Benefit and fee rates

Visit and in-patient fees

Visit or in-patient feeFees
Visit to a family doctorFree
Home visit by a family doctorUp 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 care11,05 euro per day

Benefit rates

Dental care benefitBenefits
Person aged 19-6440 euro per year

Recipient of pension for old age or incapacity

for work or persons aged at least 63 

85 euro per year
Pregnant woman85 euro per year 
Mother of a child under 1 year of age85 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 63260 euros per three years  


Supplementary benefit for medicinal products

Individual expenditur on medicina product  wit a discount per calendar yearThe Health Insuranc Fund compensates 
Less than 100 euroAdditional benefit  for medicinal products will not be paid
100 – 300 euro50% from the part exceeding 100 euro
More than 300 euro90% 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 premiumThe premium
1 month170,30  euro
1 quarter year510,90 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 servicesCost-sharing 
Induced abortion at the request of the woman (with anaesthesia), 30%59,60 euro 
Drug-induced abortion, 50%17,67 euro
In-patient fee of nursing care, 15%21,79 euro
Enteral nutrition formula 1000 kcal, 50%1,83 euro
Oral nutritional supplement 600 kcal, 25% (cost-sharing does not apply in case of inherited metabolic disorder)1,64 euro
Oral nutritionally complete modular nutritional supplement 600 kcal, 25% (cost-sharing does not apply in case of inherited metabolic disorder)9,89 euro
Oral modular nutritional supplement for food fortification 600 kcal, 25% (cost-sharing does not apply in case of inherited metabolic disorder)2,07 euro

Cost-sharing in prescriptions with a discount

Discount % for medicinal productsCost-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.

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