Tervisekindlustus

Tervisekindlustus is a term used in Estonian to describe health insurance, covering costs arising from illness or injury. In Estonia, the core of health coverage is universal and financed through the Estonian Health Insurance Fund (Haigekassa) from state and payroll contributions. All permanent residents and many workers have access to a basic package of medical services, including visits to general practitioners and specialists, hospital care, maternity services, and medicines that are reimbursed under the public system. The exact scope and reimbursement levels are defined by law and the benefits package.

Private tervisekindlustus refers to voluntary coverage provided by private insurers. It is designed to complement the public system by offering faster access to care, a wider network of providers, or coverage of services not fully covered by Haigekassa. Private plans can include additional services such as certain dental care, private clinics, or elective procedures, and they typically involve monthly premiums. Plans may also have deductibles, co-payments, or annual limits.

Eligibility and access: Public health insurance is automatic for residents with a qualifying status, such as employment or other covered categories. Private health insurance is optional and available to residents and non-residents who meet underwriting criteria set by insurers.

Costs and claims: Public services involve small co-payments or medicines’ co-reimbursements. Private plans reimburse the insured according to policy terms, which may include caps and exclusions.

Regulation: Health insurance in Estonia is governed by national law and supervised for financial stability and consumer protection by the Estonian Financial Supervisory Authority, with implementation through Haigekassa and private insurers.