I want to go abroad for treatment

EU and EEA countries are not required to provide the following healthcare services to people arriving from abroad:

• long-term care and other services intended to support a person in carrying out routine daily activities
• organ transplants
• vaccines and vaccination programmes.

The criteria for granting prior authorisation are laid down in EU Regulation 883/2004.

When deciding whether to grant prior authorisation, your state of health and the likely course of your illness are taken into account.

Kela will always grant prior authorisation if the following conditions are met:

• your need for treatment is medically justified,
• you would be entitled to the treatment in question within Finland’s public healthcare system and
• Finland’s public healthcare system cannot arrange the treatment for you within the statutory time limit for access to care.

Prior authorisation may be refused if

• the treatment is not arranged or provided within Finland’s public healthcare system or
• Finland’s public healthcare system can arrange the treatment in question or equivalent treatment within the statutory time limit for access to care.

At Kela, applications concerning international situations, such as prior authorisation, generally take longer to process than other applications.

Check the processing time for prior authorisation on Kela’s website.

Kela reimburses travel costs from Finland to the healthcare facility if you have prior authorisation for the treatment.

• You generally have to pay only the co-payment yourself.
• Kela always reimburses travel costs based on the least expensive means of transport.
• You can also receive reimbursement from Kela for accommodation costs related to the treatment.
• You can also receive reimbursement for the costs of an accompanying person if healthcare professionals assess that you need someone to accompany you on the journey.
• Claim reimbursement afterwards, no later than six months after payment.

Apply to Kela for reimbursement of travel costs

Kela reimburses the cost of treatment provided in EU and EEA countries, Switzerland and the United Kingdom. Kela reimburses costs up to the amount that equivalent treatment would have cost in your wellbeing services county in Finland.

You must always pay the client fee that public healthcare would have charged you in Finland.

In general, you can receive reimbursement from Kela if the following conditions are met:

• the treatment is included in the service choices of Finland’s public healthcare system,
• you would also have been entitled to equivalent treatment in Finland,
• you claim reimbursement within six months of receiving the treatment and
• if the treatment would have required a referral in Finland, you have a referral.

If you wish, you can find out the amount of reimbursement in advance by requesting a prior information notice from Kela.

• In the prior information notice, Kela determines whether you can receive reimbursement for treatment provided abroad and how much the reimbursement would be.
• Before travelling abroad for treatment on your own initiative, you can request a prior information notice from Kela.
• Request a prior information notice well in advance of your trip.

In practice, requesting a prior information notice means that you submit a treatment plan to Kela. Kela will then ask your wellbeing services county what reimbursement you could receive for the treatment.

If the treatment is ultimately provided as you stated in advance, you will receive reimbursement in accordance with the prior information notice.

Yes, you can. When travelling to an EU or EEA country, Switzerland or the United Kingdom for pregnancy care or childbirth,

• find a suitable healthcare provider and agree on the arrangements for the treatment or childbirth with the provider.
• You must pay the treatment costs yourself, after which you can claim reimbursement from Kela.
• You can also apply for prior authorisation to receive the treatment. In that case, you only pay the local client fee.

If you travel to any other country to give birth, you must pay all the costs yourself and cannot receive reimbursement from Kela.

Yes. You are free to travel to EU and EEA countries, Switzerland and the United Kingdom for treatment.

Kela reimburses treatment costs up to the amount that equivalent treatment would have cost in your wellbeing services county in Finland.

In other countries, your right to treatment is determined by the legislation of the destination country and you will usually have to pay the treatment costs yourself.

The cost of treatment abroad varies from country to country.

Healthcare providers are free to set their own prices. However, the prices must not discriminate between the permanent residents of the country and patients who arrive from other EU countries seeking treatment.

The treatment provider must give you an estimate of the cost of the planned treatment, as well as a clear invoice and payment receipt that you can use to claim reimbursement for the cost of your treatment afterwards.

A foreign treatment provider may require you to pay in advance or make a deposit before providing treatment.

No, you cannot. Kela reimburses treatment costs only if

• the treatment is provided in another EU or EEA country, Switzerland or the United Kingdom,
• the treatment is medically necessary and
• the treatment is included in the services provided by Finland’s public healthcare system.

You can apply for prior authorisation for treatment under the EU Regulation, which in practice is a guarantee of payment.

• You can only be granted prior authorisation for treatment that is included in the services provided by Finland’s public healthcare system.
• This means you cannot be granted prior authorisation for treatment that is not available in Finland.
• An exception is made for rare diseases, for which prior authorisation may be granted in some cases.

As a rule, you are responsible for finding out what treatment options are available in the country where you wish to receive treatment.

You can find links to websites with information on healthcare services and their prices in different countries in the Country-specific information on health services section of our website.

