Reimbursement of costs

Will I be reimbursed for treatment costs if I fall ill while travelling abroad?

By presenting the European Health Insurance Card in an EU or EEA country, the United Kingdom, Northern Ireland or Switzerland, you will receive medically necessary treatment at the same price as local residents. If you do not have the European Health Insurance Card or the treatment provider does not accept it, you can claim treatment cost reimbursement from Kela afterwards or from the health insurance institution of the country that provided the treatment.

Costs incurred by treatment required in a country other than an EU or EEA country, Switzerland, the United Kingdom or Northern Ireland will not be reimbursed. It is recommended that you take out personal travel insurance.

Can I receive reimbursement for treatment costs if I seek treatment abroad independently?

Yes. You can claim reimbursement from Kela if you seek treatment independently in an EU or EEA country, Switzerland, the United Kingdom or Northern Ireland. Kela will reimburse costs as if you had received treatment in a similar situation in your own wellbeing services county. However, you must always pay the client fee yourself. Apply for reimbursement within six months of paying for the treatment.

You can also apply for a prior authorisation pursuant to the relevant EU regulation from Kela for treatment provided abroad. In this case, you will pay the same amount for the treatment as local residents.

If you seek treatment in a country other than an EU or EEA country, Switzerland, the United Kingdom or Northern Ireland, you cannot receive Kela reimbursements for the treatment costs.

Can I find out the amount of reimbursement in advance?

You can ask Kela in advance what kind of reimbursement you can receive for treatment provided abroad. Apply for prior notification in good time before seeking treatment, as Kela requests the necessary information from the public health care of your wellbeing services county.

For the application concerning the prior notification, you will need from the doctor providing the treatment abroad an account of the treatment to be provided, an estimate of the costs of the treatment as well as a referral, if one would be required for accessing similar treatment in Finland. Kela will reimburse the costs of treatment in the manner indicated in the prior notification, if the treatment has been implemented in accordance with the information you have provided.

Can I receive Kela reimbursement for any treatment provided abroad?

No. Kela can only reimburse treatment provided in another EU or EEA country, Switzerland, the United Kingdom or Northern Ireland. Another prerequisite for reimbursement is that the treatment is medically necessary and is included in the range of services provided by public health care in Finland.

However, if you are seeking treatment abroad with a prior authorisation pursuant to the relevant EU regulation, you can only obtain a prior authorisation for treatment included in the public health care services in Finland. Therefore, you cannot obtain prior authorisation for treatment that is not available in Finland. An exception to this is rare diseases, for which prior authorisation can be granted in some cases.

Why do I have to pay the costs myself first when I seek treatment in an EU country?

If you seek treatment abroad without prior authorisation, you will be reimbursed based on the actual costs of the treatment. The practice is based on the EU Patient Directive.

If you seek treatment with prior authorisation, you will pay the local client fee for the treatment. The country that provided the treatment invoices Finland for the rest of the treatment costs.