Estonia has taken the unusual step of making PrEP reimbursable through Haigekassa (the Estonian Health Insurance Fund) for people in defined risk groups — which includes gay and bisexual men with multiple partners. The prescription copay is minimal (around €2.50), making this one of the most affordable PrEP access routes in Europe.
The Short Version
- PrEP is available and reimbursed for gay and bisexual men in risk groups
- You need to see an infektsionist (infectious disease doctor) — not your GP
- The main PrEP clinic is at Lääne-Tallinna Keskhaigla (Paldiski mnt 62, Tallinn)
- Prescription copay: approximately €2.50 per pack
- Quarterly follow-up required (HIV test, STI screening, kidney function)
- Prescriptions are digital — pick up at any Estonian pharmacy
Step 1: Book With an Infektsionist
An infektsionist (infectious disease doctor) is the specialist who manages PrEP in Estonia. Your GP cannot prescribe PrEP directly — you need a referral or direct booking with an infektsionist.
Primary PrEP clinic:
Lääne-Tallinna Keskhaigla — Nakkuskliinik Paldiski mnt 62, 10617 Tallinn ltkh.ee | Phone: +372 651 2000
Book via the Patient Portal (digilugu.ee) or by phone. You can request an appointment with an infektsionist directly — a GP referral is helpful but not always strictly required for PrEP initiation.
Tartu: Tartu University Hospital Infectious Disease Department (Kliinikumi tee 6) also initiates PrEP — contact them directly for current waiting times.
Step 2: The Initial Appointment
At your first appointment, the infektsionist will:
- Confirm your HIV-negative status (rapid or lab test)
- Take a baseline STI screen (syphilis, gonorrhoea, chlamydia, hepatitis B/C)
- Check kidney function (creatinine) — tenofovir can affect kidneys
- Discuss daily vs event-based PrEP dosing
- Write your first digital prescription
What to say:
"Soovin alustada PrEP-i. Olen mees, kellel on seks meestega." ("I want to start PrEP. I am a man who has sex with men.")
Step 3: Quarterly Monitoring
Every three months you must attend for:
- HIV antigen/antibody test (4th generation)
- STI checks — syphilis, gonorrhoea, chlamydia (ideally throat, rectal, and urethral)
- Hepatitis B/C (periodically)
- Kidney function (creatinine)
- Prescription renewal
These monitoring appointments are covered by Haigekassa.
Medication and Prescriptions
Estonia prescribes generic tenofovir disoproxil fumarate / emtricitabine (TDF/FTC) — the same active ingredients as Truvada but at generic cost. The Haigekassa reimbursement means your copay is approximately €2.50 per monthly pack.
Prescriptions in Estonia are digital — they appear in your Digilugu (digital health record) and can be dispensed at any Apteek (pharmacy) in Estonia. Show your ID card or Mobile-ID; no paper required.
If You're Visiting Estonia
If you're visiting from another EU country:
- Your EHIC covers emergency medical treatment but not routine PrEP provision
- You can access PrEP as a self-paying patient — the medication cost without Haigekassa reimbursement is approximately €50–80/month for generic TDF/FTC
- Speak to the infektsionist at Lääne-Tallinna Keskhaigla about your options
Haigekassa Registration
To benefit from reimbursed PrEP, you must be registered with Haigekassa. Most Estonian residents (employees, students, pensioners) are automatically enrolled. Check your coverage at eelisravijärjekord.ee or by calling Haigekassa on +372 669 6630.
If you are not registered (e.g., self-employed without registration), you may need to enrol or pay privately for PrEP.