Included in the Reform-Eesti 200-SDE coalition agreement is a line about increasing Estonia's annual dental benefit. Minister of Health Riina Sikkut (SDE) plans to submit the relevant proposals to the government cabinet at the end of August. Areas of concern have been mapped out, and decisions are slated to follow next month.
Adults in Estonia have been eligible for dental benefits since January 2018, i.e. six years and counting. Estonian Health Insurance Fund (EHIF) analyses indicate that these annual benefits are increasingly being utilized as well, and completely used up at that. Unfortunately, the annual benefit only suffices to cover one, at best even two appointments.
The National Audit Office has recommended focusing more on preventive care, as well as better targeting the benefit to lower-income individuals if it turns out they require more dental care than is covered by their benefits or coinsurance.
According to Sikkut, what changes can be expected and on what timetable will emerge in the course of negotiations. Things should become clear by mid-September, she added.
"Right now, the deal has only been made during coalition talks that in principle, the dental benefit will be reviewed and analyzed, and that changes will be made to it," she explained.
The benefit is tied to a budgetary cost. The health minister said that in order for the benefit to have any sort of impact, it needs to be kept up to date.
"If all prices are going up, then the benefit has to increase so that people can receive at least the current level of support to help maintain their teeth," she said. "People understandably only go to the doctor once they have health concerns, but the general attitude of prophylaxis — to prevent the occurrence of caries, to intervene sooner in case of infection or the need to extract a tooth — this is necessary for both children's and adults' dental health."
The annual adult dental benefit is currently capped at €40, with a coinsurance of 50 percent. This cap is more than doubled to €85 a year for certain categories of adults, however — including pregnant people, registered unemployed, people with a reduced capacity for work as well as seniors — whose minimum coinsurance drops to 15 percent as well.
One point of discussion will be whether this benefit should be better differentiated. It was understood during coalition negotiations that the state's support for the accessibility of dental care services was low, Sikkut noted.
"This is clearly reflected in the usability and accessibility of these services," the minister said. "Oral health is poor, and people go to the dentist too little and too late. And when looking into whether people are getting the healthcare they need or not and for what reasons, then dental care is the least accessible, and the main reason is the high cost of the service."
Dental benefits will not be converted to cash benefits; they are applied directly to patients' bills.
EHIF partners currently account for 82 percent of all dental healthcare providers in Estonia.
Editor: Aili Vahtla