Estonia’s healthcare system is anchored by its public health insurance, managed by the Estonian Health Insurance Fund (EHIF or Tervisekassa), while a growing private health insurance sector complements it by offering faster and more personalized services. Both systems play distinct but overlapping roles in ensuring access to healthcare for residents and expatriates.
Differences
The most significant difference between the two systems lies in eligibility and funding. Public health insurance is compulsory and automatically applies to residents who pay social tax contributions—primarily employees and the self-employed. It is funded through social taxes paid by employers (13% of gross salary) and pension contributions by employees. In contrast, private health insurance is voluntary and is typically purchased either individually or offered as a fringe benefit by employers. It is funded through direct premiums.
Another key difference is in coverage and access. Public insurance covers a broad range of essential services: general practitioner visits, specialist care (with referrals), hospital treatments, prescription drugs, diagnostics, vaccinations, and preventive services. However, since 2025, co-payments have significantly increased—outpatient specialist visits now cost €20, and inpatient fees rose to €5 per day. Conversely, private insurance often offers direct specialist access without referrals, minimal or no co-payments for covered services, and additional coverage such as dental care, mental health services, maternity benefits, and telemedicine. Plans from providers like Cigna, Allianz, and Meliva also include wellness programs and global coverage options, which are particularly attractive to expats.
In terms of efficiency and convenience, public insurance typically requires patients to go through a family doctor before seeing a specialist, which can result in waiting periods, particularly in urban centers. Private insurance offers a more streamlined experience with reduced wait times, especially for non-emergency consultations.
Similarities
Despite these differences, both systems share several important traits. Firstly, both are designed to ensure access to healthcare and are recognized for offering quality services. Secondly, both public and private systems include digital health solutions, a hallmark of Estonia’s e-health infrastructure. Electronic health records, e-prescriptions, and telemedicine services are common in both sectors.
Additionally, both systems are seeing an increased emphasis on preventive care. The public sector continues to cover immunizations and screening programs, while private insurers are expanding into lifestyle management services, such as nutrition counseling and mental well-being.
Top Public Health Insurance Options in Estonia
Estonia’s public health insurance system is primarily managed by the Estonian Health Insurance Fund (EHIF), the only comprehensive public health insurer in the country. As Estonia has a centralized healthcare financing model, there are no other significant public health insurers operating independently. The EHIF ensures universal coverage for insured individuals and provides a wide range of health services. Below is a detailed look at Estonia’s public health insurance framework through the lens of EHIF.
1. Estonian Health Insurance Fund (EHIF)(Official Website: https://tervisekassa.ee/en)
Cost:
Health insurance coverage through EHIF is funded via a mandatory social tax of 33%, of which 13% is earmarked specifically for health insurance. Employers are responsible for paying this tax on behalf of their employees. Self-employed individuals contribute their own social taxes, while the state covers certain groups like pensioners, children, students, pregnant women, and registered unemployed individuals.
Available Services/Coverage Features:
EHIF covers a wide array of health services including:
- Primary and specialized medical care
- Emergency and hospital care
- Prescription medications (partially reimbursed)
- Rehabilitation services
- Preventive services (vaccinations, screenings)
- Dental care for children and limited dental care for adults
- Maternity care and childbirth services
- Medical devices and nursing care
Additionally, EHIF supports cross-border care within the EU/EEA under the EU health insurance regulations and the European Health Insurance Card (EHIC).
Open for All or Limited:
EHIF coverage is limited to individuals who pay into the social tax system or fall under specific protected categories (e.g., children, students, retirees). Those who are not working and not in one of the protected categories must pay for care privately or seek voluntary insurance until they become eligible.
