- •§ 1. Scope of application of Act
- •§ 2. Definition, principles and form of health insurance
- •§ 3. Insurer
- •§ 4. Health promotion
- •§ 5. Insured person
- •§ 6. Duration of insurance cover of employees and public servants
- •§ 7. Duration of insurance cover of persons for whom social tax is paid by state or local government
- •§ 8. Duration of insurance cover of members of management or controlling bodies of legal persons
- •§ 9. Duration of insurance cover of persons receiving remuneration or service fees on basis of contract under law of obligations
- •§ 91. Duration of insurance cover of persons receiving unemployment insurance benefit
- •§ 10. Duration of insurance cover of sole proprietors entered in register
- •§ 11. Duration of insurance cover of persons considered equal to insured persons
- •§ 12. Specifications concerning duration of insurance cover of persons considered equal to insured persons
- •§ 13. Submission of documents and information
- •§ 14. Liability of persons obligated to submit documents
- •§ 15. Health insurance database
- •§ 16. Chief processor and authorised processor of health insurance database
- •§ 17. Information to be entered in health insurance database
- •§ 18. Right to collect information
- •§ 19. Entries in health insurance database
- •§ 20. Statutes for maintenance of health insurance database
- •§ 21. Proof of insurance cover
- •§ 22. Persons considered equal to insured persons on basis of contract
- •§ 23. Application of Acts
- •§ 24. Conditions under which person is considered equal to insured persons on basis of contract
- •§ 25. Definition and types of health insurance benefit
- •§ 26. Right of recourse of health insurance fund
- •§ 27. Territorial effect of health insurance benefits
- •16.12.04 Entered into force 1.01.05 - rt I 2004, 89, 614
- •§ 28. Restrictions on receipt of health insurance benefits
- •§ 29. Scope of insurance cover
- •§ 30. List of health services of health insurance fund
- •§ 31. Amendment of list of health services
- •§ 32. Payment to health care providers
- •§ 33. Dental care benefit for insured person under 19 years of age
- •§ 34. Disease prevention
- •§ 35. Contract for financing medical treatment
- •§ 36. Entry into contract for financing medical treatment
- •§ 37. Conditions of contract for financing medical treatment
- •§ 38. Waiting list
- •§ 39. Assumption of obligations
- •§ 40. Right to second opinion
- •§ 41. Scope of insurance cover in case of benefits for medicinal products
- •§ 42. Reference price, price agreement, basic rate of cost-sharing and maximum rate of benefit for medicinal products
- •§ 43. List of medicinal products
- •§ 44. Discount rates for medicinal products
- •§ 45. Entry into price agreement
- •§ 46. Assumption of obligations to pay for the sale of medicinal products
- •§ 47. Supplementary benefit for medicinal products.
- •§ 48. Scope of insurance cover in case of benefits for medical devices
- •§ 481. Amendment of list of medical devices
- •§ 49. Assumption of obligation to pay for medical devices and contracts with sellers
- •§ 50. Definition and types of benefit for temporary incapacity for work
- •§ 51. Insured event of temporary incapacity for work
- •§ 52. Certificate of incapacity for work
- •§ 53. Procedure for grant and payment of benefit for temporary incapacity for work
- •§ 54. Size of benefit for temporary incapacity for work
- •§ 55. Calculation of average income per calendar day
- •§ 56. Right to receive benefit for temporary incapacity for work
- •17.12.08 Entered into force 1.07.09 - rt I 2009, 5, 35
- •§ 57. Period of time serving as basis for calculation of sickness benefit
- •§ 58. Period of time serving as basis for calculation of maternity benefit or adoption benefit
- •§ 59. Period of time serving as basis for calculation of care benefit
- •§ 60. Restriction on right to receive benefit for temporary incapacity for work
- •§ 61. Prohibition on permitting insured person who is temporarily incapacitated for work to assume employment or service
- •§ 62. Rights of health insurance fund upon payment of benefit for temporary incapacity for work
- •§ 63. Adult dental care benefit
- •§ 64. (Repealed - 16.12.04 entered into force 1.01.05 - rt I 2004, 89, 614)
- •§ 65. Documents necessary for receipt of adult dental care benefit
- •§ 66. Connection between adult dental care benefit and specific period of time
- •§ 67. Additional fee and prohibition on extension of additional fee
- •§ 68. Obligation to provide health service in standard conditions of accommodation
- •§ 69. Fee for home visit
- •§ 70. Visit fee and additional cost-sharing upon payment for out-patient specialised medical care
- •§ 72. Maximum rate of visit fee and in-patient fee
- •§ 73. Fee for issue of documents
- •§ 74. Repeal of Republic of Estonia Health Insurance Act
- •§ 75. Amendment of Republic of Estonia Employment Contracts Act
- •§ 76. Amendment of Wages Act
- •§ 77. Amendment of Public Service Act
- •§ 78. Amendment of Medicinal Products Act
- •§ 79. Amendment of Mental Health Act
- •§ 80. Amendment of State Fees Act
- •§ 81. Amendment of Income Tax Act
- •§ 82. Amendment of Estonian Health Insurance Fund Act
- •§ 83. Amendment of Social Tax Act
- •§ 84. Amendment of Holidays Act
- •§ 85. Amendment of State Liability Act
- •§ 86. Amendment of Health Services Organisation Act
- •§ 87. Amendment of Value Added Tax Act
- •§ 88. Calculation of average income per calendar day until entry into force of § 55 of this Act
- •§ 89. Transitional provisions
- •§ 90. Entry into force of Act
§ 91. Duration of insurance cover of persons receiving unemployment insurance benefit
(1) The insurance cover of a person specified in clause 5 (2) 6) of this Act commences as of the making of an entry on commencement of the insurance cover in the health insurance database. The documents necessary for the person to be entered in the health insurance database shall be submitted to the health insurance fund by the Estonian Unemployment Fund.
