Health is the greatest asset of every person. With If’s Health Insurance, you can help maintain and promote your employees’ health, thus caring for their overall well-being.
Health insurance is an investment that helps reduce time lost due to illness and avoid additional costs or decreased revenue caused by employees being ill. Our health insurance allows you to truly care for your most valuable resource – your people.
With employer-provided health insurance, medical care is more quickly accessible, and preventive health checks allow health issues to be detected early. This enables timely intervention and helps avoid serious complications and costly treatments.
Illness of an employee causes additional costs for the employer. Although the Health Insurance Fund covers part of the sick leave expenses, the employer still has to pay for several days of absence, while the work remains undone or needs to be reorganised. Labour costs also remain during the absence of an employee.
Indirect costs must also be considered – reduced productivity, missed deadlines, and sometimes temporary substitution of employees. Such hidden costs can exceed the labour costs while the employee of on sick leave.
For example, if an employee with a net salary of €1,500 is absent for 10 days, the employer’s expenses can already amount to €300–400. Yet this equals the average annual premium for one employee’s health insurance.
Health insurance helps to manage these risks. If preventive checks and medical care are more quickly accessible, recovery can begin sooner, reducing the time on sick leave. As a result, the employer’s financial burden decreases – while you take good care of your company’s most valuable resource: your people.
Tax incentive for promoting employee health
Did you know that an employer can invest up to €400 per year (€100 per quarter) per employee in promoting health without additional tax costs? The tax incentive applies provided that health insurance is offered to all company employees.
Which healthcare expenses are covered by health insurance?
When concluding health insurance, you can choose the particular insurance covers that your company needs most.
Available health insurance covers
The costs related to the following healthcare services are reimbursed: Family doctor or specialist consultations, including remote consultations (e-consultations) and home visits; doctor-prescribed diagnostic examinations (including laboratory, X-ray, and ultrasound examinations), procedures and analyses (including blood tests); appointments with ophthalmic nurses or optometrists (including eye examinations, vision tests, ophthalmoscopy); doctor-prescribed nursing care, e.g., post-traumatic or post-surgical wound dressing changes provided at a healthcare facility or at home; medical pedicure and podiatry services; laser procedures for removal of skin lesions when medically indicated; prescribed allergen-specific or oncological immunotherapy; emergency medical care (including in private medical facilities): immediate assistance at the scene of an accident or at home, and medical transport in life-threatening conditions; special medical transport or ambulance transport to the nearest healthcare facility or between facilities when necessary for treatment. Day treatment: doctor-prescribed outpatient healthcare service, which may include minor outpatient surgeries (e.g. draining abscesses, suturing wounds, stopping bleeding), short-term monitoring of the patient’s health condition after which the patient leaves the health facility on the same day. Pregnancy monitoring. In addition, health insurance fully covers e-Doctor telemedicine services.
Reimbursable costs of statutory occupational health checks required by law.
Reimbursable costs for preventive healthcare services requested by the insured, i.e., without a medical indication or doctor’s referral, including: preventive medicine physician’s consultation; issuance of medical certificates, e.g. for driving licence, firearm licence, or food handler’s health certificate; health check packages (including doctor’s consultation); full-body health checks; laboratory test packages and other examinations; sports medicine specialist consultations and sports-related examinations, including exercise stress tests; comprehensive allergen panel tests; antibody tests; food intolerance tests; genetic tests; tests for sexually transmitted diseases.
Reimbursable costs related to consultations and examinations (including tests) by the following specialists: mental health nurse; psychologist; psychiatrist; psychotherapist (including family or couple therapy); addiction specialist (narcologist); sleep specialist; nutrition therapist (including conditions related to obesity and overweight).