Each EU country also has a Contact Point for Cross-Border Healthcare, which you can ask about healthcare services in that country.

Ask the hospital or healthcare provider where you would like to receive treatment about prices in advance.

Not without a valid reason.

The admission of patients coming from another EU country can be restricted if, for example, it would compromise the availability of treatment to domestic patients.

For example, if the number of patients coming from abroad exceeds a hospital’s capacity to treat patients without compromising care for local patients, the hospital may refuse to accept patients from abroad. The hospital must report any such restrictions.

Check for any restrictions with the contact point for cross-border healthcare for the country in question.

Waiting times for treatment vary from country to country. Ask the Contact Point for Cross-Border Healthcare in your destination country about waiting times. You can also ask the healthcare provider directly how long you will have to wait for treatment.

At Kela, applications concerning international situations generally take longer to process than other applications.

Check the processing times for claims on Kela’s website.

Yes. You can receive reimbursement from Kela for medicines.

If you travel for treatment without prior authorisation, you must first pay for the medicines yourself. You can subsequently apply to Kela for reimbursement of the cost of the medicines. The reimbursement can be no more than the amount you would receive for an equivalent medicine in Finland.

If you travel abroad for treatment with prior authorisation, you do not usually have to pay for medicines included in your treatment.

Yes. You may receive reimbursement from Kela if you travel to another EU or EEA country, Switzerland or the United Kingdom for treatment.

When travelling for medical treatment without prior authorisation

• Kela reimburses travel costs in the same way as if you had travelled within Finland to the nearest healthcare facility where you would have received the necessary treatment.
• Thus, you cannot receive reimbursement for travel costs up to the destination country but only to the nearest place of treatment in Finland.
• You will only be reimbursed for travel costs that exceed the excess.

When travelling for medical treatment with prior authorisation

• Kela will reimburse travel costs up to the place of treatment in the destination country.
• You will be reimbursed for travel costs that exceed the excess.

Apply for travel reimbursement within 6 months of paying for the treatment.

Kela may reimburse you for overnight accommodation, but only if you have prior authorisation from Kela.

• You may be reimbursed for overnight accommodation if it is necessary for the purposes of your treatment.
• No reimbursement is paid for overnight hospital stays.
• You may also receive reimbursement for the costs of an accompanying person if the healthcare system considers their presence necessary.

You may be entitled to reimbursement from Kela for the travel costs of an accompanying person if the healthcare system considers it necessary for you to have an accompanying person.

You will receive follow-up treatment in Finland in the usual way. This means that if you have received treatment abroad, you do not also need to receive follow-up treatment abroad.

• If you need follow-up treatment in Finland, contact your local health centre. The doctor treating you will assess your need for treatment and you will receive treatment accordingly.
• Treatment is always provided in accordance with Finnish practices. The treatment provided in Finland may differ from the follow-up care recommendations you received abroad.

Yes. If you are dissatisfied with Kela’s decision regarding reimbursement for treatment received abroad, you can appeal against the decision.

You can lodge an appeal with the Administrative Court if Kela considers that it cannot revise its decision as you have requested. Decisions of the Administrative Court can be appealed to the Supreme Administrative Court if the Supreme Administrative Court grants leave to appeal. The Supreme Administrative Court’s decision is final and cannot be appealed.

You can appeal directly to the Social Security Appeal Board if your appeal concerns the reimbursement of travel, accommodation and medicine costs. You can appeal against the decision of the Social Security Appeal Board to the Insurance Court, which is the highest appellate instance.

Further information on the appeal process is available on the Kela website.

Check with the treatment provider in advance to find out in which languages you can receive treatment.

Countries are obliged to provide treatment in their official languages, but you can ask if the treatment personnel can speak another language with you.

Yes. Before travelling, find out whether you can receive rehabilitation by contacting your insurer or Kela. Rehabilitation abroad may differ from what you would receive in Finland.

A certificate of entitlement to medical care is a card or document that proves your right to receive treatment abroad in the country’s public healthcare system for the local client fee.

A certificate of entitlement to medical care may, for example, be a European Health Insurance Card, prior authorisation or an S form based on residence.

In the Nordic countries, you can also prove your entitlement to medical care by presenting your passport or official identity card, provided you give your current address in Finland.

Without a certificate of entitlement, you will usually have to pay all the costs of treatment yourself.

People have many reasons to seek treatment abroad,

such as lower costs or shorter waiting times. Treatment for some rare diseases may be concentrated in specific countries. Some people may want to be treated at a specific hospital or by a specific doctor. Many also have family, language or cultural ties to other countries.

If you travel abroad for treatment, you can apply for prior authorisation for the treatment.

