The cost of healthcare in Estonia depends on the kind of treatment that you need, and also the type of insurance that you have. If you have signed up with the national health insurance system, the Haigekassa (also known as the Estonian Health Insurance Fund/EHIF) [LINK HERE], then you will be covered for a range of care and treatment which will be free at the point of delivery.If you are not insured, either via public or private health insurance, then the cost of health procedures will differ. We will look below at overall costs in the public and the private sector.
State health insurance costs in Estonia
Everyone resident in Estonia can sign up for the Haigekassa/EHIF if they are paying national health contributions: these will normally be deducted from your salary if you are employed. You will then be eligible to access the public healthcare system.
What is covered by the state health insurance system?
You will be covered for:
• GP visits
• hospital treatment
• referrals from your doctor
If you go to another EU country to seek medical treatment, this can also be covered by EHIF in certain cases, but you will need to check with them first to seek pre-approval.
How much does treatment cost in the public system?
Pregnant women, children and pensioners are automatically covered by EHIF, so if you or your dependents fall into one of these categories, your treatment will be free. For everyone else in the system who is making contributions, it will be free at the point of delivery.
If you are not insured under EHIF, your GP will make a small charge for home visits: around €5. There is also a €5 charge when you visit your GP for the first time.
If you are admitted to hospital, there will also be a small charge: around €2.50 per day for up to 10 days. If there is an emergency; if you need to go into intensive care; if you go into labour; or if one of your children has to be hospitalized, there is no fee. Check with the hospital to find out whether there are any ongoing treatment costs once your case is deemed no longer urgent, however.
You may find that you have some additional out-of-pocket payments even if you have national health insurance. These could consist of:
• user charges for EHIF benefits
• direct payments to providers for services that fall outside the EHIF’s benefits package
• direct payments to providers not contracted by the EHIF
• informal payments (for example, to speed up access to medical diagnosis or treatment)
The WHO notes that the average annual amount spent out of pocket per person in Estonia rose from €45 in 2000 to €203 in 2015, increasing in the years of strong economic growth before the economic crisis of 2005–2007 and after the crisis of 2015. Out-of-pocket payments are mainly made by patients in the upper-income bracket.
Some emergency dental care is free, but in general you will need to pay for your dental treatment and the costs won’t be refunded. Basic treatment will cost you upwards of €30, and you will usually have to pay half: the state insurance will cover the rest. Dental care for children and young adults up to the age of 19 is free.
However, this does not apply to all private clinics: it is only applicable to those dental practices that are covered by EHIF. In practice, however, most private dentists have an arrangement with EHIF. Remember to take your EHIC or your insurance policy/ID card with you to all medical visits.
Prescriptions
Prescriptions will involve co-payment, but this is usually minimal: there is a standard fee of €2.50. You may also have to pay a percentage of the costs above the standard fee, or even the full fee, depending on the medication: for example, if the medicine you have been prescribed is not on the national list of medicinal products, you’ll be charged the full cost and it is not refundable. If there’s a preferential rate for the medicine, however, you will only have to pay the preferential price and the pharmacy will receive the remaining amount of the full price from EHIF.
Note that some medicines that are available over the counter in the UK, such as aspirin and various ointments, are only available in pharmacies. You will need to present your ID card to the pharmacist before they will give you your medication.
How much does treatment cost in the private sector?
With more than 20 private hospitals and clinics and a dedicated orthopaedic hospital, Estonia is currently a centre for medical tourism, including bariatric surgery, gynecology, gastric bypass treatment, otolaryngology, dental treatment, urology, general surgery and plastic surgery. In 2016, around 1.2% of visitors to the country had come for the purpose of seeking private medical treatment. Bariatric treatment is particularly popular.
Costs for private treatment are generally less than elsewhere in Europe or the USA, while the quality of treatment and care is of a high standard and uses cutting-edge technology. Companies arranging your visit will also arrange flights and ferries, as well as liaising with your surgeon. Medicine Estonia promotes the country’s medical services to overseas patients.
Some patients prefer either to pay out-of-pocket for procedures, or to claim under private health insurance. A hip or knee operation will cost around €5,600 in Estonia. The cost of a total knee replacement will be €6,400. For a gastric sleeve (a bariatric procedure in which part of your stomach is removed for weight loss purposes), the cost will be about €6,000 euros in Estonia, compared to around €9,000 euros in Finland and €7,450 in Sweden.
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