Working adults

An employee working under an employment contract, recipient of employment or the service fees on the basis of a contract under the law of obligations, a member of the directing body and the controlling body of a legal person, a self-employed person and their spouses participating in their business activities, and business income tax payers are entitled to health insurance cover.

The following persons are entitled to health insurance cover: 

  • persons who work on the basis of an employment contract concluded for a term exceeding one month
  • persons receiving remuneration or service fees on the basis of a contract under the law of obligations, who are not entered in the commercial register as self-employed persons and for whom the other party to the contract pays social tax in the monthly total amount at least to the extent of the minimum social tax obligation. In 2020, the monthly rate is 540 euros and thus, the minimum amount of social tax is 178.20 euros per month.
  • members of the management or controlling bodies of legal persons for whom the legal person or legal persons pay social tax in the monthly total amount either separately or together at least to the extent of the monthly rate of social tax. In 2020, the monthly rate is 540 euros and thus the minimum amount of social tax is 178.20 euros per month
  • a payer of business income tax (a person using a business account) who, under the Simplified Business Income Taxation Act, pays social tax at least to the extent of the minimum social tax obligation per month. In 2020, the monthly rate is 540 euros and thus the minimum amount of social tax is 178.20 euros per month.

All natural and legal persons offering employment must register the employment data of their employees (commencement, suspension and termination of employment) in the employment register of the Tax and Customs Board.

Employees working under an employment contract

Commencement of health insurance cover

Persons who work on the basis of an employment contract concluded for a term exceeding one month or for an unspecified term (including persons legally staying and working in Estonia based on a temporary ground for stay) and for whom the employer pays social tax are entitled to health insurance cover.

The insurance cover will commence upon expiry of a waiting period of fourteen days from the date of commencement of work entered in the employment register. If the date of commencement of work entered in the employment register remains within the term of validity of the valid insurance cover, the insurance cover will continue on the new ground without interruption.

Suspension and termination of health insurance cover

The insurance cover will be suspended two months after the date of commencement of the suspension of work entered in the employment register (for example, an employee enters active service, goes on parental leave, etc.)

The insurance cover won’t be suspended in the case of unpaid leave granted by agreement of the parties, provided that social tax is paid for the person at least to the extent of the monthly rate of social tax. In 2020, the monthly rate is 540 euros and thus the minimum amount of social tax is 178.20 euros per month.

The insurance cover will continue as of the date following the date of termination of the suspension of work entered in the employment register.

Termination of health insurance cover

The insurance cover of persons insured as employees will terminate two months after the date of termination of work entered in the employment register.

Termination of employment must be registered in the employment register within ten days from the date of termination of employment. More information available at the Tax and Customs Board.


Persons receiving remuneration or service fees on the basis of a contract under the law of obligations

Commencement of health insurance cover

The insurance cover will commence on the day following the term for submitting the income and social tax, mandatory funded pension payment and unemployment insurance contribution declaration (TSD), provided that the declaration has payments declared with codes 17, 18, 19, 123 or 125.

In order to qualify for health insurance cover, social tax must be declared either in the TSD of one employer or in the TSDs of several employers in the monthly total amount at least to the extent of the minimum social tax obligation (in 2020, the monthly rate is 540 euros and thus the minimum amount of social tax is 178.20 euros per month).

Suspension and termination of health insurance cover

The insurance cover of an insured person is suspended after a month has passed from the due date where according to the information received from the Tax and Customs Board social tax has not been declared to the extent of the minimum social tax obligation.

The suspended insurance cover resumes on the day following the receipt from the Tax and Customs Board of data certifying the declaration of the minimum social tax obligation.


Members of the management or controlling bodies of legal persons

Commencement of health insurance cover

The insurance cover will commence on the day following the term for submitting the income and social tax, mandatory funded pension payment and unemployment insurance contribution declaration (TSD), provided that the declaration has payments declared with codes 21, 22, 29, 30, 156 or 158.

In order to qualify for health insurance cover, social tax must be declared either in the TSD of one employer or in the TSDs of several employers in the monthly total amount at least to the extent of the minimum social tax obligation (in 2020, the monthly rate is 540 euros and thus the minimum amount of social tax is 178.20 euros per month).

Suspension and termination of health insurance cover

The insurance cover of an insured person is suspended after a month has passed from the due date where according to the information received from the Tax and Customs Board social tax has not been declared to the extent of the minimum social tax obligation. 

The suspended insurance cover resumes on the day following the receipt from the Tax and Customs Board of data certifying the declaration of the minimum social tax obligation.

You can check the validity of health insurance cover in the state portal eesti.ee under the service “Health Insurance and family physician information“, by calling the EHIF’s customer service (+372) 669 6630.

The deadline for submitting a TSD is the 10th of each month. If the 10th day falls on a day off or a public holiday, EHIF will receive the data on the following working day.

If the TSD is submitted before the deadline, the Tax and Customs Board will forward the data to EHIF on the day following the deadline for submission of the TSD (for example, the 10th date).

If the TSD of previous calendar month is corrected, the corrected data will be submitted to EHIF on the next day. Corrections made to declarations from previous periods will not be submitted to EHIF.


Payer of business income tax

People can do business in a simplified way - with a lower tax rate and without bureaucracy. For this purpose, a special bank account or so-called business account will be introduced.  

In order to receive insurance coverage, the person's social tax for the previous month must be payed to the extent of the minimum social tax obligation. The insurance cover commences after the receipt of the social tax on the day following the deadline for submission of the TSD, and is suspended after one month, if the minimum social tax obligation has not been fulfilled by the due date of the next declaration.

The Tax and Customs Board will submit the data on persons for whom the minimum amount of social tax has been received to EHIF on the day following the deadline for submission of the TSD. More information is available at the Tax and Customs Board.


Data provider’s liability

Please submit declarations in a timely manner to avoid interruption of insurance cover.

If a person applying for insurance cover would have had the right to receive health insurance benefits if a person obligated to submit documents necessary for insurance cover to commence had performed such obligation as required, the person who violated the obligation must compensate the person applying for insurance cover for the loss incurred due to the failure to receive the health insurance benefits.

Examples

Example 1: The employment contract is signed on 1 January. The person receives a payment on 31 January, TSD is submitted on 10 February and the health insurance cover will be valid from 11 February to 10 March. Please note! The insurance cover commences every month after the submission of TSD.

Example 2: The employment contract is signed on 1 January. The person receives a payment on 1 February, TSD is submitted on 10 March and the health insurance cover will be valid from 11 March to 10 April. Please note! The insurance cover commences every month after the submission of TSD.

Example 3: The board member contract has been entered into for a term of five years as of 1 January. Every month, social tax is paid on the remuneration of a board at least to the extent of minimum rate. Please note! The health insurance cover of a board member commences every month after the submission of TSD.

Example 4: A person works under an authorisation agreement at several different employers. Social tax is paid on all the agreements in total of at least to the extent of minimum rate. Please note! The health insurance cover commences every month after the submission of TSD.