Copays for specialist doctor appointments rising from €5 to €20 from April 1
Starting April 1, appointment fees, or copays, for specialist medical care and emergency room (ER) visits will rise from €5 to €20. Pensioners, registered unemployed individuals, pregnant people and recipients of subsistence benefits will be exempt from this increase.
In cases of more serious health issues requiring hospitalization, no copay will be charged for an ER visit.
Lii Pärg, an expert in healthcare funding policy at the Ministry of Social Affairs, explained that copays are being increased due to the fact that copay rates have remained unchanged for more than a decade, even as both the strain on Estonia's medical system and the costs of services have increased over time.
"These changes are based on OECD recommendations, which suggest that increasing appointment fees can help improve the efficiency of a healthcare system, provided that vulnerable population groups are protected," Pärg said.
The lower, €5 copay will continue to apply to recipients of subsistence benefits, individuals with partial or no work ability, registered unemployed individuals, those over the age of 63, old-age and incapacity pensioners, children under the age of 19, pregnant people and mothers of children under the age of one.
"Notably, pregnant people cannot be charged even the lower copay if outpatient specialist care is provided in connection with pregnancy or childbirth," the ministry expert added.
An additional safeguard will be implemented as well: if a patient requires repeat visits to the same specialist, they may only be charged for a copay once within a one-year period. Likewise, no copay may be charged for referrals within the same medical institution or the same specialist at another facility.
Pärg emphasized that family doctor, or primary care, appointments will remain free of charge.
Beginning in April, hospitals' daily bed fee rate will also increase from the current €2.50 to €5, capping out at a maximum of ten days of hospitalization.
Time spent in intensive care and specialist medical care related to pregnancy or childbirth or for minors will remain exempt from bed fees.
If a patient is unable to attend a scheduled appointment, they must cancel the appointment at least 24 hours in advance. Should a patient cancel less than 24 hours in advance or fail to show up for their appointment, the medical institution has the right to charge double the copay at their next appointment.
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Editor: Aili Vahtla
