European Economic Area countries (EEA)
All European Union member states have reciprocal health agreements with all countries in the EEA. In addition to EU members, the group includes Iceland, Liechtenstein and Norway. Although Switzerland is not an EEA member, it has bilateral agreements with this group.
All visitors from countries not listed above should obtain private medical insurance; many embassies of the EEA countries also recommend private insurance as a precaution.
European Healthcare Insurance Cards (EHIC)
A European Health Insurance Card permits travellers from the European Economic Area (EEA) to free and subsidised medical treatment for illness and injury that happens during their stay in one of the EEA countries. Treatment must be carried out in state run institutions and not private medical facilities. The card also covers treatment for chronic disease, existing illness and routine maternity care. Travellers in need of kidney dialysis or oxygen therapy whilst they are abroad must arrange their treatment before they travel.
The card is obtained from your home country’s health authority and you should apply for it in advance of your visit. Most health authorities have their own website, which tells you how to apply.
The EHIC does not cover you for medical and dental tourism, where obtaining medical treatment is the purpose of your visit. Nor does it cover the costs of transferring you (or in the event of death, your body) to another country for treatment, although if that country is an EEA member it will cover the costs of treatment there.
Visitors in need of medical care must be certain it is necessary and has occurred during their stay in Estonia. If your illness or injury is not a medical emergency you will have to pay for any treatment you receive. Remember, a sprained ankle is unlikely to be deemed as a medical emergency, when a little rest will cure the problem and treatment for such a minor injury can prove to be very expensive and is unlikely to be reimbursed through the EHIC scheme when you get back home.
State-provided emergency health is available free on the same terms as Estonian nationals, but only from the accident and emergency treatment centres of main hospitals.
Certain fees exist in the Estonian health service. Consultations with doctors are free for citizens from countries with a reciprocal heath agreement, unless the doctor is called out to the patient, in which case there is a fee up to EEK 50. Specialist medical care is also charged at this rate. Ambulance services are free but hospital stays cost around EEK 25 a day for up to 10 days of hospitalisation. Children under 19, maternity care and intensive care do not incur inpatient fees. Doctors may also charge for any documentation requested, but not for prescriptions.
Dental treatment for children under 19 is free of charge. Adults must pay for all dental treatment except removal of teeth and lancing of abscesses.
Citizens who are not from countries with a healthcare agreement must pay all fees themselves and claim them back from their insurance company on their return home.
Private Health Insurance
Visitors to Estonia, especially those not covered by a reciprocal agreement, should make sure they have a private medical insurance policy or comprehensive travel insurance to cover them during their stay here.
Travellers should be fully versed with the level of health cover their policy provides. Important points to note are whether the policy will cover expenses like medical evacuation and repatriation, which is payment for your transportation costs if you are moved to another country for treatment or in the event of your death, payment to have your body shipped home. You should also check whether your policy covers you for accidents resulting from high-risk activities like skiing.
Most policies do not cover treatment for pre-existing illness and medical conditions and such travellers should get advice from their doctor about travelling here and should make sure they have enough medication to cover their visit.
Most private health insurance policies carry an excess, whereby you must pay the first part of a claim and often, if treatment is minor, this is more than the treatment cost. Most private insurance companies expect clients to pay medical costs themselves and claim a reimbursement on their return home and it can take several months before your claim is settled. Travellers are advised to keep all receipts for medical treatment and prescription drugs to present to your insurance company on their return. In the case of serious injury or illness and long stays in hospital, some insurance companies will negotiate directly with the hospital and the doctors concerned and pay fees directly to them.
In the case of emergency treatment, you can call an ambulance on 112 or go to the emergency department at the hospital. The hospital doctor decides if a patient requires inpatient care.
There are no compulsory vaccinations for visitors to Estonia, but medical experts recommend the following:
Diphtheria. This is spread by droplet infection through close personal contact.
Tetanus. This is contracted through dirty cuts, bites and scratches. It causes a serious infection to the central nervous system.
Typhoid and hepatitis A. These are spread through infected food and water. Typhoid causes blood poisoning and hepatitis A causes liver disease.
Hepatitis B. This is a disease affecting the liver, which is spread through contaminated blood, needles and sexual intercourse.
Tick-borne encephalitis. This is spread through tick bites and affects the way the brain functions. Ticks are prevalent in forested areas from spring through to autumn. If you are visiting forests, protect yourself by wearing a hat, long sleeved tops, trousers and socks. You should use a tick-repellent spray and check your body for ticks at the end of your trip to the forest.
Influenza. Flu vaccine is recommended for older people who visit Estonia between November and April.
In rural areas, it may be wise to vaccinate against rabies.
The Estonian Health Insurance Fund subsidises a list of approved medicines, which are available on prescription from a doctor. There are varying levels of subsidy if you come from a country with a bilateral health agreement with Estonia. All patients must pay the first EEK 20 of the cost of their prescription. The type of drug prescribed determines the level of subsidy the patient receives after this and it various from payment of the complete cost of the drug to 50 percent of the cost.
There are various exceptions to the standard subsidy rate, which applies to medicines for children aged 4 to 16 years and old age pensioners. Children under four are exempt from all charges.