Specialist medical care
Specialist medical care is needed when your family doctor thinks your health issue needs to be checked out by someone with more specialized knowledge.
You have the right to choose a specialist and appointment time that suits you at any medical institution that has a contract with the Health Insurance Fund(Opens in new tab), regardless of your place of residence.
In most cases, you will need a referral letter to see a specialist. Without a referral, you can see an ophthalmologist, dermatologist, gynecologist, and psychiatrist.
Specialist medical care is divided into outpatient care, day care, and inpatient care:
- Outpatient care – a doctor's appointment where the doctor examines you, performs any necessary tests (blood tests, ECG, etc.), some procedures or minor surgery, and gives you further treatment instructions. You do not need to stay in the hospital.
- Day care – tests or treatment procedures (including minor surgeries), after which medical staff monitor your condition for a longer period of time on the same day. You do not stay in the hospital overnight.
- Inpatient treatment – hospital treatment. You stay in the hospital overnight or for a longer period of time.
Important to know!
The Health Insurance Fund will only pay for treatment if you have Health Insurance Fund treatment insurance and the medical institution has a contract with the Health Insurance Fund.
Only those health services that are included in the list of health services(Opens in new tab) and for which you have a medical indication will be reimbursed. The doctor decides on the indication.
Important to know!
The Health Insurance Fund will only pay for treatment if you have Health Insurance Fund treatment insurance and the medical institution has a contract with the Health Insurance Fund.
Only those health services that are included in the list of health services(Opens in new tab) and for which you have a medical indication will be reimbursed. The doctor decides on the indication.
Treatment queues
You can see a specialist based on the treatment queue. If you have a more serious health problem, you will be seen sooner.
The Health Insurance Fund and medical institutions have agreed that:
- For specialists who require a referral letter, the healthcare institution must keep appointments open for at least four months.
- For specialists who can be seen without a referral letter (dermatologists, ophthalmologists, gynecologists, psychiatrists), appointments must be open for at least three months in advance.
This helps to avoid situations where you are asked to call back later because there are no available appointments. The Health Insurance Fund regularly monitors compliance with the agreement.
How quickly you need to see a family doctor or specialist is described under waiting times for medical care.