Health insurance in Estonia
Estonia has solidary health insurance system. Solidarity in health insurance means that someone’s health insurance payments or contribution to the system or access to the necessary assistance does not depend on age, income or health risks. All the medically insured people in Estonia are entitled to the same quality health care, regardless of whether or not they pay the health insurance tax.
Health insurance payments are made by the majority of the working age population, and from the social tax payable from the gross salary of a working person the treatment services also to the population groups in society who currently are not making insurance payments are compensated for. This group includes children, seniors and mothers raising small children at home, also the unemployed and pregnant women. Mutual solidarity includes the young and the old, the rich and the poor and the sicker and the healthier people. Today’s working age people use the services relatively little, but health insurance payments paid from their gross wages also cover the health care costs of children and the elderly family members of the taxpayers. Also, today’s working-age people will use health care services in the future when they can no longer contribute to the system. The existing funds are used on an ongoing basis to treat all people in need; no one has a personal account.
An insured person is a permanent resident of the Republic of Estonia or a person living in Estonia by virtue of a temporary residence permit or by the right of permanent residence, who pays the social tax for himself/herself or for whom the payer of social tax is required to pay social tax. Insured persons are:
- a person working on the basis of an employment contract;
- a public servant;
- a member of the management or supervisory board of a legal entity;
- a person employed on the basis of a contract under the law of obligations;
- a person registred at Estonian Unemployment Insurance Fund;
- a person, who participated in the elimination of the consequences of a nuclear disaster:
- a conscript;
- the non-working spouse of a diplomat or a public servant;
- the curator of a disabled person;
- a person receiving child care allowance;
- a dependant spouse, for whom the government pays social tax;
- a person receiving social allowance.
According to the Health Insurance Act persons for whom no social tax is paid are considered as having equal status to the insured person.The persons having equal status are:
- a pregnant woman;
- a person under 19 years of age;
- a person receiving state pension granted in Estonia;
- an insured person’s dependent spouse, who is no more than 5 years away from attaining the age limit for old-age pension;
- pupils (there are age limits);
- a student, who is permanent resident;
- a person joining with the scheme voluntarily.
Source: Estonian Health Insurance Fund