Services Funded Under the Contract with the Estonian Health Insurance Fund (Tervisekassa)

Terena has entered into a healthcare financing agreement with the Estonian Health Insurance Fund (Tervisekassa) for the following specialties:

• Gynaecology and Obstetrics (gynaecology consultations, pregnancy care, and fetal ultrasound examinations)
• Dermatovenereology (dermatology)
• Cervical Cancer Screening
• Breast Cancer Screening (screening mammography provided under a subcontracting arrangement with the North Estonia Medical Centre)

For these specialties, we provide services within the scope of our contract with Tervisekassa, in accordance with the treatment waiting list and the requirements of the Health Insurance Act. Insured patients are added to the waiting list on an equal basis. We offer the earliest available appointment or another appointment time that suits you. All appointment slots funded by Tervisekassa are available through the national Health Portal (Terviseportaal), our Self-Service Portal, and can also be booked by telephone or email. The volume of services financed by Tervisekassa is distributed evenly throughout the calendar year. 

To book an appointment for specialties covered by the Tervisekassa contract (except gynaecology and dermatovenereology), a referral, a screening invitation, or eligibility for the relevant screening programme is required. If you do not have health insurance or the required referral, you may book a self-paid appointment.

For appointments funded by Tervisekassa, a visit fee is payable. The standard Tervisekassa visit fee is €20. For preferential groups, the visit fee is €5 or €0, in accordance with the following rules.

A reduced visit fee of €5 applies if you:

• are under 19 years of age;
• are pregnant (except where outpatient care is provided in connection with pregnancy or childbirth);
• are the mother of a child under one year of age;
• are over 63 years of age;
• receive an incapacity pension or old-age pension under the State Pension Insurance Act;
• have partial or no work ability determined under the Work Ability Allowance Act;
• are registered as unemployed within the meaning of the Labour Market Measures Act;
• receive subsistence benefits or are a member of the recipient’s household under the Social Welfare Act, provided that the benefit was paid during the month in which the outpatient specialist care was provided or during either of the two preceding months.

The visit fee is not payable:

• if emergency outpatient specialist care is immediately followed by inpatient treatment;
• if outpatient treatment is provided in connection with pregnancy or childbirth;
• when a physician refers the patient to another physician of the same specialty (including referral to another healthcare provider);
• when the patient is internally referred within Terena to another physician or another healthcare professional with equivalent status;
• for repeat visits within 365 days where the physician or equivalent healthcare professional keeps the patient under continued treatment or follow-up;
• when participating in a screening programme, for all insured and uninsured women who belong to the screening target group during the relevant calendar year.

Booking an Appointment

Appointments may be booked through the national Health Portal (Terviseportaal), our Self-Service Portal, by email at info@terena.ee, or by telephone at +372 608 2218.

If you are unable to attend your appointment at the agreed time, you must notify us and cancel your appointment at least 24 hours before the scheduled time. Under the Health Insurance Act, if you fail to attend your appointment or cancel it less than 24 hours before the scheduled time, you will be required to pay a double visit fee when booking your next appointment.

Feedback

If, during your visit, you experienced anything that you believe could have been organised differently, we kindly ask you to send your written feedback to tagasiside@terena.ee.

If you would like us to investigate an issue relating to the content of your appointment, please also include your personal details so that we can review the relevant medical documentation.