Kela: Now possible to get higher reimbursement for medical treatment abroad


The amendments to the Act on Cross-Border Healthcare entered into force retroactively. It is possible to claim reimbursement for costs incurred when seeking treatment on one’s own initiative in an EU or EEA country, Switzerland, the United Kingdom or Northern Ireland 1 January 2023 or later. Reimbursement is paid at the most to the amount that corresponding treatment would have cost in Finland in the customer’s wellbeing services county.

Contrary to what has been reported in this article, prior authorisation under the directive will not be introduced from 2024, as there are currently no measures in the service choices in health care that would qualify for it. For more information, see the Kela press release.

Customers can seek treatment in another EU or EEA country, Switzerland, the United Kingdom or Northern Ireland and receive reimbursement from Kela for the costs for the treatment. You can seek treatment on your own initiative or request a prior authorisation to seek treatment from Kela.

The Act on Cross-Border Healthcare was amended 1 May 2023. Going forward, the way Kela reimburses costs for seeking medical treatment abroad without prior authorisation will change, so that the maximum amount reimbursed is the equivalent of the costs for the corresponding treatment in the customer’s own wellbeing services county in Finland. Kela requests the necessary information from the healthcare provider of the customer’s wellbeing services county. In some cases, the change can mean that the reimbursement paid by Kela will increase. The amendments entered into force retroactively on 1 January 2023, which means that reimbursement can be claimed for costs incurred 1 January 2023 or later.

The treatment must correspond to the treatment in Finland

When customers seek treatment in another EU or EEA country, Switzerland, the United Kingdom or Northern Ireland on their own initiative, they should themselves find a suitable place of treatment and check their possibilities of obtaining treatment there.

One prerequisite for reimbursement is that the treatment is deemed medically necessary. The treatment must also correspond to the treatment that the customer would have received in the Finnish public healthcare system. In addition, a referral is needed, if a referral would be needed for corresponding treatment in Finland.

Customers must first pay the costs for the treatment themselves and claim reimbursement afterwards within 6 months of paying the costs for the treatment.

Reimbursement is claimed on the form Medical care expenses incurred abroad SV 128e (pdf).

Customers can ask for advance information on the amount of reimbursement

Customers can ask Kela to give them advance information on whether Kela will provide reimbursement for their treatment abroad and to what amount. This is called an advance notice. If the treatment abroad corresponds with the customer’s claim, Kela will pay the reimbursement as stated in the advance notice.

An advance notice is requested on form Prior information notice of reimbursement for medical care abroad (pdf).

From the beginning of 2024 reimbursement may require prior authorisation

As a consequence of the legislative amendment, a new prior authorisation will be introduced in early 2024 in accordance with the Directive on Patients’ Rights.

In some cases, prior authorisation will be required for Kela to reimburse costs of treatment abroad. Prior authorisation will be mandatory for example in the case of treatment that involves a particular element of risk and requires an overnight stay at a hospital.

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Seeking treatment abroad

Source: Kela