Dental care benefits | Health Portal

Compensation for dental treatment applies to all persons from 19 years of age who have medical insurance.
The amount of compensation is 60 euros per calendar year (50% co-payment).
In some cases, the benefit rate is 105 euros per calendar year (the co-payment is 12.5%).
Dental care benefits can only be used at dental care institutions that have concluded an agreement with the Health Insurance Fund(Opens in new tab).
The compensation can be used in full within one calendar year. When the year changes, a new calculation begins and any unused compensation from the previous year is not carried over to the next year.
The reimbursable amount is calculated at the time of payment of the medical bill, and no application or documents need to be submitted to the Health Insurance Fund for this purpose.

Compensation for dental treatment applies to all persons from 19 years of age who have medical insurance.
The amount of compensation is 60 euros per calendar year (50% co-payment).
In some cases, the benefit rate is 105 euros per calendar year (the co-payment is 12.5%).
Dental care benefits can only be used at dental care institutions that have concluded an agreement with the Health Insurance Fund(Opens in new tab).
The compensation can be used in full within one calendar year. When the year changes, a new calculation begins and any unused compensation from the previous year is not carried over to the next year.
The reimbursable amount is calculated at the time of payment of the medical bill, and no application or documents need to be submitted to the Health Insurance Fund for this purpose.

Dentist examining a woman's teeth with a mirror

Your benefit rate will be checked on the day of receiving the service. If you are eligible for increased compensation on that day, you can use up to €105 in compensation (12.5% co-payment). If you are no longer eligible for increased compensation on that day, €60 in compensation and a 50% co-payment will apply.

Check the amount of compensation and your remaining balance before visiting the dentist. You can view this under "Dental health"(Opens in new tab)north_east(Opens in new tab) in Health Portal or the under "Dental and prosthetic services information" service on the state portal eesti.ee.

Who is eligible for higher dental care benefit?

Dentist looking at an X-ray of a patient's teeth

The following groups have the right for higher dental care benefit:

pregnant women,
mothers of children under 1 year of age,
people with partial or no working capacity,
old-age pensioners,
registered unemployed persons,
recipients of subsistence benefits (the benefit is automatically applied if you have received subsistence benefits for two months prior to receiving dental care),
people with higher need for dental care.

These individuals are eligible for a higher dental care benefit of 105 euros per calendar year (the co-payment is 12.5%).

Good to know

How is dental care compensation calculated?

If the reimbursement is €60

If your dental care bill for reimbursable services is, for example, €120, you will have to pay 50% of this yourself, i.e. €60, and the other 50% will be reimbursed by the Health Insurance Fund.

The Health Insurance Fund will not reimburse any further dental services in the same calendar year, meaning that you will have to pay the full amount of the treatment bill yourself next time.

However, if your treatment bill for reimbursable services is, for example, €100, the Health Insurance Fund will cover 50% of this, or €50, and you will pay the remaining €50. You will still have €10 left to use in that calendar year.

If the reimbursement is €60

If your dental care bill for reimbursable services is, for example, €120, you will have to pay 50% of this yourself, i.e. €60, and the other 50% will be reimbursed by the Health Insurance Fund.

The Health Insurance Fund will not reimburse any further dental services in the same calendar year, meaning that you will have to pay the full amount of the treatment bill yourself next time.

Calculation process

The dental bill is €100.

The patient pays 50% of the cost, or €50.

The remaining 50%, or €50, is paid by the Health Insurance Fund.

Remaining reimbursement for the same year: 60 – 50 = €10.

Calculation process

The dental bill is €100.

The patient pays 50% of the cost, or €50.

The remaining 50%, or €50, is paid by the Health Insurance Fund.

Remaining reimbursement for the same year: 60 – 50 = €10.

If the reimbursement is €105

If the dental care bill for reimbursable services is €120, you pay 12.5% of the cost yourself, i.e. €15, and the Health Insurance Fund reimburses €105.

The Health Insurance Fund will not reimburse any further dental services in the same calendar year, meaning that you will have to pay the full amount of the treatment bill yourself next time.

However, if the dental care bill for reimbursable services is, for example, €80, you will still pay 12.5% of this, or €10, and the Health Insurance Fund will reimburse 87.5%, or €70.