The costs related to the following healthcare services are reimbursed: Family doctor or specialist consultations, including remote consultations (e-consultations) and home visits; doctor-prescribed diagnostic examinations (including laboratory, X-ray, and ultrasound examinations), procedures and analyses (including blood tests); appointments with ophthalmic nurses or optometrists (including eye examinations, vision tests, ophthalmoscopy); doctor-prescribed nursing care, e.g., post-traumatic or post-surgical wound dressing changes provided at a healthcare facility or at home; medical pedicure and podiatry services; laser procedures for removal of skin lesions when medically indicated; prescribed allergen-specific or oncological immunotherapy; emergency medical care (including in private medical facilities): immediate assistance at the scene of an accident or at home, and medical transport in life-threatening conditions; special medical transport or ambulance transport to the nearest healthcare facility or between facilities when necessary for treatment. Day treatment: doctor-prescribed outpatient healthcare service, which may include minor outpatient surgeries (e.g. draining abscesses, suturing wounds, stopping bleeding), short-term monitoring of the patient’s health condition after which the patient leaves the health facility on the same day. Pregnancy monitoring. In addition, health insurance fully covers e-Doctor telemedicine services.
Reimbursable costs of medically indicated inpatient treatment, provided that the insured person stays overnight in hospital. For example: consultations, diagnostic tests, surgical treatment, intensive care; planned and emergency operations (including those related to oncological diseases); costs of medicines and aids prescribed and used in hospital; daily hospital charges and private room services. Inpatient treatment must be pre-approved by If.
Costs of vaccines, vaccination fees, and vaccination certificates are reimbursed.
Costs of medicines prescribed by a doctor and registered in the European Union Register of Medicinal Products, as well as medicines prepared in a pharmacy based on a prescription are reimbursed.
Reimbursable costs: prescription medicines prescribed by a doctor and registered in the European Union Register of Medicinal Products:; medicines prepared in a pharmacy based on a prescription; over-the-counter medicines (non-prescription medicines); vitamins and food supplements registered in the European Union Register of Medicinal Products and purchased from a pharmacy.
Reimbursable costs of the following dental services: dental hygiene services (including soda cleaning, pearl cleaning, and tartar removal); consultations; dental treatment, including caries treatment, root canal treatment, periodontology, orthodontics, prosthetics, crowns, dental implants (including porcelain), and aftercare of prostheses, crowns, and implants; restoration of a tooth with a laboratory-made ceramic or metal filling (e.g. inlay, onlay, or overlay); placement of veneers and aligners; injections required for treatment; X-rays; tooth extraction and anaesthesia; oral surgery, including surgical treatment of teeth and jaws or jaw-related diseases and related services.
Reimbursable dental services related to treatment of gum and tooth damage caused by an unexpected and sudden accident (e.g. domestic accident, facial impact, fall): dentist’s consultation; treatment plan preparation; dental treatment (including tooth extraction); dental hygiene services (including soda cleaning, pearl cleaning, and tartar removal); oral surgery; X-rays; anaesthesia; orthodontic services; prosthetics; crowns; implants; tooth restoration with a laboratory-made ceramic or metal filling (e.g. inlay, onlay, or overlay); porcelain implants. If does not reimburse dental services that are not related to trauma.
Reimbursable costs: cost of purchasing glasses or contact lenses prescribed by a doctor or optometrist, as well as costs of repairing glasses or replacing lenses. The costs of purchasing glasses or contact lenses are reimbursed only if the purchase is made from an optical shop or pharmacy registered in Estonia, Latvia, or Lithuania.
Reimbursable healthcare costs related to doctor-prescribed rehabilitation after illness or injury, provided that the insured person was treated in a hospital inpatient department and rehabilitation started within 90 days after discharge. Accommodation and catering costs related to rehabilitation are also reimbursed if included on the hospital’s invoice for rehabilitation services. Only one insured event per insurance period is reimbursed under this insurance cover. Inpatient rehabilitation must be pre-approved by If.
Reimbursable medical service costs related to childbirth, including: caesarean section and pain relief during childbirth for the insured mother; comfort services for the insured mother and the insured parent of the newborn (e.g., family room). To receive compensation, a healthcare cost document and the child’s birth certificate must be submitted.
Reimbursable healthcare costs: cost of leg vein surgeries and related hospitalisation, sclerotherapy, and doctor-prescribed compression stockings and socks. Vein treatment and sclerotherapy must be pre-approved by If.
A critical illness is a sudden and unforeseen serious illness of the insured person that occurs for the first time during the insurance period. In the event of a critical illness, the insurer pays compensation as a one-off payment up to the insured sum specified in the policy, according to If’s critical illness insurance terms and conditions.
