If you do not have a municipality of residence in Finland, public health care may, under some circumstances, collect your treatment costs from Kela, but you are ultimately in charge of your own treatment costs.
However, non-residents may not be charged for vaccinations included in the national vaccination programme provided for in the Communicable Diseases Act, general voluntary vaccinations decided by the Government, or compulsory vaccinations provided for by a Government decree.
In addition, no fee may be charged for examinations done to prevent the spread of a generally hazardous communicable disease and for emergency treatment referred to in Section 50 of the Health Care Act, as well as for medicines prescribed for the treatment of a generally hazardous communicable disease, or for the examination, treatment and medication prescribed for the treatment of a pregnant HIV-positive person.
The actual costs of providing the service are substantially higher than the client fee you pay.
Client fee for residents of a municipality
If you have a municipality of residence in Finland, you can use all public health care services. The client fee charged for treatment is the same for all residents regardless of their citizenship or the country from which they arrived in Finland.
You will usually receive an invoice for the client fees to your home address. Alternatively, you can receive an invoice for the client fee at the place of treatment. In some public health care units, you can pay the client fee directly in cash or with a debit card.
As a rule, health care client fees are fixed. The client fee for public health care will not vary according to the actual cost of the health care service that you use or the treatment that you receive.
Client fees vary slightly from municipality to municipality, but the maximum fees are as follows (2022–2023):
- Consultations with a doctor: The maximum one-time fee is EUR 20.90. A health centre may charge the fee up to three times per calendar year. Alternatively, an annual fee of up to EUR 41.80 per calendar year may be charged.
- Basic fee per dental care visit (on top of the basic fee, there are separate procedure fees for dental treatments and examinations):
- up to EUR 10.30 for treatment provided by an oral hygienist
- up to EUR 13.30 for treatment provided by a dentist
- up to EUR 19.50 for treatment provided by a specialist dentist
- Outpatient clinic fee: EUR 41.80 per visit
- Daily hospital charge: EUR 49.60 per day
- Day surgery procedure: EUR 136.90
- Daily psychiatric hospital charge: EUR 22.80 per day
- Serial therapy: EUR 11.60 per visit (serial therapy includes, e.g. continuous dialysis, radiotherapy or cytostatic therapy and medical rehabilitation)
Public health care can invoice an appointment that has been reserved but not used.
Free public health care services
Legislation defines free public health care services for which a client fee will not be charged.
The client fee is not collected for, e.g. the following primary health care services:
- Health examinations and health advice
- Outpatient care services and oral health care services for persons under the age of 18
- Nurse’s consultations in primary health care
- Mental health work performed in non-institutional health care in primary health care
- Medical certificates or statements related to the treatment or rehabilitation of the client
- Birth control advice and other services promoting sexual health
- Maternity and child health clinic visits
- School and student health care for all ages
- Laboratory and X-ray examinations with a referral from public health care
- Sailor health care organised by Hamina, Helsinki, Kemi, Kotka, Oulu, Pietarsaari, Pori, Rauma, Savonlinna, Turku and Vaasa
- Mental health work performed in non-institutional health care in primary health care
- Rehabilitation counselling, examinations to determine rehabilitation needs and opportunities, adaptation training and rehabilitation guidance
- Assistive devices and their fitment, replacement and maintenance
In addition, fees may not be charged for the following services:
- Emergency medical treatment which is the responsibility of the hospital district (with the exception of medical transport)
- Screening, treatment and follow-up of pregnant substance abusers in maternity outpatient clinics targeted at them
- Services of SERI support centres for victims of sexual offences
- Treatment provided in a psychiatric outpatient unit
- Treatment and upkeep provided for respiratory arrest patients and transport related to the treatment
- Mental health work
- Guidance and advice related to factors that may protect an individual’s mental health or endanger it, as well as the necessary psychosocial support for an individual and their family
- Coordination of psychosocial support for individuals and communities in sudden, shocking situations
- Mental health services referring to research, treatment and medical rehabilitation of mental health disorders.
- Vaccinations according to the
- national vaccination programme, general voluntary vaccinations decided by the Government and mandatory vaccinations provided for by Government decree
- vaccinations for those in the target group of the vaccine in question.
- For generally hazardous communicable diseases:
- Examinations, treatment and medicines prescribed for the treatment
- Quarantine of a person found or reasonably suspected to have been exposed
- Isolation of infected patients or persons suspected to have been infected with reasonable cause
- Medicines prescribed for the treatment of patients with a controlled communicable disease and for the investigation and treatment of HIV infections, chancre, gonorrhoea and sexually transmitted chlamydia infections, as well as for the treatment and (in practice HIV) pre-exposure prophylaxis.
- Examinations and care for donors of human organs, tissues or cells
- For persons under the age of 18
- Health centre and outpatient clinic visits
- Dental care
- Hospital inpatient care and upkeep when the number of treatment days exceeds seven per calendar year
- Medical rehabilitation provided in series and hyposensitisation, speech and voice therapy, radiation therapy, cytostatic therapy and other similar therapies
- Continuous dialysis treatment
- The transport of a registered patient from a health centre or hospital to another place of treatment or home care when the transport is done using a medical transport vehicle and according to a doctor’s orders
- Treatment materials and supplies intended for the treatment of a chronic illness
There is a maximum amount for public health care client fees
There is a maximum amount (information only in Finnish) or payment ceiling for public health care client fees. After the payment ceiling has been reached, services that count towards it are free until the end of the calendar year. However, you may be charged a so-called upkeep fee for short-term institutional care or institutional services even after the payment ceiling has been reached. If you have paid more than the payment ceiling for services counting towards the ceiling during one calendar year, you are entitled to receive a refund for the payments exceeding the ceiling. As a rule, the claim for refund of overpayments must be made within the calendar year following the overrun.
The payment ceiling amount is reviewed once every two years.
The following fees do not count towards the payment ceiling:
- Medical transport fees
- Fees for doctor’s certificates
- Fees for laboratory and imaging examinations made with a referral from a private doctor
- Fees for long-term institutional care
The payment ceiling also does not apply to persons who do not have a municipality of residence in Finland. However, if you are a homeless person and are entitled to receive treatment in Finland on the basis of EU legislation or international conventions, you are covered by the payment ceiling for the payments included in the payment ceiling.
Fees charged for services used by a client under the age of 18 may be taken into account together with those of his or her guardian. In this case, the services are free of charge for persons whose payments are taken into account together.
You need to follow the amount of your client fees over the course of the calendar year. If the amount of your client fees exceeds the payment ceiling, you will receive a certificate for this from the wellbeing services county. If necessary, contact the public health care unit for more detailed guidance on matters related to the payment ceiling.
If a health care professional considers that providing treatment requires arranging interpretation, this will usually be arranged by the treatment provider. The costs of interpretation are also part of the costs of treatment and may be invoiced from your wellbeing services county or another party responsible for your costs of treatment as part of the service provision costs.