• Prior authorisation is a guarantee of payment under which your wellbeing services county pays part of your treatment costs.
• You can apply for prior authorisation under the EU Regulation (form S2) for treatment provided in an EU or EEA country, Switzerland or the United Kingdom.
• If you are granted prior authorisation, you pay the same amount for the treatment as local residents do. Your wellbeing services county pays the remaining treatment costs.
• Agree on practical arrangements with the healthcare provider and check in advance that it accepts the prior authorisation.

Apply to Kela for prior authorisation.

• Attach documentation concerning your treatment, such as a doctor’s statement, to the application.
• Kela requests a statement on your situation from the public healthcare system and grants prior authorisation if the healthcare services in your wellbeing services county support the application.

At present, only prior authorisation under the EU Regulation is used in Finland.

Yes, you can. Find a suitable healthcare provider and check whether it accepts prior authorisation (form S2).

Prior authorisation is usually accepted only by public healthcare providers or by providers that have an agreement with the public healthcare system.

Kela grants prior authorisation for a specific treatment in a specific country. Prior authorisation also has a time limit within which you must travel for treatment.

The public healthcare services of your wellbeing services county will assess your application for prior authorisation.

Prior authorisation must be granted if

• the treatment is justified in your case,
• the treatment you are seeking is included in the services provided by Finland’s public healthcare system and
• you cannot be provided with the treatment in Finland within the statutory time limit for access to care.

In some cases, prior authorisation may be granted, for example, on linguistic or cultural grounds even if the treatment is also available in Finland.

An application for prior authorisation may be rejected if

• in your case, the treatment is not medically justified,
• the treatment is no included in the services provided by Finland’s public healthcare system; or
• your treatment could be arranged in Finland within the statutory time limit for access to care.

That said, prior authorisation may be granted based on, for example, language or cultural criteria, even if the treatment is also available in Finland.

Public healthcare in your wellbeing services county will evaluate your particular case.

• Kela grants or refuses prior authorisations according to the statement by public healthcare.
• Kela cannot refuse your application for prior authorisation the public healthcare services recommend that it be granted.

Yes. You can also apply for prior authorisation retrospectively if you have paid the full cost of your treatment abroad yourself. You can obtain prior authorisation retrospectively if it would have been granted to you before you travelled for treatment.

Apply to Kela for prior authorisation within 6 months of paying for the treatment.

You cannot apply for prior authorisation if you have suddenly fallen ill whilst abroad and have therefore received treatment abroad.

Yes. If you are dissatisfied with Kela’s decision, you can appeal against it.

You can lodge an appeal with the Administrative Court if Kela considers that it cannot revise its decision as you have requested. Decisions of the Administrative Court can be appealed to the Supreme Administrative Court if the Supreme Administrative Court grants leave to appeal. The Supreme Administrative Court’s decision is final and cannot be appealed.

You can lodge an appeal with the Social Security Appeal Board if you have received treatment under a prior authorisation and are dissatisfied with Kela’s decision regarding the reimbursement of travel, accommodation and medicine costs. You can appeal against the decision of the Social Security Appeal Board to the Insurance Court, which is the highest appellate instance.

Further information on the appeal process is available on the Kela website.

Yes, you can.

You can claim reimbursement from Kela if you travel for treatment on your own initiative to an EU or EEA country, Switzerland or the United Kingdom.

• Kela reimburses treatment costs based on what equivalent treatment would have cost in your wellbeing services county in Finland.
• You must always pay the client fee yourself, i.e. the amount that Finland’s public healthcare system would have charged you for the treatment.
• Claim reimbursement from Kela within six months of paying for the treatment.

You can also apply to Kela for prior authorisation under the EU Regulation for treatment provided abroad. If you are granted prior authorisation, you pay the same amount for the treatment as local residents do.

You cannot receive reimbursement from Kela if you travel for treatment to a country other than an EU or EEA country, Switzerland or the United Kingdom.

If you are granted prior authorisation, you only have to pay the local client fee for the treatment. The country where you received the treatment invoices Finland for the rest of the treatment costs.

If you do not have prior authorisation for treatment abroad, you will have to pay the costs of the treatment yourself first. You can be reimbursed for your treatment up to the amount that the treatment would have cost in your wellbeing services county in Finland.  The practice is based on the EU Patients’ Rights Directive.

If you wish, you can ask Kela in advance what reimbursement you could receive for treatment provided abroad. This is called a prior information notice.

Request a prior information notice well in advance of travelling for treatment, as Kela will ask your wellbeing services county what reimbursement you could receive for the treatment.

For a prior information notice, you will need:

• a statement from the doctor providing treatment abroad describing the treatment planned for you,
• an estimate of the treatment costs and
• a referral, if one is required for equivalent treatment in Finland. The referral can be issued in Finland or abroad.

Kela will reimburse treatment costs as stated in the prior information notice if the treatment is provided in accordance with the information you submitted.