Reimbursable healthcare costs without a doctor’s referral: outpatient rehabilitation services (physiotherapy, therapeutic massage as manual therapy, classical, sports and general massage including wellness massage, vacuum massage, cryomassage, lymphatic massage, prostate and gynaecological massage, therapeutic exercise, therapeutic swimming, speech therapy, and myofunctional therapy); health capsule services; medical or orthopaedic aids used for trauma or rehabilitation (e.g. orthoses, crutches, wheelchair, orthopaedic shoes, insoles, support belts, prostheses, etc.). Mental health consultations and examinations by the following specialists: mental health nurse, psychologist, psychiatrist, psychotherapist (including family or couple therapy), addiction specialist, sleep specialist, nutrition therapist (including conditions related to obesity and overweight). Homeopathy consultations and homeopathic preparations received at healthcare facilities; acupuncture provided in healthcare facilities; trichologist consultation and procedures; immunotherapy.
Each insurance contract includes specific insurance terms that we rely on when indemnifying damages when an insurance event occurs. Please always review the insurance terms and conditions for coverage, exclusions, and insured events.
Health Insurance Terms and Conditions for Employers (ENG) THE-20231 (for policies issued before 01.10.2025)
Health Insurance Term and Conditions for Private Customers (ENG) THE-ER-20231 (for policies issued before 01.10.2025)
General insurance conditions TG-20211 (for policies issued till 13.05.2025)
Health Insurance Product Information Document (EST) - 2023/01
Health Insurance Terms and Conditions for Employers (EST) - THE-20221 (for policies issued till 07.11.2023)
Health Insurance Product Information Document 2020/01 (for policies issued till 07.11.2023)
How If supports you
For the employer: good to know
We inform insured persons of policy becoming effective
We send an SMS to all employees (including those who join the company after the start of the insurance period) and share information about the insurance period and digital solutions.
We guide employees on how to use the insurance
We provide your employees with all the necessary information about the insurance conditions and the claims indemnification process.
Research on how satisfied employees are with the insurance
Upon request, we conduct a survey among employees to learn how satisfied they are with the current insurance covers and services, and whether there is anything that could be improved.
Updating the list of insured employees is easy
No excessive bureaucracy – simply fill in the policy amendment form with the data that needs updating, and we will make the changes in the list within 2 working days.
Updating the list of insured persons automatically
You can reduce administrative work by allowing us to update the list of insured employees automatically via the employment register of the Estonian Tax and Customs Board.
Overview of insurance usage
For companies with more than 50 employees, we can prepare an overview of the use of healthcare services of the insurance and how it has supported the employees.
Good to know: for the insured
How to use health insurance benefits?
e-Doctor – online doctor consultations
If your health concerns do not require a physical visit, the e-Doctor service included in If health insurance is a convenient option to consult with a doctor online, receive health advice, and extend prescriptions. The e-Doctor service is provided by Meliva Digital Clinic, which is open:
Mon–Fri 8:00–20:00
Weekends and public holidays 9:00–16:00
The consultation fee is €19.90, and it is fully covered by your health insurance policy.
Health insurance and employer’s medical insurance – what is the difference?
Health insurance and employer’s medical insurance are two names for the same insurance product: in both cases, it is voluntary insurance provided by the employer, supplementing national health insurance, which:
enables the employee to access a specialist doctor more quickly, thus reducing absences from work – an important issue for employees in terms of both health and morale;
helps cover the costs of health checks so that possible illnesses can be detected quickly;
demonstrates the employer’s care for employees and their health.
How is the insurance premium calculated if the number of insured persons changes during the insurance period?
Health insurance premiums are calculated on a monthly basis. This means that if changes are made to the list of insured employees at any time during the current month, the full monthly premium must be paid.
For example: if a new employee joins the company on 10 September and you add them to the list of insured persons on 15 September, we will calculate the premium for the entire month of September.
What is the insurance sum for employees who joined the group during the insurance period and obtained insurance later?
If new employees have joined your company during the insurance period and you add them to the list of insured persons, their insurance limits will be the same as those of their colleagues for all insurance covers. The insurance sum is not tied to the number of months worked, but applies for the entire insurance period.