Worker with permanent residence in another EU Member State

Cross-border worker

A cross-border worker is a person who is employed or self-employed in a Member State of the European Union, a Member State of the European Economic Area or Switzerland and resides in another of the above countries to which he or she returns regularly every day or at least once a week.

In order for a cross-border worker to receive an S1 certificate from Estonia, he/she must submit an application to the Estonian Health Insurance Fund. When processing the application, the Estonian Health Insurance Fund may request a copy of a person's employment contract, copies of tickets, etc. in order to find out the details that may prove his or her weekly border crossing.

For example, if a person works in Estonia, but travels to Finland with his or her family at least once a week, Estonia will remain his or her country of affiliation because his or her employer is in Estonia and the social tax paid on his or her salary is paid to Estonia.

An S1 certificate issued by the Estonian Health Insurance Fund entitles a person to register with the health insurance system of the country of residence. This means that a cross-border worker is entitled t to receive medical care under the same conditions as the insured there according to the legislation of the country of residence, but Estonia will later reimburse his her medical expenses to his/her country of residence (the scope of medical care is wider than that provided under the European Health Insurance Card).

Holders of S1 certificate may apply to the Estonian Health Insurance Fund for a European Health Insurance card. The card entitles a person to receive necessary medical care in a country where he or she is not registered with an S1 certificate, but where, for example, he or she is on holiday or on a short-term posting.

Family members

If dependent family members live with the cross-border worker and do not have health insurance in the country of residence, they are entitled to an S1 certificate. A separate S1 certificate is issued to each member of the family and the competent authority of the country of residence will register it or not. The laws of the country of residence determine who is considered a family member. Once the certificate has been registered, family members residing in another member state are also entitled to medical care on the same terms as insured persons there.

Who pays incapacity benefits to a cross-border worker?

A cross-border worker who works in Estonia but lives in another member state is a member of the Estonian social security system and his country of affiliation is Estonia. Consequently, sickness and maternity benefits are paid to a cross-border worker by the Estonian Health Insurance Fund in accordance with the Health Insurance Act.

A parent on parental leave living in another European country

A person who has an employment contract with an Estonian employer, but who is on parental leave with a child under the age of three and who has settled permanently in another EU Member State, European Economic Area member state or Switzerland for family reasons, can apply for an S1 certificate from the Estonian Health Insurance Fund. For this, a person has to send an application to the Estonian Health Insurance Fund.

Example: Anna has an employment contract with an Estonian employer. After maternity leave, Anna goes on parental leave and moves permanently to live with her child's father, who works in France. In order to receive an S1 certificate from the Estonian Health Insurance Fund, Anna's permanent residence must be in another EU member state on the basis of the Estonian population register and her health insurance suspended by her employer.

An S1 certificate issued by the Estonian Health Insurance Fund entitles Anna to register with the health insurance system of the country of residence or in this case French health insurance system. This means that she is entitled t to receive medical care under the same conditions as insured people of her country of residence according to the legislation of the country of residence, but Estonia will later reimburse her medical expenses to her country of residence (the scope of medical care is wider than that provided under the European Health Insurance Card).

Holders of S1 certificate may apply to the Estonian Health Insurance Fund for a European Health Insurance card. The card entitles a person to receive necessary medical care in a country where he or she is not registered with an S1 certificate, but where, for example, he or she is on holiday.

Family members

If dependent family members live with an employed person and do not have health insurance in the country of residence, they are entitled to an S1 certificate. A separate S1 certificate is issued to each member of the family and the competent authority of the country of residence will register it or not. The laws of the country of residence determine who is considered a family member.  Once the certificate has been registered, family members residing in another member state are also entitled to medical care on the same terms as insured persons there.