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Whenever you visit another country, it is a good idea to educate yourself a little about the health system in your destination. Every country has a different system, and you can’t expect the same free treatments you get on the NHS at home. Many countries require you to make a contribution to the cost of any treatments you receive, and Estonia is no exception. There are various ins and outs to understand about the Estonian healthcare system, and you will need to do different things depending on your reasons for travelling. Be aware that Brexit may have an impact on this information, so keep following the ongoing situation.
Healthcare up until Brexit
Anyone who requires emergency attention will be provided with the appropriate medical care, but you can expect to be charged in full if you don’t have a European Health Insurance Card (EHIC).
You should never travel without buying sufficient travel insurance to ensure there is funding available in the event that you require medical treatment overseas. Remember to retain all paperwork and receipts that may be necessary for you or your insurance company to apply for a refund – make copies where possible. Failure to do this could cause complications in making a claim with your insurance provider.
As it stands, an EHIC will enable you to receive state-provided healthcare in Estonia when necessary for a reduced fee. This is for if you are staying in the country temporarily, and may sometimes even qualify you for free treatment. Any medical provider who asks you to pay for treatment upfront is probably not a provider under the state health system, so your EHIC won’t apply.
In addition to private medical treatment, your EHIC does not cover the following costs:
- Mountain rescue services
- Transport back to the UK
If you have an EHIC, make sure you seek treatment from a healthcare provider in the state system to ensure you are covered. State healthcare providers will have a contract with the EHIF. Be aware that if you allow a hotel or travel representative to make arrangements for you, you will need to request that they don’t arrange treatment from a private medical facility – any costs you incur for private treatment will not be refundable.
If the EU and the UK part ways without agreeing on a deal, the access to healthcare for Britons visiting Estonia is liable to change.
If you have plans to visit Estonia post-Brexit, it is important that you buy travel insurance to ensure you can access healthcare if you need it. Any EHIC issued by the United Kingdom will be valid until Brexit, but what happens afterwards remains uncertain as the UK government continues to seek agreements on healthcare arrangements with Estonia.
If you have a pre-existing health condition
Anyone who already has a health condition should take out medical insurance before travelling to Estonia. It is crucial that you inform your insurance company of any pre-existing health conditions, no matter how ‘minor’, to ensure you are fully covered in the event that you require medical assistance. Any information that is omitted could result in your insurance policy being void in the event that you need to make a claim. Anyone with an EHIC should be aware that it will remain valid until Brexit is completed, but it may not work after that.
If your pre-existing health condition will require routine treatment while you are overseas, consult your doctor at home for advice before departing. If there are any documents regarding your health condition or medication, you should take them with you. This information may be essential for any medical professionals you see abroad to ensure you get the correct treatment.
Anyone travelling specifically to obtain medical treatment in Estonia should ensure they know all the facts about what they are doing. There will be specific requirements that you need to be aware of, so be sure to get comprehensive advice and research the situation thoroughly before you travel.
Anyone admitted as an inpatient in Estonia must pay a fee of up to €2.50 for 0-10 days of hospitalisation. This cannot be refunded. The exceptions to this are:
- Children and young people under 18
- People admitted to intensive care
- Treatment relating to pregnancy and/or childbirth
There is a standard fee to pay for prescriptions in Estonia. In some cases, you will be required to pay an additional percentage of costs above the standard fee. The minimum payment will be €2.50. There is detailed information about prescriptions on the EHIF website.
If you are prescribed a medication which isn’t included in the national list of medicinal products, you will be liable for the full costs. This is non-refundable.
In Estonia, some of the medicines that can be bought over the counter in the UK – including Aspirin and certain ointments – can only be obtained from pharmacies.
Bringing medications into Estonia
Some prescription medications contain substances that are listed as controlled under the UK’s Misuse of Drugs regulations. There are additional legal controls that apply to such medications.
If you wish to take controlled medicines overseas, it may be necessary for you to acquire a personal licence. You must also understand your requirements in terms of the way your medicines must be carried and the information that you need to take with you. If you don’t adhere to your responsibilities with regards to your controlled medications, you could be refused permission to travel and even face legal problems in some cases.
The GOV.UK website has further information about travelling with these medicines – learn what you need to do, and make sure you do it.
There is no escaping the reality that accidents can happen, and while you are in Estonia you may find yourself in an emergency. If this happens, and you need an ambulance, you should dial 112. Emergency ambulance transport does not incur a charge in Estonia, so you don’t need to worry about fees.
