Health claim notice

Guidance for health insurance claim

To receive medical care, you can contact an ERGO medical partner or another medical institution or professionally qualified provider of your choice.

If you have concluded your health insurance, then you can find our health insurance partners here.

If your employer has concluded your health insurance, then you can find our health insurance partners here.

When contacting an ERGO medical partner

When contacting other medical institutions that are not ERGO partners

  1. Choose the appropriate doctor.
  2. When booking your appointment, tell the medical institution that you have ERGO health insurance.
  3. ERGO pays the cost of the treatment covered by the insurance contract directly to the medical institution.
  4. You will have to pay the deductible stated in the insurance contract and the part exceeding the compensation limit, based on an invoice provided by ERGO or the medical institution. You can find information on the amount of the deductible and compensation limit in the ERGO Estonia mobile app.
  5. You do not have to submit an application for compensation to ERGO.
  1. Pay the entire treatment invoice yourself first.
  2. Then submit to ERGO the application for compensation and the additional documents required for compensation*.
  3. You can submit your application for compensation through the ERGO Estonia mobile app or the ERGO website.
  4. ERGO will notify you of any clarifications or missing documents by email.
  5. ERGO will take a decision on compensation within 10 working days of receiving the necessary documents.

*Examples of additional documents needed for a decision on compensation:

Paid visit to a family physician or specialist

  • Invoice for treatment provided

Tests, diagnostics, procedures, and analyses

  • Extract from the medical history of the person treated
  • Invoice for treatment provided


  • Copy of the vaccination card or the corresponding entry in the Patient Portal
  • Invoice for treatment provided

Dental treatment

  • Invoice containing a list of dental services provided


  • Extract from the Patient Portal or the occupational health doctor’s decision on the need for rehabilitation treatment
  • Invoice issued in the name of the person who received the treatment, which includes a description of the service

Glasses or lenses

  • Documentary evidence of change in visual acuity, prescription
  • Invoice for glasses or lenses


  • Invoice containing a description of the treatment provided

Hospital treatment

  • Coordinate the cost of planned hospital treatment with ERGO beforehand
  • Extract from the Patient Portal or medical record
  • Invoice for hospital treatment in the name of the person treated


  • Copy of the prescription
  • Proof of purchase of the medication

You can find most of the required additional documents at and

If you have any questions, please contact ERGO:

ERGO mobile app is the simplest and quickest way to apply for health insurance compensation.

To submit the claim notice take a photo of the medical service invoice with your smartphone and fill in the amount and description fields in the mobile app. 

You can download the mobile app on the Apple Store or Google Play.

See ERGO mobile app usage guide >

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