Health insurance

The Health Insurance Fund shall cover medical treatment expenses of a person with health insurance. If social tax is paid for you then you are automatically insured.

If you work, your employer pays social tax for you. If you are unemployed or if your employment contract has been suspended, as during the period you are at home with a small child, you are eligible for health insurance together with national family allowances.

The state guarantees health insurance to you when

• You raise a child under 3 years old in Estonia
• You raise seven or more children under 19 years old in Estonia
• Do not work and are raising three or more children under 19 years old in Estonia, and at least one child is younger than 8 years
• Do not work, your spouse works and the employer pays their social tax, your family has at least one child under 8, or 8 years old child until the end of the 1st grade, or at least three children under 16.

Note! The Social Insurance Board interprets work as all working activities, for example:

• a person working on the basis of an employment contract,
• member of the management or control body,
• a person working on the basis of a contract under the law of obligations (VÕS)
• elected or appointed member of local government,
• owner of an entrepreneurial account, etc.

The state guarantees health insurance and it is assigned automatically (you dont need to apply) to you when you raise a child under 3 in Estonia, you dont work and raise 3 or more children, one of which is less than 8 years old, or your raise 7 or more children. The state guarantees health insurance to one parent – in general, to the recipient of the parental benefit or later the parental leave.

In addition to a child’s parent, these conditions also apply to a guardian or a person who has concluded a written foster care contract, or to other persons who receives the parental benefit and uses the parental leave instead of the parents.

Note that if you decide to change the recipient of allowances in your family, then the right for health insurance shall also transfer to that person to whom the allowances are paid to (adoption premium, parental benefit, or an allowance for a family with many children). It is important to check that the mother, who is indeed actually at home with the child, would not lose her health insurance.

Example. A mother is at home with her 10-month-old, and receives parental benefit. The family decides to change the parental benefit recipient and the father submits the application. At the same time, the mother wishes to remain at home with the child.
As the mother will no longer be paid parental benefit for the child, nor will she return to work, she will lose the health insurance and should she need medical assistance, the Health Insurance Fund will not cover her medical treatment expenses.

When the payment period of the shared parental benefit ends, the parent who received it the last will continue being insured by the state until the child turns 3 years old. You can change the insured person until that by writing to us about it.

Insurance for a dependent spouse

You must file an application for getting health insurance if you:

• Do not work, your spouse works and the employer pays their social tax, your family has at least one child under 8, or 8 years old child until the end of the 1st grade, or at least three children under 16

It is important to know that if the family has the right to receive social tax from the state in connection with raising a child under 3 years old, in connection with raising 3-6 children or in connection with raising 7 and more children, then you cannot apply for the payment of social tax as a dependent spouse.

NB!

• If the working spouse also receives parental benefit at the same time, it is not possible for you to get health insurance through his/her employment.
• Only one parent can get health insurance from the state at the same time. For example, if there is one child under the age of 3 in the family and 3 or more children in addition, we insure the parent who receives the parental benefit. You cannot get at the same time health insurance in connection with raising a child under 3 years old, and the other parent in connection with raising 3 or more children.