Here are some other important numbers you should take note of, to ensure you aren’t left stranded in the event of an emergency situation:
- 112 – Emergency services, includes fire brigade and police.
- 1220 – The family practitioners info line (medical advice)
- 16363 – Estonian Health Insurance Fund information
The majority of doctors and emergency services personnel speak English, but there will be exceptions. If necessary, ask a local to help you make your emergency call.
Any dental treatment you receive in Estonia must be paid for, and it will be non-refundable. Different dental practices will have different fees for their services, so make yourself aware of what you will be charged before agreeing to treatment.
If you require emergency extraction of a tooth or lancing of an abscess, this service does not incur a charge. Be advised that dental treatment in Estonia is free for all persons under the age of 19.
For working in Estonia
Medical care up until Brexit
Anyone who is a temporary or permanent resident in Estonia and EHIF-registered is entitled to the same healthcare Estonian nationals receive. Having temporary or permanent resident status is dependent on the acquisition of the relevant residence card, which you can apply for if you are going to be working in Estonia (or if you are already there).
If you have been posted to work in Estonia for a UK company, you may qualify for health cover funded by the UK. There are various things that will affect whether or not this applies to you. Make an enquiry with HM Revenue and Customs to find out if you are eligible.
Medical care after Brexit
Any EHIF-registered resident in Estonia, whether temporary or permanent, may continue to qualify for the same healthcare as an Estonian national.
It is likely that you will be required to apply for a temporary or long-term residence permit if you don’t already have one. A temporary residence permit can cover you for up to 5 years, with the option to extend it for up to 10 years if necessary. Anyone who has lived in Estonia for 5+ years with a temporary residence permit may be eligible to apply for their long-term residence permit if they want. This will secure residency for the longer term and help ensure you have access to the state-provided healthcare whilst you are there.
It would also be necessary to register with the EHIF in order to access the same healthcare as Estonian nationals. It is advisable that you obtain private health insurance cover until you have confirmed coverage under the state system.
British posted workers may need to be EHIF-registered to continue receiving medical care on the same terms as Estonian nationals. Alternatively, private health insurance may be required.
For students in Estonia
Students who are currently studying or going to study in Estonia as part of a course registered in the UK may be entitled to UK-funded healthcare until the UK departs from the EU. It will be necessary for you and any dependents you have to apply for an EHIC. It is highly recommended that you proceed to take out private health insurance in addition to your EHIC to ensure you don’t incur excessive costs.
After Brexit has been completed, it is likely that you will require a long-term visa to study in Estonia. You should apply for this at London’s Estonian Embassy, or at the Police and Border Guard Board when you are in Estonia. Once you gain residence, you can become EHIF-registered to obtain the healthcare that Estonian nationals are entitled to. You may wish to take out additional private health insurance, but that is your prerogative.
For pensioners in Estonia
Healthcare up until Brexit
Anyone in receipt of an exportable UK benefit like the State Pension, and who lives in Estonia, may qualify for state healthcare funded by the UK. To get this, you will need to apply for an S1 certificate of entitlement.
This is standard certification for people heading into an EU country, but the exportable benefit you receive will determine the team you need to liaise with – further information can be found on the GOV.UK website. There are different rules in relation to healthcare cover for different exportable benefits, so look up yours and find out what you need to do.
What is an S1 certificate?
The S1 certificate exists to help you and your dependents get medical care in EU countries, including Estonia. Any current S1 certificate will remain valid at least until the UK leaves the EU. Whether it continues to be valid after that date will depend on decisions by member states. In any case, you should continue to apply for an S1 certificate until Brexit actually happens because it is currently the only way to ensure you get your healthcare entitlements.
Factors that impact on your eligibility for an S1 certificate include:
- Whether or not you receive certain UK benefits like pensions
- Whether you have worked and made contributions in a UK country
You can apply for your S1 certificate through the Business Services Authority or the Overseas Healthcare Team. Further information on the topic is available from the GOV.UK website.
If you are living in Estonia and EHIF-registered, you may continue being entitled to the same healthcare an Estonian national is entitled to.
If you have not obtained a residency permit, it may be necessary for you to apply. Temporary residence permits cover you for up to 5 years, and can then be extended to cover you up to a maximum of 10 years. Anyone who has lived with a temporary residence permit in Estonia for 5+ years may be able to apply for the long-term residence permit.
You will need to be EHIF-registered to have your entitlement to the same healthcare as an Estonian national. You are advised to seek private health insurance to keep you covered up until you are confirmed for coverage under the state system.