Government backs rehabilitation reform and sends bill to parliament

The Estonian government has approved and sent to parliament a bill that would make access to rehabilitation services depend on how a person’s health affects daily life and whether they need support from several specialists, rather than on the severity of a disability or the result of a work ability assessment, ERR reported, citing the Ministry of Social Affairs.

Under the proposed system, people would no longer need to submit a separate application to the Social Insurance Board. A family doctor, specialist doctor or nurse would identify a rehabilitation need and could refer the person to the service through an electronic consultation.

A rehabilitation provider would then assess the person’s situation in greater detail. Together with the person, the rehabilitation team would set goals, prepare an action plan and determine the necessary interventions, as well as the volume and duration of the service. Progress towards the goals and the effectiveness of the assistance would be assessed regularly.

Data related to rehabilitation and a summary of the service would be entered into the health information system. This is intended to improve the flow of information and reduce the need to submit the same information repeatedly to different authorities.

Health Insurance Fund to organise service

The Social Insurance Board’s social rehabilitation service will end on September 30, 2027. From October 1, 2027, the new rehabilitation service will be organised within the healthcare system by the Health Insurance Fund.

At least one hospital named in the hospital network development plan must provide rehabilitation services in every county. The government says this will help ensure that the service is available throughout Estonia.

Other healthcare providers that meet the requirements will also be able to provide the service. Existing social rehabilitation providers can continue operating if they bring their activities into line with the new requirements, obtain the necessary healthcare service licence and sign a contract with the Health Insurance Fund. They may also provide part of the rehabilitation service as partners of a qualified Health Insurance Fund contractor.

People who have a valid decision referring them to social rehabilitation services on September 30, 2027, will automatically be issued a referral for the new rehabilitation service.

In 2025, 10,827 people received social rehabilitation services. They included 5,857 children with disabilities aged up to 15, 536 children up to 18 whom municipalities had assessed as needing assistance, 3,899 working-age people and 576 people of retirement age.

The cost of social rehabilitation services was 20.1 million euros in 2025. The already approved state budget funding for rehabilitation services is 22.3 million euros in 2027, 26.7 million euros in 2028 and 29.6 million euros in 2029. These amounts are the approved base budget for rehabilitation services, not additional costs resulting from the reform.

The service budget will be transferred from the Social Insurance Board to the Health Insurance Fund. Rehabilitation services will continue to be financed from the state budget, not from the health insurance budget.

Amendments to the Public Health Act and other legislation are scheduled to take effect on October 1, 2027. The Ministry of Social Affairs will assess the impact and effectiveness of the new rehabilitation service by 2031 at the latest.

Current system

At present, access to rehabilitation services depends not only on a person’s actual need for assistance, but also on whether they have been assigned a degree of disability, have partial or no work ability, or meet another legal condition for receiving the service.

People must undergo several assessments and submit a separate application to the Social Insurance Board to access the service. As a result, assistance may be delayed or not provided even when a person’s health condition is already making it more difficult to study, work or manage everyday life.

Similar services are currently offered in both the healthcare and social sectors.