(2) The insurance cover of a person specified in clause 5 (2) 6) of this Act terminates two months after termination of the obligation of the Estonian Unemployment Fund to pay social tax for the person. The Estonian Unemployment Fund is required to notify the health insurance fund of termination of the obligation to pay social tax within ten calendar days.
(28.06.2004 entered into force 01.08.2004 - RT I 2004, 56, 400)
§ 10. Duration of insurance cover of sole proprietors entered in register
(15.12.2005 entered into force 1.01.2006, 1.04.2006 - RT I 2005, 71, 546)
(1) The insurance cover of a person specified in subsection 5 (3) of this Act commences upon expiry of a waiting period of fourteen days calculated as of the entry on the commercial register or the register of taxable persons. The documents necessary for the person to be entered in the health insurance database shall be submitted to the health insurance fund by the registrar of the central database of the registration departments of county courts or the Tax and Customs Board within seven calendar days after the entry in the commercial register or the register of taxable persons.
(11.12.08 entered into force 1.01.09 - RT I 2008, 60, 331)
(2) If the data necessary for an entry on commencement of the insurance cover of a person to be made in the health insurance database are submitted to the health insurance fund during the period of validity of the insurance cover of the person, the insurance cover continues on the new basis without interruption. (15.12.2005 entered into force 1.04.2006 - RT I 2005, 71, 546)
(3) The insurance cover of a person specified in subsection 5 (3) of this Act terminates two months after making of the deletion entry in the commercial register or register of taxable persons. The registrar of the central database of the registration departments of county courts or the Tax and Customs Board are required to inform the health insurance fund of the termination of the activities of a person specified in subsection 5 (3) of this Act within ten calendar days after making the deletion entry.
(11.12.08 entered into force 1.01.09 - RT I 2008, 60, 331)
(4) The insurance cover suspends two months after the entry in the commercial register or register of taxable persons of the suspension of the activities, including seasonal activities of a person specified in subsection 5 (3) of this Act. The registrar of the central database of the registration departments of county courts or the Tax and Customs Board are required to inform the health insurance fund of the termination of the operation of an enterprise or the professional activities of a person within ten calendar days after making the entry on suspension of activities in the commercial register or register of taxable persons.
(11.12.08 entered into force 1.01.09 - RT I 2008, 60, 331)
(41) The insurance cover suspends two months after the local Tax Board Office of the residence or place of business is notified of suspension of engagement in business. A person is required to submit the notice on suspension of his or her engagement in business concurrently to the health insurance fund.
(28.06.2004 entered into force 01.08.2004 - RT I 2004, 56, 400)
(42) If, after the suspension, the local Tax Board Office of the residence or place of business is notified of the continuation of engagement in business, a person is required to notify the health insurance fund concurrently of the continuation. Upon submission of the notice on expiry of a period of suspension of engagement in business to the health insurance fund, insurance cover resumes without a waiting period.
(28.06.2004 entered into force 01.08.2004 - RT I 2004, 56, 400)
(43) The provisions of subsection (41) of this section do not apply in the event of suspension of engagement in business for a period during which the insured person is entitled to receive benefit for temporary incapacity for work.
(28.06.2004 entered into force 01.08.2004 - RT I 2004, 56, 400)
(5) If a person continues to engage in business after such suspension, the Tax and Customs Board is required to submit the data on the termination of the suspension of engagement of business to the health insurance fund within ten calendar days. Upon receipt of the data, the insurance cover resumes without a waiting period. (15.12.2005 entered into force 1.04.2006 - RT I 2005, 71, 546)
(6) The provisions of subsection (4) of this section do not apply in the event of suspension of engagement in business for a period during which the insured person is entitled to receive benefit for temporary incapacity for work.
(15.12.2005 entered into force 1.04.2006 - RT I 2005, 71, 546)