The purpose of the 24-hour general care service provided outside of home is to ensure a safe environment and coping of an adult who is temporarily or permanently unable to cope independently at home due to health reasons, functional capacity or physical and social environment. A person needs around-the-clock general care if other social services or other aids cannot ensure the person’s welfare.

The service is provided:

•  To a person whose address acciording to the population register and actual place of residence is the city of Tallinn
•  A person whose needs have been evaluated by the City of Tallinn and the city has found that the appropriate support for the person is around-the-clock general care and other aids (for example, a home care service) are not enough to ensure the person’s welfare.

The price of nursing homes providing around-the-clock general care and their service is made up of two components:

• The care component (expenses related to maintenance workers and aid workers – maintenance personnel wages, labour taxes, personal protection equipment, work clothes, health checks, education and supervision-related expenses).
• Recipient’s co-payment contribution (housing and food costs, nursing service, medications, hygiene products, care products, aids, other costs related to personnel, etc.).

Coverage by the City of Tallinn

The City of Tallinn covers care components by up to 856 euros.

The City of Tallinn helps to pay for a nursing home spot and cover monthly care service costs (care components) within the limit, i.e. up to 856 euros. This assumes that the district social worker has determined during the assessment of the need for assistance that the person has a real need for general care services, i.e. living in a nursing home.

The City of Tallinn helps citizens of Tallinn in paying the co-payment contribution.

The City of Tallinn also covers the difference between a lower income and the average retirement pension. Income includes state pension, funded pension, work ability allowance and income subject to social tax.

A person is entitled to lower income compensation if their income is lower than the average retirement pension in the second quarter of the year prior to the budget year published by Statistics Estonia and they need an additional subsidy to pay for their co-payment contribution. The average retirement pension in the second quarter of 2024 was 781.30 euros per month. If a person’s income is below 781.30 euros, then the city will provide an additional subsidy in the amount equal to the gap between their income and 781.30 euros.

Example 1: If a person is staying at a nursing home where the cost of the spot is 1639 euros, the city will cover expenses in the amount of 856 euros and the person has to cover 783 euros.

If your pension is 650 euros, then in 2025, Tallinn will cover the lower income difference in the amount of 131.3 euros per month (781.30 – 650 = 131.30). The remaining part (783 – 781.3 = 1.7 euros) of their co-payment contribution comes from the person’s own resources, or if they are lacking, the resources of their relatives.

If a person lacks the means to pay for their co-payment contribution of a nursing home cost, then according to the Family Law Act, the responsibility falls to the person required to provide maintenance.

The City of Tallinn also partially takes over co-payment obligations from people with a maintenance obligation (children and/or parents, i.e. relatives) in order to reduce their cost and care burden and to help them stay employed. Relatives are exempt from paying their co-payment contribution in the amount of 70 euros if the person’s income and average retirement pension in the second quarter of the year prior does not cover their contribution.

Example 2: If a person is staying at a nursing home where the cost of the spot is 2000 euros, the city will cover expenses in the amount of 856 euros and the person has to cover 1144 euros.

If the person’s income is lower than the average retirement pension in the second quarter of 2024 (781.30 euros), then the City will cover the gap between the lower income and the average retirement pension (example 1). In addition, the city will exempt the person required to provide maintenance from having to pay their co-payment contribution in the amount of up to 70 euros (781.30+70=851.30 euros). Therefore, the relative has to pay 292.70 euros (1144-851.30=292.70).

Coverage by the person

The recipient of general care services will pay their co-payment contribution, i.e. the housing and food costs and other costs related to the service offered by their nursing home.

If the person is not capable of paying their co-payment contribution for the general care service in full and has assets that could be realised, the person must submit a corresponding application to the Social Welfare Department of the District Government that they are registered in based on the population register. The application must explain the need for additional funding. In addition to the application, you must submit documents necessary for assessing payment ability: proof of income and assets and, if necessary, other relevant documents that are not available in national databases.

If the person owns assets that allow them to pay for the service, the city will partially cover service fees until the assets are realised but not for longer than six months.

If the person is not capable of paying the missing part and has people with a maintenance obligation, then the obligation to cover the remainder of the service fees falls on the people with the maintenance obligation.

Coverage by people with a maintenance obligation

A person (children and/or parents, henceforth family members) who is capable of fulfilling their maintenance obligation partially or in full must submit written consent on it that includes:

• the amount of co-payment;
• the obligation to pay co-payments every month until the end of service;
• the obligation to pay co-payments to a greater extent if their ability to fulfil maintenance     obligations improves;
• a declaration stating that the information provided is correct;
• consent to the processing of personal information.

If a person with a maintenance obligation is not capable of covering the missing part, the situation will be assessed by a social worker of the social welfare department and they will decide whether the family member is capable of fulfilling their maintenance obligation.

If a person cannot fulfil their maintenance obligation and cannot pay the remaining funds for their relative’s nursing home, then the person must submit an application to the Social Welfare Department to evaluate their solvency. For this, they must submit information about their assets, proof of their income in the last six months and proof of living expenses (including rent or mortgage payments, investments in ensuring their future to the same extent as before becoming subject to a maintenance obligation). As a result of the evaluation, the City may completely or partially take over financial maintenance obligations. 

A person with maintenance obligation is not obliged to cover care costs if the recipient of the service has severely violated their maintenance obligation or is guilty of committing an intentional criminal offence towards the person with a maintenance obligation or people close to them. Only a court can legally release a person from maintenance obligation.

Transport to a nursing home

Usually, the person or their relative orders transportation to a nursing home directly from a transportation company and pays for it with their own means. The local government does not pay for transportation to a nursing home if the person or their relatives have the financial means to pay for it.

The City of Tallinn will finance transportation to a nursing home if:

• the City additionally compensates for the person’s co-payment contribution;
• the evaluation of the person and their relatives determined they lack the financial means to pay for the transportation;
• the origin or the destination of the order is Harju County.

If a person or their relative applies for the City to pay for the transportation, then during the application process, the District's social worker will determine:

• whether the person has the financial means to order and pay for the necessary     transportation (including disability benefits, funds in a bank account, etc.);
• whether the person responsible for maintenance is capable of paying for the transport.

If, during the evaluation, it is determined that the person or their relative does not have the financial means to pay for the transportation or they do not have relatives or the person does have relatives but the relatives do not have the financial means to pay for the transportation, then the City of Tallinn will pay for transportation to the nursing home.

Ordering a transportation service when the City is paying for it

For the City to pay for the transportation to the nursing home, the aforementioned requirements have to be met. Ordering transportation:

• The client/relative or a hospital social worker makes an order to the Social Welfare Department by letter or phone three working days before the requested date.
• The social worker who assigns people to receive general care services at the District’s Social Welfare Department compiles the order for using transportation.
• Transportation funded by the City of Tallinn to a nursing home is provided by AndMar Medservice OÜ. The service is provided within Estonia on weekdays from 7:00-18:00.

The invoice to the Tallinn Social Welfare and Health Care Department

• The invoice is submitted by the 5th day of the month following the provided service.
• The invoice for the service must be a summary invoice that has the name of the nursing home and the requisite information;
• The invoice must be submitted via e-Financials (XML-format machine-processed invoice).