of nursing care

11,05 euro per day

Benefit rates

Dental care benefit

Benefits

Person aged 19-64

40 euro per year

Recipient of pension for old age or incapacity

for work or persons aged at least 63 

85 euro per year

Pregnant woman

85 euro per year 

Mother of a child under 1 year of age

85 euro per year 

Person with an increased need for dental care services as a result of health services

provided to them

85 euro per year  

Dentures benefit

 

Recipient of pension for old age or incapacity for work or persons aged at least 63

260 euros per three years  


Supplementary benefit for medicinal products after 01.01.2018:

Individual expenditur on medicina product  wit a discount per calendar year

The Health Insuranc Fund compensates 

Less than 100 euro

Additional benefit  for medicinal products will not be paid

100 – 300 euro

50% from the part exceeding 100 euro

More than 300 euro

90% from the part exceeding 300 euro, there is no rates per calendar year anymore.

 

Voluntary insurance premium

The insurance premium is calculated on the basis of Estonia’s average monthly gross salary, published by the Statistical Office of the Republic of Estonia, multiplied by 0.13. The amount of the insurance premium is adjusted annually, once the Statistical Office of the Republic Estonia has published Estonia’s average gross salary per calendar month.

 

Insurance premium

The premium

1 month

170,30  euro

1 quarter year

510,90 euro

1 year

 2043,60 euro

 

Cost-sharing in health services

In accordance with the additional conditions set forth in the list of health services

Health services

Cost-sharing on 2019

Function-supporting in-patient medical rehabilitation, 20%.

14,15 euro per 24 hours

Induced abortion at the request of the woman (with anaesthesia), 30%

41,75 euro 

Drug-induced abortion, 50%

17,67 euro

In-patient fee of nursing care, 15%

11,86 euro

Cost-sharing in prescriptions with a discount

Discount % for medicinal products

Cost-sharing

Prescription with a discount rate of 50%

2,50 euro

Prescription with a discount rate of 75% (90%)

2,50 euro

Prescription with a discount rate of 100%

2,50  euro


In case the price agreement/reference price of a prescription drug is lower than the retail price, the patient pays the amount exceeding the price agreement/reference price.