Until now, things were simple — any visit to a specialist doctor or the ER involved a uniform €5 copay.

From April 1, this copay will quadruple, but a patchwork of exceptions and discounts will also come into effect, which can vary even from hospital to hospital.

For example, the law stipulates that the existing €5 copay will remain in effect for children up to 19 years old and pregnant people, but East Tallinn Central Hospital (ITK) won't be charging them a cent.

"In Tallinn, no one under 19 is charged at any hospital," noted ITK customer service chief Lea Karik. "This is as decided by the City of Tallinn, and this is standard in all hospitals. Since we have a large maternity hospital and welcome pregnant people, we also won't charge our pregnant patients."

Likewise in Tallinn, however, anyone brought to the ER by ambulance will also start being charged a copay, with the exception of patients who end up admitted for treatment at the hospital.

Tartu University Hospital (TÜK), meanwhile, has decided that specialist care for kids under two, dental care for kids under 19, healthcare services related to tissue and organ donation as well as other special cases will be included among those exempt from copays.

"This has been requested for years by specialty clinics, which have likely assessed the need for their patients and families to receive the necessary services," explained TÜK board member Ilona Pastarus.

"For example, we're talking about genetic disease screening for relatives, preventive measures or the treatment of patients with pulmonary tuberculosis (TB)," she added.

South-Estonian Hospital has opted not to introduce any additional discounts, as hospital director Arvi Vask noted that copay regulations are already filled with exemptions.

"As of April 1, the copay for an initial appointment with a specialist doctor will be €20, except for certain groups — those over the age of 63, pregnant people, the unemployed and mothers with children under the age of one," Vask confirmed. "And there's a whole list beyond that, including recipients of social benefits and so on. For them, copays will remain what they are today — €5."

The Ministry of Social Affairs confirmed that patients eligible for a discounted copay do not need to provide any proof at the registration desk — with one exception.

"The only difference is that the Estonian Health Insurance Fund (EHIF) does not have data on all pregnant women, as not all of them have registered their pregnancy for insurance purposes," noted Lii Pärg, a healthcare funding policy expert at the ministry. "This only comes into play if the person is unemployed; in that case, they would need to provide their proof of pregnancy document to be eligible for the €5 copay."

Family doctor, or primary care, appointments will continue to be free of charge. A €5 copay will apply, however, to speech therapy, physical therapy and psychologist appointments.

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