Medical care outside of Europe
If you are traveling outside Europe and unexpectedly need medical care, it is important to know that the Health Insurance Fund does not reimburse the costs of necessary medical care outside the member states of the European Union (EU), the European Economic Area (EEA) countries (Norway, Iceland, Liechtenstein), and Switzerland.
To ensure you are not left without medical care in the event of an unexpected health emergency, the Health Insurance Fund recommends purchasing travel insurance before traveling, which, in addition to covering medical, hospital, and emergency care costs, would also cover transportation costs for repatriating the patient to their home country if necessary.
- The Estonian Health Insurance Fund recommends reviewing the Ministry of Foreign Affairs' recommendations before traveling abroad.
Planned treatment outside of Europe
In certain cases, the Health Insurance Fund will reimburse the costs of planned medical treatment if a person seeks treatment in a country that is not a member of the EU or the EEA, or Switzerland. To do so, the insured person must apply to the Health Insurance Fund for prior authorization to cover the necessary medical expenses.
Whether a specific patient’s case meets the aforementioned criteria is assessed by at least three specialists, one of whom is the patient’s treating physician (a specialist, not a family doctor). The Health Insurance Fund initiates the decision-making process upon receipt of the application and the consultation report. In the event of a positive decision, the Health Insurance Fund issues a document confirming its assumption of payment (a guarantee letter or Form S2) and reimburses the medical expenses incurred abroad. The issued guarantee letter or Form S2 does not cover potential non-medical expenses (patient copayments, transportation costs, translation costs, administrative or office costs, non-hospital accommodation, insurance, etc.). These costs must be paid to the foreign healthcare facility by the patient or their legal representative. The criteria for reimbursement are set forth in the Health Insurance Act (§ 271, subsection 1).
