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 in Estonia
• You raise seven or more children under 19 in Estonia
• Do not work and are raising three or more children under 19 in Estonia, and at least one child is younger than 8
• Do not work, your spouse works and the employer pays their social tax, your family has at least one child under 8 or at least three children under 16

The state guarantees health insurance to you when you raise a child under 3 in Estonia. The state guarantees health insurance to one parent – in general, to the recipient of the parental benefit or the child care allowance. 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 child care allowance 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, child care allowance, 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-moth-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.

Automatically, the state guarantees health insurance to you (without the need to submit a separate application) when:

• you receive parental benefit or are on parental leave

• you receive allowance for a family with many children for 3 to 6 children and you don't work

• You receive allowance for a family with many children for seven or more children

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 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. 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. At the same time, one parent does not receive health insurance in connection with raising a child under 3 years old, and the other parent does not receive health insurance in connection with raising a child of 3 or more.