How Much Does Occupational Health Service Cost in 2025-2026?

Why do prices vary so much?

The cost of occupational health service consists of two main components: a monthly base contract fee and the cost of health assessments. The combined total depends primarily on three factors.

The first factor is the number of employees - the more employees, the greater the volume and cost of the service, although the per-employee price often falls at larger volumes.

The second factor is the risk level of the working environment. Office work is low-risk - health assessments are needed less frequently and workplace measurements are often not required. In noisy manufacturing environments, construction, or workplaces involving exposure to chemicals, the requirements are considerably more extensive.

The third factor is the provider's pricing policy. Different providers may charge very different prices for the same content - which is why it always pays to compare at least 2-3 quotes.

Costs by company size

The actual price depends on your working environment, the number of employees, and the provider you choose. The following gives an overview of which factors shape the price in each company size category.

For an indicative figure for your company size and sector, use the TT24 cost calculator.

What does a standard package include?

Before comparing quotes, it is important to understand what "occupational health service" actually means. The content of the service varies considerably between providers.

A standard base package typically includes the following:

Risk assessment: a visit by an occupational health physician or specialist to your workplace, an evaluation of the working environment, and the preparation of a written risk assessment. With some providers this is included in the base contract; with others it is an additional service.

Organising health assessments: periodic assessments during the contract period in accordance with the frequency specified in the risk assessment. The assessment itself takes place with the doctor for the employee; the doctor then provides the employer with a fitness-for-work decision.

Advisory support: answering questions from the employer and employees by e-mail and/or telephone on working environment matters, health risks, and recommended measures.

Annual review: a summary of the risk assessment and health assessment findings for the employer - what has changed and what the physician recommends improving.

Hidden costs that do not appear in the quote

This is where many employers are caught off guard. The base package often covers only part of the actual costs.

Workplace measurements - measurements of noise, lighting, air quality, radiation, and similar factors are rarely included in the base contract and are usually charged separately. The cost of measurement depends on the number and extent of the factors being measured - ask the provider for a price list. Measurements are not required everywhere - in an office environment probably not, in a manufacturing setting probably yes.

Specialist consultations - an ophthalmologist for screen workers, an audiologist for those exposed to noise, a dermatologist for those handling chemicals. These are often outside the base contract and charged separately.

Vaccinations - tetanus, hepatitis B, and similar vaccinations may be required in certain working environments. These are usually charged separately.

Emergency consultations - if an employee develops a health problem outside the normal scheduled period, urgent advice may fall outside the contracted scope and be subject to an additional charge.

How to compare quotes

The lowest price alone is not a good reason to choose a provider. The quality of the occupational health service directly affects whether your obligations are genuinely met - not merely fulfilled on paper.

Here are five questions to ask about every quote:

1. Is the risk assessment carried out on-site? A good provider visits your workplace rather than sending a questionnaire by e-mail. Ask whether the physician comes to your office or factory.

2. How frequently are health assessments organised? The frequency should derive from the risk assessment, not be a fixed number. In lower-risk environments the interval between assessments is longer; in higher-risk environments it is shorter. The occupational health physician determines the frequency of periodic health assessments according to need, but the interval until the next assessment may not exceed three years (TTOS § 13-1 lg 8).

3. Who is your named contact? Do you have a dedicated physician to consult, or do you reach a different person each time? Continuity significantly improves the quality of service.

4. What are the contract termination terms? If the service does not meet expectations, how quickly can you exit the contract? Long notice periods are a warning sign.

5. What are the prices for additional services? Ask specifically: measurements, specialists, vaccinations - with an exact price list, not an estimate.

Tax treatment of occupational health costs

Understanding the tax treatment of occupational health costs helps with budgeting - and often it turns out that the actual net cost is lower than it initially appears.

VAT: occupational health service is treated in Estonia as a VAT-exempt medical service (Value Added Tax Act § 16(1)(1)), which means the provider does not charge VAT and the employer cannot deduct input VAT. In plain terms: the invoice shows the amount without VAT - that is the final price.

Corporate income tax: occupational health service expenditure is a deductible business expense, as it is a cost associated with fulfilling a statutory obligation. This means the expenditure reduces the company's taxable profit - so the actual net cost is lower than the gross invoice amount.

For employees: health assessments and occupational health service arranged by the employer are a tax-free benefit for the employee (Income Tax Act § 48(4)(7)). No additional burden or tax liability falls on the employee.

Summary: what to bear in mind

There are three main recommendations when choosing an occupational health service.

First: request at least 2-3 quotes and compare the content of the service, not just the price. The cheapest option is not always the worst, but a low price combined with a vague scope of service is a warning sign.

Second: always ask for a separate price list for additional services - measurements, specialist consultations, vaccinations. In the first year, these can amount to more than the initial contract fee.

Third: plan on the basis of the net cost figure - after corporate income tax deduction, the actual cost is lower than the gross amount.

Before requesting quotes, it is useful to complete the TT24 self-assessment - it gives you an overview of which services are likely to be needed in your working environment and helps you ask providers more precise questions.

Sources: the State Gazette (Riigi Teataja).