Starting today, inhabitants of Estonia have the option to travel for treatment into thirty countries in Europe, afterwards compensated by Estonian Health Insurance Fund – even with related legislation still stuck in Riigikogu.
Treatment pan-European, starting today
25th October 2013, 18:39
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As specified by Health Insurance Fund (HIF) foreign relations head Anette Soosaar, HIF will be compensating treatment received abroad according to its Estonian price list. «It is important to know that health insurance fund shall only compensate for such healthcare services as the patient would have been entitled to, at HIF expense, in Estonia as well,» explained Ms Soosaar. «This means that patients cross-border movement directive will not cover health care services not offered or compensated in Estonia; neither shall HIF cover other expenses such as visit fees, patient’s own financing, travel and accommodation expenses,» she added.
In case the treatment abroad is more expensive than allowed by Estonian price list, the difference shall be covered by the patient. Always, however, treatment abroad shall first be paid by patients, the HIF money generally transferred during three months, but no later than within half a year.
Even though inhabitants of Estonia are under no obligation to apply for preliminary permission from HIF, Ms Soosaar still advised that people first clarify the entire situation and all details involved. «To avoid a situation where patient undergoes investigations not compensated by health insurance, we heartily advise that people ask the foreign health institutions for a preliminary written overview of the procedures planned and ask some Estonian medical specialist or HIF experts to give an assessment,» Ms Soosaar advised.
It is continually possible to head abroad for treatments unavailable in Estonia, with agreement by HIF, the latter then providing payment for it.
According to social ministry healthcare department head Heli Paluste, many have shown interest towards being treated abroad; they are already aware of a person suffering from a rare disease who will have surgery in Finland, in November, pursuant to the new order. «This is an operation included in our HIF price list; even so, local doctors found they would not be able to perform such surgery on that patient. The patient went and asked for Finnish physicians for a second opinion and they concluded they were ready to do it; and so that’s the way it will be,» explained Ms Paluste.
Under the new order, inhabitants of Estonia will have the option to ask for opinion by doctors abroad and be compensated by HIF for that. Ms Paluste specified that with each treatment case only one opinion shall be compensated; not so that a patient asks in all possible countries and hospitals and gets HIF compensation for the entire tour.
Even with the directive entering into force today, in Estonia, Riigikogu has not yet approved the necessary amendments – in November, these only undergo second and third readings.
Ms Paluste said social ministry has ruled that the option of going elsewhere in Europe, for treatment, will open starting today i.e. October 25th, as prescribed by the EU directive. Into legislation, it will afterwards be written that it is in force, retroactively, since October 25th.
Estonia is not the only country lagging behind with legislation. According to Ms Paluste, Finland has gone so far as to postpone the implementation of the new directive into the new year.
Meanwhile, Estonian medical institutions are making preparations for increased amounts of foreign patients to arrive. How much extra money this would mean for Estonian health care, nobody dares predict. According to Ardo Reinsalu, board member at Estonian Association of Private Healthcare Providers and private Hospital of Orthopaedics, they are already having increased numbers of foreign patients and the trend is upwards.
In all states joining the directive, internet websites with information on cross-border movements by patients will be provided. In Estonia, the address will be at kontaktpunkt.sm.ee. «For starters, it is in Estonian only; Russian and English will be added,» promised Ms Paluste.
«We will definitely be in cooperation with health insurance funds of other countries, so that information forwarded to partners and insured persons would be precise and up-to-date,» the promise continued.