Health care and Health insurance

Living in Europe | Health insurance, Medical care | Iceland

The Health Care System

The Social Insurance Administration (Tryggingastofnun) is a governmental service institution seeing to the payment of pension insurance and social assistance, health insurance and occupational injury insurance in accordance with the Act on Social Security. The agency works under the Ministry of welfare which is responsible for the supervision of its activities. The Directorate of Health (Landlæknisembættið) is a government agency headed by the Medical Director of Health. The Medical Director of Health (Landlæknir) is an advisory minister whom oversees all health issues and executes specific operations for the Minister of Welfare (or Health).

The main functions of the Directorate of Health are:

  • To advise the Minister of Welfare and other Government bodies, health professionals and the public on matters concerning health, disease prevention and health promotion.
  • To sponsor and organise public health initiatives.
  • To promote improvements of health care quality.
  • To supervise the health care services and health care professionals.
  • To monitor prescription medicines and promote their prudent use.
  • To collect and process data on health and health care services and promote research in that field.
  • To handle complaints from health care users.
  • To issue licences to practise to health care professionals and ensure that their education meets requirements at all times.

Health care clinics and general medical practitioners

In the health clinics there are general medical practitioners or "family doctors" that in general see to preventative medicine and medical care in cases of illness. Health clinics also see to maternity care, newborn baby and children's health services, mental health, drug prevention, sexually transmitted diseases prevention. Health clinics and their doctors give health examinations and usually have a good overview of their patient's health history. Clinics are usually the first place people call when they are sick and medical practitioners treat most of the common ailments that people face during their lifetime. Remember to request an interpreter if you need one.

How do I choose a clinic?

There are health centers in most neighborhoods and individuals are free to choose which clinic and doctor they prefer. There are certain clinics, especially in downtown Reykjavik that are currently full and are not taking any new patients. In that case individuals are free to sign up at any clinic with openings. Make sure that the family practitioner or specialist you choose is contracted with The Social Insurance Administration (Tryggingastofnun). Doctors that are not contracted with Tryggingastofnun may be more expensive and the social insurance system will not participate in any reimbursements. Those that have not yet found a clinic may call their local clinic and make an appointment for after 17:00 on the same day when patients are seen on an emergency basis or on short notice. These appointments must be made on the same day. This service is open to all regardless of availability.

For medical problems that arise after the closing time of the clinics there is a medical service called Læknavakt.

On weekends, evenings and holidays it is possible to call 1770 for medical services.

  • Open on a walk-in basis from 17:00-23:30 weekdays, and from 09:00-23:30 on weekends and holidays.
  • Telephone lines are open for advice and house call requests between 17:00-08:00 on weekdays, and is open 24 hours on weekends and holidays.
  • If your child becomes sick and you cannot get in contact with your family doctor or clinic you may call Læknavakt, or you may wish to call a pediatrician.

If you wish to call a specialist call Pediatric Services at Domus Medica at (+354) 563-1010. It is important to note that as they are specialists they are more expensive than Læknavakt. Emergency and trauma services (Slysa- og bráðamóttaka) are located at the National University Hospital (Landspítaliháskólasjúkrahús) at Fossvogur. Located in 108 Reykjavík just off Bústaðavegur. If you need immediate assistance or ambulance then call 112. Be prepared to state your name, what the problem is and your location.+

Fee for health services

The patient pays a minimum fee for the services of a general practitioner or of a specialist, outside of a hospital, while the rest is covered by insurance. This applies to most services. Old-age pensioners, invalidity pensioners and children with disabilities pay a lower fee. It is important to note that after patients have a paid over a certain amount for health services in a year they eligible for a discount.

Health insurance

Who is entitled?

Everyone who has been legally resident in Iceland for six months automatically becomes a member of the Icelandic social insurance system, regardless of nationality. This applies unless intergovernmental treaties say otherwise. Children and adolescents under the age of 18 are covered for health insurance with their parents.

How to obtain benefits

There is no public health insurance coverage for the first six months of residency if intergovernmental treaties do not apply to you. Medical assistance during this period must be paid in full by the patient.   

If you are from a country within the EEA you should bring the European Health Insurance Card (EHIC) for use in Iceland.

Periods of insurance, employment or residence in other EEA Member States are taken into account in order to fulfill the six months' qualification. These periods are confirmed on form E104. Persons transferring their residence to Iceland from another EEA Member State should obtain the E104 form confirming these insurance periods (or form E106/E109/E121, as appropriate) from the insurance institution where the person was last insured. These forms should be submitted to Icelandic Health Insurance with a registration form called Application for registration at Icelandic Health Insurance.

Benefits

The insurance contains health care that includes:

  • hospitalization
  • maternity clinics
  • hospitalization abroad
  • general medical assistance outside a hospital by the patient's physician with whom the Icelandic Health Insurance has a contract
  • all necessary examinations and treatment carried out by specialists and institutions with whom the Icelandic Health Insurance has a contract
  • medicine
  • x-ray examinations and radiation
  • per diem cash sickness benefits
  • midwife assistance in cases of birth at home
  • dental and orthodontic treatment for children, people over 66 years, and pensioners
  • transport costs and travel costs
  • nursing in the patient's home
  • aid apparatus
  • physiotherapy

A fee to be paid for each consultation and other services is fixed by regulations. The extent of patient participation in the costs of the above health care services varies according to the service in question.

General medical assistance outside a hospital

The insured individual pays a minimum fee for the services of a general practitioner or a specialist outside of a hospital, while the remaining cost  is covered by the insurance.  The fee is decided in a regulation issued by the ministry of health. This applies to most services. Old age pensioners, invalidity pensioners and children with disabilities pay a lower fee.

Discount cards

Afsláttarkort (discount cards) are available to persons who have, during one calendar year, paid a specified amount for physician and health care services. When an individual has a card the fees for health services are lower.

Hospitalization

Insured persons are entitled to free hospitalization, including maternity clinics.  Hospitalization is ensured for as long as necessary, along with medical care, required medicines and other hospital services.

Maternity care

Women with health coverage insurance in Iceland are entitled to free maternity care. Hospitalization is ensured for as long as necessary, along with medical care, required medicines and other hospital services.

Medicine

Medicine is obtained at pharmacies. A medical prescription must be presented.  Costs of medicine which the insured must of vital necessity use regularly are covered in full. With respect to other necessary pharmaceutical costs the insured pays a specified fee, from 0-100% of the cost depending on the type of medicine. The fee for each prescription that the insured is required to pay is specified in a regulation issued by the Minister.

Dental and orthodontic treatment

General dental and orthodontic treatment for persons between 18 and 66 years of age is not covered by the insurance.  However, in case of congenital defects, accidents or illness or in case of an invalidity pensioner there is a partial reimbursement of the costs.   Dental treatment provided to children and adolescents under the age of 18 is partially reimbursed by the insurance. There is also a partial reimbursement of orthodontic care for persons under age 21. Dental treatment is partially reimbursed for people over 66 years and old age or invalidity pensioners.  The reimbursement of dental costs is in accordance with a standard rate schedule issued by the ministry of health. Private dentists charge for their services according to their own fee schedules.

How to get in touch with Icelandic Health Insurance:

Our Service Centre is open Mondays-Fridays from 10:00-15:00.

Address: Vínlandsleið 16, 150 Reykjavík.

Phone: 515 0000

E-mail: sjukra@sjukra.is

 

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