Health insurance
Health is a person’s most precious asset. In Estonia, the national health insurance is at a good level, but sometimes it is difficult to access medical services due to long waiting lists. Voluntary health insurance supplements the health insurance from the Health Insurance Fund or, in the absence of national health insurance, helps to cover medical expenses.
Why voluntary health insurance for a private person?
Voluntary health insurance gives you the opportunity to use paid medical services in a health care institution of your choice, buy medicinal products, visit a dentist, and use rehabilitation services without worrying about large medical bills, because we cover them for you. You can conclude a voluntary health insurance contract for yourself and your family member.
If your employer has taken out health insurance for you, read on here.
Digital clinic
Solve simpler health problems conveniently in a digital clinic.
Doctor’s appointment
When booking an appointment for a doctor’s visit, you do not need a referral.
Hospital treatment
We will indemnify the cost of hospitalisation required after an illness or accident.
Additional covers
Prevent illnesses and check your health regularly.
Health insurance for Estonian and European Union citizens
The health insurance of a private person covers the costs of paid medical services, which are not covered by the Health Insurance Fund. Voluntary health insurance is also helpful if you do not have insurance from the Health Insurance Fund. ERGO health insurance helps you to access a medical specialist without waiting in a long waiting list for treatment and allows you to see a doctor even without a referral.
Digital clinic
A digital clinic is a safe environment where general practitioners and family physicians are easily accessible concerning health issues in real time and 7 days a week.
Outpatient family medicine and specialised medical services
In the case of complaints arising during the period of insurance cover, it covers the necessary visit fee to the family physician and medical specialist, the costs of examinations, diagnostics, analyses, and medical procedures prescribed by the doctor.
Hospital treatment
Covers the costs of hospitalisation due to illness that occurred for the first time during the insurance period and after the end of the waiting period.
Prophylactic health checks
Covers the costs of medical examinations and examinations carried out at the insured person’s request. In addition, the costs of medical examinations necessary for monitoring illnesses incurred before the conclusion of the insurance contract (including extension of the prescription) are indemnified.
Prescription medications
We will indemnify the costs of prescription medicines registered in the European Union and prescribed by our doctor.
Dental treatment
Covers the costs of dental treatment and hygiene services, and examinations prescribed by a dentist.
Post-accident rehabilitation
We will indemnify the costs of rehabilitation and aids necessary after an accident, up to three months after the end of active hospitalisation, including:
- massage;
- electrotherapy;
- therapeutic gymnastics;
- support bandages;
- orthopaedic aids;
- wheelchair.
Post-accident dental treatment
We will indemnify the costs of repairing teeth that were damaged after an accident, including cosmetic surgery and prosthodontics involving the jaw or teeth.
Medical treatment expenses for critical illnesses
The costs of outpatient treatment, hospitalisation, medicinal products or rehabilitation for a critical illness that occurs for the first time will be indemnified during the insurance period and after the waiting period.
The following are considered critical illnesses: active tuberculosis, Alzheimer’s disease (before the age of 65), aplastic anaemia, bacterial meningitis, Crohn’s disease, organ or bone marrow transplantation, idiopathic Parkinson’s disease (before the age of 65), liver failure, multiple sclerosis, malignant tumour, cerebral stroke, coronary artery bypass grafting, acute chronic renal failure, heart surgery, acute myocardial infarction.
Health insurance for Estonian and European Union citizens
The health insurance of a private person covers the costs of paid medical services, which are not covered by the Health Insurance Fund. Voluntary health insurance is also helpful if you do not have insurance from the Health Insurance Fund. ERGO health insurance helps you to access a medical specialist without waiting in a long waiting list for treatment and allows you to see a doctor even without a referral.
A digital clinic is a safe environment where general practitioners and family physicians are easily accessible concerning health issues in real time and 7 days a week.
In the case of complaints arising during the period of insurance cover, it covers the necessary visit fee to the family physician and medical specialist, the costs of examinations, diagnostics, analyses, and medical procedures prescribed by the doctor.
Covers the costs of hospitalisation due to illness that occurred for the first time during the insurance period and after the end of the waiting period.
Covers the costs of medical examinations and examinations carried out at the insured person’s request. In addition, the costs of medical examinations necessary for monitoring illnesses incurred before the conclusion of the insurance contract (including extension of the prescription) are indemnified.
We will indemnify the costs of prescription medicines registered in the European Union and prescribed by our doctor.
Covers the costs of dental treatment and hygiene services, and examinations prescribed by a dentist.
We will indemnify the costs of rehabilitation and aids necessary after an accident, up to three months after the end of active hospitalisation, including:
- massage;
- electrotherapy;
- therapeutic gymnastics;
- support bandages;
- orthopaedic aids;
- wheelchair.
We will indemnify the costs of repairing teeth that were damaged after an accident, including cosmetic surgery and prosthodontics involving the jaw or teeth.
The costs of outpatient treatment, hospitalisation, medicinal products or rehabilitation for a critical illness that occurs for the first time will be indemnified during the insurance period and after the waiting period.
The following are considered critical illnesses: active tuberculosis, Alzheimer’s disease (before the age of 65), aplastic anaemia, bacterial meningitis, Crohn’s disease, organ or bone marrow transplantation, idiopathic Parkinson’s disease (before the age of 65), liver failure, multiple sclerosis, malignant tumour, cerebral stroke, coronary artery bypass grafting, acute chronic renal failure, heart surgery, acute myocardial infarction.
