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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 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.

If you have applied for international protection from Estonia and received international protection granting decision and Estonian residence permit from the Police and Border Guard Board, and you:

  • Live in Estonia
  • Are of the pensionable age
  • Do not work
  • Do not receive pension appointed in Estonia

then we grant you health insurance starting from the first validity date of your residence permit.
How to Apply for Health Insurance?

You do not have to file an application to get health insurance. The Police and Border Guard Board forwards information about you to us automatically.

If you do not have valid health insurance for some reason, then turn to one of our customer services and take along:

  • Identity document
  • Supplementary legal protection and residence permit decision

You can check the validity of the health insurance by calling our infoline at 612 1360.

We guarantee you health insurance, if you have moved to Estonia, and you are:

  • an Estonian citizen, or
  • a person of Estonian nationality, or
  • the spouse, child, or parent of an Estonian citizen,

and

  • you are of the pensionable age, or
  • your monthly income is below the national pension rate, or
  • we pay you some social benefit.
     

How to Apply for Health Insurance?

You do not have to file a separate application for getting health insurance. If you have filed an application to receive returnee support and we have issued a decision to you, then you have also automatically received health insurance.

Having a business account affects health insurance only if it has been applied for by a person who:

  • does not work and is raising three or more children under the age of 19 living in Estonia, at least one of whom is under the age of 8. (§ 6 subsection 1 point 11 of the Social Tax Act (STA)) 
  • does not work, but whose spouse works, and the employer pays social tax for them.
  • whose family has at least one child under the age of 8 or at least three children under the age of 16. (STA § 6 subsection 1 point 8) 

In these cases, the condition for obtaining health insurance is that the person does not work. Since having a business account is equated with working, you no longer have the right to health insurance from the state after opening a business account. In this case, you get health insurance through the social tax paid from business income.

Please note, however, that only having a business account does not provide health insurance!

In order to obtain health insurance, the social tax must be received through the business account, at least to the extent of the minimum obligation.

In 2022, the monthly rate underlying the minimum social tax obligation is 584 euros, and the minimum social tax obligation is 192.72 euros per month (584 × 33%).

For example: If a person operates only through a business account, then in order to obtain health insurance, they must receive at least 1,606 euros per calendar month in 2022 from the provision of services or the sale of goods, on which the business income tax is 321.20 euros (1,606 × 20%) and on which, in turn, the share of social tax is 192.72 euros (321.20 × 33/55 in the case of a person liable for funded pension). Since the minimum social tax obligation has been met, the person has the right to health insurance.

You can read more about the emergence of health insurance on the " Employer insured" website of the Health Insurance Fund.
Other possibilities of obtaining health insurance from the state are not related to working or not working, and therefore having a business account does not affect them.

Last updated: 23.03.2023