NOTICE CONCERNING THE DENTAL CARE BENEFIT FOR ADULTS
The Estonian Health Insurance Fund and Vagodent Dental Clinic have entered into a contract for funding the dental care services provided to insured persons of at least 19 years of age which is implemented from 14 January 2019 until the expiry of the contract.
In order to make the provision of the service and using the benefit as quick and simple as possible for all persons insured by the Health Insurance Fund in Estonia, as well as for those providing dental care services, the limit of the benefit is calculated and accounts are settled between the Health Insurance Fund and provider of dental services electronically. For this purpose, the Health Insurance Fund and the provider of dental services have entered into contracts for provision of service.
As of 1 January 2018, the Estonian Health Insurance Fund pays the dental care benefit for adults in the amount of 40 euros per year (cost-sharing by the patient in the extent of 50%). The amount of the benefit paid to the elderly, pregnant women, and mother of children under one year of age was increased to up to 85 euros per year (cost-sharing by the patient in the extent of 15%).
The contract entered into with the Health Insurance Fund does not place the service provider under the obligation to provide all services based on the price list of the Health Insurance Fund – the price list only applies to the services covered by the benefit and in the extent of the maximum amount of the benefit.
The benefit remains valid for one calendar year and any unused amount cannot be transferred to the next year. If a person’s limit is used up, the service provider is not required to provide services based on the price list of the Health Insurance Fund.
Vagodent also has valid funding contracts with the Health Insurance Fund for providing dental care for (insured) persons under 19 years of age, as well as for using the prosthetic dentistry benefit for pensioners (€260 over three years).
For further information, please contact the Heath Insurance Fund by calling the information line at 16363 or the customer support line at (+372) 6696630; by e-mailing firstname.lastname@example.org; by visiting the customer service of the Health Insurance Fund at Lastekodu 48 in Tallinn; or by vising the website www.haigekassa.ee