If you visit the dentist again in the same year, the Health Insurance Fund will reimburse €35 of the treatment bill, and your annual €105 reimbursement will have been used up.

If the reimbursement is €105

If the dental care bill for reimbursable services is €120, you pay 12.5% of the cost yourself, i.e. €15, and the Health Insurance Fund reimburses €105.

The Health Insurance Fund will not reimburse any further dental services in the same calendar year, meaning that you will have to pay the full amount of the treatment bill yourself next time.

However, if the dental care bill for reimbursable services is, for example, €80, you will still pay 12.5% of this, or €10, and the Health Insurance Fund will reimburse 87.5%, or €70.

If you visit the dentist again in the same year, the Health Insurance Fund will reimburse €35 of the treatment bill, and your annual €105 reimbursement will have been used up.

Calculation process

The dental bill is €80.

The patient pays 12.5% of the cost, or €10.

The Health Insurance Fund pays 87.5%, or €70.

Remaining reimbursement for the same year: €105 – €70 = €35.

Calculation process

The dental bill is €80.

The patient pays 12.5% of the cost, or €10.

The Health Insurance Fund pays 87.5%, or €70.

Remaining reimbursement for the same year: €105 – €70 = €35.

What dental services are covered by the reimbursement?

Dental care benefits cover various dental services, such as:

Initial or follow-up appointment with a dentist
Diagnostics (including X-rays)
Use of the medicine and placement of a temporary filling
Installation of permanent filling

Tooth extraction
Opening and treating an abscess
Root canal treatment
Surgical removal of tartar from under the gums
Anesthesia

Additional information and service prices can be found on the Health Insurance Fund website.

Dental benefit for pregnant women and mothers of children under one year of age

All pregnant women and mothers of children under one year of age can use dental benefit up to 105 euros per year, with the patient paying at least 12.5% of the bill themselves.

Check the amount of the benefit and your remaining balance before visiting the dentist. If the higher benefit has not been automatically activated, present your pregnancy card or corresponding certificate to the Estonian Health Insurance Fund.

All pregnant women and mothers of children under one year of age can use dental benefit up to 105 euros per year, with the patient paying at least 12.5% of the bill themselves.

Who are eligible for higher dental benefit?

The following groups have the right for higher dental care benefit:

pregnant women,
mothers of children under 1 year of age,
people with partial or no working capacity,
old-age pensioners,
registered unemployed persons,
recipients of subsistence benefits (the benefit is automatically applied if you have received subsistence benefits for two months prior to receiving dental care),
people with increased need for dental care.

The following groups have the right for higher dental care benefit:

pregnant women,
mothers of children under 1 year of age,
people with partial or no working capacity,
old-age pensioners,
registered unemployed persons,
recipients of subsistence benefits (the benefit is automatically applied if you have received subsistence benefits for two months prior to receiving dental care),
people with increased need for dental care.

Increased dental care need is a diagnosis that may accompany several other diseases or conditions:

surgical and/or radiation treatment of head and neck tumors; (in certain oncological and hematological conditions, a person has the right to apply for free dental care);
surgical treatment of cleft lip, alveolar process and cleft palate;
treatment of genetic and metabolic diseases causing malformations of dental tissues or facial and jaw bones;
surgical treatment of trauma and inflammation of the maxillofacial region;
medical procedure (endoscopy, anesthesia, etc.) during which trauma to the maxillofacial region has occurred;
transplantation or preparation for transplantation of lung, liver, heart and/or kidneys, hematopoietic stem cells;
addition to the endoprosthetics queue;
type 1 diabetes;
Sjögren's syndrome.

Increased dental care need is a diagnosis that may accompany several other diseases or conditions:

surgical and/or radiation treatment of head and neck tumors; (in certain oncological and hematological conditions, a person has the right to apply for free dental care);
surgical treatment of cleft lip, alveolar process and cleft palate;
treatment of genetic and metabolic diseases causing malformations of dental tissues or facial and jaw bones;
surgical treatment of trauma and inflammation of the maxillofacial region;
medical procedure (endoscopy, anesthesia, etc.) during which trauma to the maxillofacial region has occurred;
transplantation or preparation for transplantation of lung, liver, heart and/or kidneys, hematopoietic stem cells;
addition to the endoprosthetics queue;
type 1 diabetes;
Sjögren's syndrome.