Estonian Health Insurance Fund: Access to specialist treatments in Lasnamae resumed

TALLINN – The Estonian Health Insurance Fund will continue cooperation with the private health service provider AS Medicum in the Tallinn borough of Lasnamae in the new contract period, while as a result of a procurement, admissions will increase to certain specialist doctors and decrease to others.

As a result of a procurement for specialized care, the management of the Health Insurance Fund decided that admissions to Medicum's cardiologists and psychiatrists will increase and decrease to the following specialties: lung diseases, dermatology, orthopedics, urology, gynecology and gastroenterology, spokespeople for the Health Insurance Fund told BNS on Tuesday.

Admissions to neurology will continue in the same volume as before. Medicum will be providing some new services -- ambulatory rehabilitation and day care in gynecology. Some services, which were awarded the contract by the Health Insurance Fund, are already available to patients. Other services are on hold until the end of challenge period.

Maivi Parv, member of the management board of the Health Insurance Fund, said that admissions to specialist doctors will continue in the Lasnamae borough with the support of the Health Insurance Fund's contracts. "There is no cause for alarm, access to medical aid in Medicum will continue to be provided. There is only one specialty in Medicum which is not funded by the Health Insurance Fund but there are alternative options for patients," Parv said.

During the new contract period, admissions to ear, nose and throat specialists are no longer available at Medicum, the service is instead provided by the North Estonia Medical Center (PERH), East Tallinn Central Hospital (ITK) and West Tallinn Central Hospital (LTK). Currently, negotiations between PERH and Medicum are ongoing with the purpose of making PERH's treatment of ear, nose and throat disorders available at Medicum. Thus, patients could still have access to the service in the same building.

Medicum also submitted its offers for the public procurement of specialized care for the specialties of endocrinology, ophthalmology and general surgery, but were not awarded the contracts. It is important to note that Medicum did not provide services regarding these types of treatment on the basis of the contracts of the Health Insurance Fund for the last four years either, Parv said.

Regardless of the fact that procurements for specialized care by the Health Insurance Fund will continue, all patients already in line as of Sept. 30 will be admitted and can finish their treatment with their doctor.

The procurement for specialized care excludes services by hospitals and general practitioners, which can be accessed by patients the same way as before.