Health insurance for a foreigner to apply for a visa or residence permit
Do you need health insurance to apply for or renew a temporary residence permit or visa? ERGO offers health insurance to a foreigner: - who is staying in Estonia on the basis of a residence permit or visa; - who applies for or extends a temporary residence permit or visa.
Digital clinic
A digital clinic is a safe environment where general practitioners and family physicians are easily accessible concerning health issues in real time and 7 days a week.
Outpatient family medicine and specialised medical services
In the case of complaints arising during the period of insurance cover, it covers the necessary visit fee to the family physician and medical specialist, the costs of examinations, diagnostics, analyses, and medical procedures prescribed by the doctor.
Hospital treatment
Covers the costs of hospitalisation due to illness that occurred for the first time during the insurance period and after the end of the waiting period.
Prophylactic health checks
Covers the costs of medical examinations and examinations carried out at the insured person’s request. In addition, the costs of medical examinations necessary for monitoring illnesses incurred before the conclusion of the insurance contract (including extension of the prescription) are indemnified.
Prescription medications
We will indemnify the costs of prescription medicines registered in the European Union and prescribed by our doctor.
Additional cover for dental treatment
Covers the costs of dental treatment and hygiene services, and examinations prescribed by a dentist.
Vaccination
We will indemnify the costs of vaccination.
Returning to home country
We will indemnify medically justified expenses related to your return to your home country.
Technical aids
We will cover the costs of technical aids, such as glasses, wheelchair, crutches.
Health insurance for a foreigner to apply for a visa or residence permit
Do you need health insurance to apply for or renew a temporary residence permit or visa? ERGO offers health insurance to a foreigner: - who is staying in Estonia on the basis of a residence permit or visa; - who applies for or extends a temporary residence permit or visa.
A digital clinic is a safe environment where general practitioners and family physicians are easily accessible concerning health issues in real time and 7 days a week.
In the case of complaints arising during the period of insurance cover, it covers the necessary visit fee to the family physician and medical specialist, the costs of examinations, diagnostics, analyses, and medical procedures prescribed by the doctor.
Covers the costs of hospitalisation due to illness that occurred for the first time during the insurance period and after the end of the waiting period.
Covers the costs of medical examinations and examinations carried out at the insured person’s request. In addition, the costs of medical examinations necessary for monitoring illnesses incurred before the conclusion of the insurance contract (including extension of the prescription) are indemnified.
We will indemnify the costs of prescription medicines registered in the European Union and prescribed by our doctor.
Covers the costs of dental treatment and hygiene services, and examinations prescribed by a dentist.
We will indemnify the costs of vaccination.
We will indemnify medically justified expenses related to your return to your home country.
We will cover the costs of technical aids, such as glasses, wheelchair, crutches.
Health insurance helps keep medical expenses under control
Quick access to medical care at a lower cost in the event of an unexpected illness or accident
Wide network of medical partners
Fast and transparent claims handling
A wide selection of insurance covers
How to use ERGO health insurance?
For medical care, contact ERGO’s medical partner or another suitable medical institution. When contacting ERGO’s medical partner, you only have to pay the deductible agreed in the insurance contract and there is no need to submit an application for indemnity to ERGO. If you have chosen another medical institution, pay for the treatment services yourself first and submit an application for indemnity to ERGO.
Here you will find more detailed information about claims handling.
Before seeing a doctor, you can conveniently check your insurance cover from ERGO health app.
Good to know / FAQ
Doctors can only add to the family physician’s list those persons who have insurance from the National Health Insurance Fund. If a person does not have insurance from the National Health Insurance Fund, they can use the paid services of doctors, as well as attend a paid appointment with the same family physician of their choice.
Yes. In the case of a medical institution outside the list of ERGO partners, the insured person first pays for the outpatient medical care themselves and then submits an application for indemnity to ERGO together with a document certifying payment and a medical certificate. In addition, the following documents have to be attached to the medical bill:
- in the case of examinations and analyses, an extract from the medical history must also be submitted to ERGO;
- in the case of dental treatment, an invoice with a list of dental services issued in the name of the person who has received the treatment must be submitted.
The family physician sees a valid contract for ERGO health insurance only if they are a partner of ERGO. In other cases, the family physician does not see the ERGO insurance contract.
The insurer indemnifies the costs up to the indemnity limit specified in the insurance policy. The indemnity limit is determined for the insurance period, not for the insured event.
If the dental treatment indemnity limit is used during the current period, then this cover will no longer be available during this period. In the new period, the dental treatment indemnity limit will be restored to the extent of the amount specified in the policy. The indemnity limit will not be restored in the new period with additional cover for critical illnesses in the case of a critical illness diagnosis that has already been indemnified.
The insurance premium is calculated according to the age of the insured person, taking into account their state of health. The state of health is assessed only before entering into an insurance contract, and for this, the insured person has to fill out a health questionnaire. The insurance contract is open-ended and there is no need to assess the state of health during the period of validity of the insurance period.
The insurance cover starts after the conclusion of the insurance contract and after the expiry of the waiting period specified in the insurance contract.
Voluntary health insurance and private health insurance are two different names for a similar insurance product.
Terms and conditions of health insurance and information documents
General terms and conditions of health insurance contracts TI.0190.20
Effective as of 01.07.2020
Special terms and conditions of ERGO health insurance for residents TI.0159.17
Effective as of 01.11.2017
List and description of critical illnesses covered Annex 1 to the Terms and Conditions
Effective as of 01.01.2017
