Benefits provided by the Health Insurance Fund
Benefits for temporary incapacity for work is paid based on a certificate of incapacity to work to an employed insured person who, due to a temporary leave from work, loses the income subject to social security tax.
The calculation of incapacity for work benefit does not take account of doctoral student benefits, parental benefit and other benefits paid by the rural municipality, city or creative association and the social security tax paid from them.
The subcategories of temporary incapacity for work benefit are as follows:
- Sickness benefit is paid on the basis of a certificate of incapacity for work to an insured person who is on a temporary leave from work. More information on different sickness benefits can be found here.
- Carer’s allowances are paid to an insured person who is nursing a sick child or a family member. More information on benefits can be found here.
- From 01.04.2022, the maternity allowance changed to the mother's parental allowance. The compensation is paid by the Social Insurance Board.
In addition to temporary incapacity for work benefits, there are many other non-monetary benefits available.
- Dental care benefit is paid to insured adults, people with partial or no capacity for work, insured persons over the age of 63, pregnant women, mothers of children under one year of age and people with an increased need for dental care. More information on benefits can be found here.
- Denture benefit is paid to insured persons over the age of 63, people with partial or no capacity for work, old-age and incapacity pensioners, people registered as unemployed with the Unemployment Fund and those who have received subsistence benefit during the two calendar months prior receiving dental care. More information on the terms of compensation.
- Additional benefit for pharmaceuticals is granted to insured persons who pay for reimbursable prescriptions at least €100 per calendar year. Additional benefit for pharmaceuticals applies to the costs of reimbursable pharmaceuticals. Additional benefit for pharmaceuticals is granted if the conditions for receiving the benefit are met.
- Reimbursement of pharmaceuticals The EHIF reimburses to a certain extent for prescription medicines, the effectiveness of which has been previously thoroughly assessed and therefore have been included in the list of reimbursed pharmaceuticals. More information on the reimbursement of pharmaceuticals is available here.