Health insurance in Estonia for expats

The healthcare system in Estonia is mixed, in the sense that it’s largely funded publicly, but it’s operated entirely by private healthcare providers.

The majority of people living and working in Estonia access public healthcare through employer social security contributions, or by paying a voluntary insurance premium themselves, although some pay on a pay-as-you-go basis. This allows most core healthcare services to be made available either free at the point of use or significantly subsided with patients required to cover the shortfall through co-payments.

The Estonian healthcare system is also highly digitised compared to many other countries. Patients can access the ‘Terviseportaal’ digital health information system to check their medical data and prescription information. Over 99% of prescriptions in Estonia are now issued digitally.²

Healthcare in Estonia is of a good standard. According to Numbeo’s Health Care Index, it ranks tenth out of 37 European countries and is the joint-highest country in Eastern Europe alongside the Czech Republic.³

While the quality of facilities is generally high, Estonia has faced some challenges, including shortages of doctors and nurses⁴, which has led  to longer waiting times. Eurostat data has found that Estonians have the largest proportion of people in the EU who aren’t satisfied with how long they’ve had to wait to be seen.⁵

 There have also been difficulties in ensuring that people on lower incomes can consistently access high-quality care. Those who don’t receive health insurance contributions paid by their employers, and who can’t afford the voluntary insurance premiums, often face poorer health outcomes than higher earners.⁴

If you qualify for public healthcare in Estonia through employer social security contributions, then your employer should register you for the system automatically. Once your registration is confirmed, you’ll then be able to register with a local GP surgery in your area.

If you don’t qualify through your employer (for example, you’re a retiree or a cross-border worker), then you’ll need to apply for coverage through an S1 certificate.⁷ This form can be downloaded online, and should be submitted either by post or in person at an Estonian Health Insurance Fund customer service office.

What kind of documentation do I need to access healthcare in Estonia?

For both approaches mentioned above, the key documentation will be your residence permit, or your right of residence in Estonia if you’re from outside the European Union. Presented alongside the usual forms of identification and (if applicable) your European Health Insurance Card (EHIC), the registration process should be relatively straightforward.

As Estonia is a member of the European Union, holders of a EHIC are eligible for a basic level of care thanks to their citizenship and contributions made in their native country. However, this is only suitable for very short stays (such as holidays). Those staying longer should make sure they’reregistered for public healthcare.

The public healthcare system in Estonia is funded by social security contributions from everyone that works in the country. Employers contribute 13% of an employee’s earnings towards their health insurance.⁸ People who aren’t able to make health insurance payments through employer contributions can purchase the insurance premium on a voluntary basis instead, at a rate of 13% of Estonia’s average salary. This payment is currently €170.30 per month (approx £145; $190), and the rate is reviewed annually according to average salary fluctuations.⁹

This makes some elements of care free at the point of use, although for others, only a proportion of the cost is covered and a co-payment is required from the patient from the rest.⁹ These co-payment amounts vary according to the type of care involved, but common costs include:

• Home visits by doctors: up to €5 (approx £4.20; $5.50)
• Appointments with specialists and dentists: up to €20 (approx £16.80; $22.20)
• Hospital stays: up to €5 per day for the first ten days.

All temporary and permanent residents of Estonia (including Digital Nomads) must have some sort of health insurance in place. This can be through the provisions of your EHIC; public health insurance contributions by your employer; voluntary contributions to the public health insurance fund; or taking out private insurance cover.

If you’re staying for a sustained period of time and don’t get employer contributions, then you’ll need to cover the cost of health insurance yourself. If you're planning to stay for a while and don’t have health insurance through your employer, you’ll need to arrange your own cover. Often, going with a private policy can give you much better protection than the public option, without necessarily costing you more.

What are the benefits of private health insurance in Estonia?

Of course, this isn’t the only reason to take out private healthcare in Estonia. It can also be beneficial to those who have public healthcare provision, too. Benefits of the Estonian system include:

• Shorter waiting times: there can be some lengthy waiting times for non-urgent procedures in Estonia when using the public system – having a private alternative can get around these waiting times and get you seen much quicker.
• Co-payment cover: some private policies may be able to take care of the co-payments that are required to access some public healthcare facilities, including dental care.
• Better facilities: while Estonian public health facilities are generally good, going private means you can take advantage of more comfortable surroundings and more dedicated care.
• Multi-lingual staff: official statistics show that 48% of people in Estonia speak English.¹¹ This means that you may well find English-speaking staff in public healthcare facilities, but these chances will generally increase at private clinics.
• Peace of mind: private cover gives you complete confidence that you’ll be in the best of hands, as and when medical issues arise for you and your loved ones.

Would I need dental insurance in Estonia?

There is a limited amount of coverage for dental treatment by the public healthcare system in Estonia. Adults making the Tervisekassa contributions will get 50% of the costs of their dental care covered, up to a maximum allowance of €60 per year (approx. £50; $65).⁷ For pensioners, new mothers and those who are pregnant, this allowance increases to €85 per year (approx. £70; $95).¹² You’ll need to make a co-payment for the other 50%, and then cover any further dental care required in full.

Typical total costs for dental care treatments are as follows:¹²

• Hygienist visit: €25 (approx. £20; $28)
• Teeth cleaning: €65 (approx. £55; $75)
• Root canal surgery: €50 (approx. £40; $55)
• Full ceramic crown: €415 (approx. £350; $465)

As a result, anyone needing regular dental care (beyond regular check-ups) will find themselves needing to cover their own costs. This can get expensive if paying for appointments directly, so having private dental insurance in place to cover these costs can represent a substantial saving.

The standard emergency phone number in Estonia is 112 for all emergency services, and is accessible to everyone, regardless of nationality or health insurance status. There is also a family doctor counselling line available at 1220, which is available in English between 3pm and 5pm everyday.