Core Financial Features:
- No additional premiums for insured individuals, apart from the general social tax paid by employers or self-employed persons
- Co-payments exist for certain services such as outpatient specialist visits, hospital stays (typically €2.50 to €6 per day), and some medications
- Reimbursement rates for prescription drugs vary between 50%, 75%, and 100%, depending on the medication and the patient’s condition
- EHIF uses a capitation and fee-for-service hybrid model to compensate providers, helping to balance quality and efficiency in care delivery
Consumer Satisfaction Score:
Surveys conducted by Estonia’s National Institute for Health Development and international studies (such as the Euro Health Consumer Index) indicate generally high satisfaction levels, particularly for the accessibility of digital health services, the e-health system, and transparency.
- Overall satisfaction with the EHIF hovers around 75%–80%, with particular praise for its digital-first approach and easy access to medical records and prescriptions.
- Challenges remain in rural access and wait times for specialist care, but reforms and technology are steadily addressing these issues.
Top Private Health Insurance Providers in Estonia
Estonia’s private health insurance market is growing steadily, primarily offering supplementary coverage to complement the public system. Private insurance is popular among expatriates, employers providing employee benefits, and individuals seeking faster access, additional services, or specialized care. Here are the top private health insurers operating in Estonia, each with unique offerings, pricing, and features.
1. Meliva(Official Website: https://meliva.ee/en )
- Cost: Premiums vary depending on coverage level and age but typically range from €30 to €100 per month for individual plans. Employer-sponsored group plans may differ.
- Available Services/Coverage: Focus on outpatient and inpatient care, dental care, mental health services, family doctor consultations, physiotherapy, and preventive programs.
- Open for: Available to individuals and corporate groups; widely accessible to residents and expats.
- Core Financial Features: Monthly premiums; co-payments depend on plan specifics; employer co-financing common; flexible coverage options.
- Consumer Satisfaction: High marks for personalized care and prompt appointments, especially in dental and mental health. Satisfaction estimated around 80%.
2. Cigna(Official Website: https://www.cigna.com)
- Cost: International plans start around €50 to €200 per month, depending on coverage and age.
- Available Services/Coverage: Comprehensive international health insurance including inpatient and outpatient care, maternity, dental, evacuation, telemedicine, and chronic disease management.
- Open for: Global coverage available for individuals and employers; well-suited for expats.
- Core Financial Features: Premium-based plans with tiered coverage; deductibles and co-insurance apply depending on the plan.
- Consumer Satisfaction: Known for global reach and multilingual support; satisfaction typically rated above 85% globally.
3. Bupa Global(Official Website: https://www.bupaglobal.com)
- Cost: Premiums start from approximately €70 monthly, varying by plan type and age.
- Available Services/Coverage: Extensive inpatient/outpatient care, specialist consultations, maternity, dental, mental health, preventive screenings, and digital health services.
- Open for: Individual and group plans; strong focus on expat and international clients.
- Core Financial Features: Tiered premium plans with optional add-ons; co-payments vary; emergency evacuation included in many plans.
- Consumer Satisfaction: High satisfaction (85%+), praised for customer service and wide provider network.
4. Allianz Care(Official Website: https://www.allianzcare.com)
- Cost: Premiums typically range from €60 to €180 per month.
- Available Services/Coverage: Specialist care, hospital stays, cancer treatment, maternity, dental, outpatient services, and wellness programs.
- Open for: Individuals, families, and corporate clients; international plans available.
- Core Financial Features: Premiums with flexible deductibles and co-pays; comprehensive coverage options; cashless treatment options in network.
- Consumer Satisfaction: Strong reputation for claims handling and service quality; satisfaction around 80-85%.
5. AXA PPP Healthcare(Official Website: https://www.axaglobalhealthcare.com/en)
- Cost: Plans usually cost between €50 and €150 monthly.
- Available Services/Coverage: Tiered plans offering inpatient and outpatient care, emergency evacuation, wellness programs, dental, and mental health services.
- Open for: Individuals, groups, and expatriates; flexible for different needs.
- Core Financial Features: Premium-based; co-payments and deductibles vary by plan; extensive global provider network.
- Consumer Satisfaction: Well-regarded for customer support and digital tools; satisfaction scores near 80%.
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