Worker and family members living in different countries
A person living and working in Estonia has family members who live in another EU Member State
If a person starts living and working in Estonia (his/her social tax is paid in Estonia and he/she receives health insurance as an employee), but his/her dependent family members remain in another EU member state, EEA member state, Switzerland or United Kingdom where they do not have health insurance, the employee can apply for an S1 certificate from the Estonian Health Insurance Fund for his/her family members.
For family members to receive health insurance with an S1 certificate in their country of residence, you must go through the following steps:
- The employee submits an application to the Estonian Health Insurance Fund for an S1 certificate. A separate application for an S1 certificate is submitted for each family member.
- After verifying the insurance and residence details, EHIF forwards the certificates to the employee's family members, who should register the certificates with the health insurance institution of their home country.
- Family members who have received an S1 certificate from the Estonian Health Insurance Fund receive a European Health Insurance Card from the Estonian Health Insurance Fund. You can read more about the benefits available under the European Health Insurance Card and how to order the card on our website.
Pawel, who is from Poland and whose family stayed there, started working in Estonia and he has health insurance here. Her husband, Marta, lives in Poland but does not work there. If Pawel worked in Poland, Marta would be entitled to health insurance there. Consequently, in accordance with Regulation 883/2004 in force in the European Union, Marta is entitled to health insurance in Poland as a dependent spouse of a person working in a EU member state. For this, Pawel must contact the Estonian Health Insurance Fund and apply for an S1 certificate. The S1 certificate will be sent to Marta, who must contact the Polish health insurance institution and register the certificate there. If Marta wants to travel to another EU member state, then in order to prove her right to receive necessary medical care during her stay, Marta must bring a European Health Insurance Card, which she can order from the Estonian Health Insurance Fund.
If a person goes to work in another EU member state, European Economic Area member state, Switzerland or United Kingdom (his/her social tax is paid in another country and he/she receives insurance from another country), but his/her dependent family members stay in Estonia then the family members will be granted health insurance by the Estonian Health Insurance Fund after registering the certificate issued by the new country of employment. For this, the employee must apply to the competent authority of his/her country of employment for an S1 certificate for family members who have remained in Estonia, which must be then sent to the Estonian Health Insurance Fund for registration. After registering the certificate, family members will be granted health insurance. EHIF also sends family members a respective notice.
For the purposes of the Health Insurance Act, the following persons are deemed to be dependent family member:
- persons with up to five years left until attaining the retirement age who are maintained by their spouses or registered partners who are insured persons;
- a dependent spouse or registered partner of an insured person who is raising at least one child under the age of 8 or an 8-year-old child until the end of grade I or at least three children under the age of 16 and whose spouse or registered partner is an insured person of a EU member state, EEA member state or Switzerland.
People insured under a S1 certificate receive a European Health Insurance Card from the institution where the employed person is insured. You can read more about the benefits available under the European Health Insurance Card on our website.
Example
Toomas started working in Finland and has health insurance there. Her wife, Maarika, lives in Estonia. Maarika does not work, but raises their five-year-old child. Thus, in accordance with Regulation 883/2004 in force in the European Union, Marta is entitled to health insurance in Finland as a dependent spouse of a person working in a EU member state. For this, Toomas must contact the Finnish competent authority Kansaneläkelaitos (hereinafter KELA) and apply for an S1 certificate. The S1 certificate must be submitted to the Estonian Health Insurance Fund together with the application available on the EHIF's website.
EHIF registers the certificate and notifies Toomas thereof in writing. If Maarika wants to travel to another EU member state, then in order to prove her right to receive necessary medical care during her stay, Maarika must present a European Health Insurance Card. Maarika can order it from KELA.