Take these things into account when seeking access to healthcare services abroad

You hear from a friend that they have visited an Estonian clinic to have their teeth taken care of and have then received retrospective reimbursement from Kela for the treatment. You become interested in that clinic yourself – the place seems to offer good care and at the same time you could visit Tallinn, a city where you have not been for a long while. But what things should you take into account before going abroad? How can you ensure that you will get reimbursement from Kela? What if you need follow-up treatment or something goes wrong?

What is “seeking treatment”?

Seeking treatment means that you intentionally travel to another country to use healthcare services. You are free to seek treatment within the EU and receive reimbursement for treatment according to certain criteria. However, if you fall ill in the middle of a holiday, for example, you access treatment with your European Health Insurance Card. This is not seen as seeking treatment.

You can arrange your treatment directly with the clinic or hospital where you want to be treated. Ask them about the treatment price list, practical arrangements and schedules.

How much can you be reimbursed?

Kela reimburses the costs of treatment given in another EU or EEA country, Switzerland and the United Kingdom up to what similar treatment would have cost in your wellbeing services county in Finland. However, you always have to pay the client fee that the healthcare system would have charged you in Finland. In general, Kela will reimburse your treatment if the following conditions are met:

• treatment is part of the range of public healthcare services provided in Finland
• you would have been entitled to similar treatment in Finland
• you apply for reimbursement within 6 months of receiving treatment
• if the treatment would have required a referral in Finland, you have such a referral.

You can find out the amount of reimbursement in advance by requesting a prior information notification from Kela. In practice, this means that you present Kela with a plan for your treatment, after which Kela will ask your wellbeing services county what kind of reimbursements you can receive for the treatment. If the treatment ultimately takes place as you have indicated in advance, you will receive reimbursement accordingly.

For treatment, it is also possible to apply for prior authorisation from Kela (form S2), in which case you only need to pay the local client fee, and there is no need to apply for reimbursement afterwards.

Ensure that your patient data is transferred

You may be wondering how to view treatment information after the fact. Will the information become available in the MyKanta service as usual?

At the moment, you are responsible for ensuring that your patient information is transferred between countries. Request information about the treatment you have received from the clinic and deliver it to public healthcare in Finland so it can be recorded in the relevant systems. When you do this, doctors treating you in the future will be able to see what kinds of procedures you have undergone in another country.

There is also the possibility that the clinic based abroad will need your patient records written in Finland for your treatment. If you need a referral for treatment, you must deliver it yourself. In general, referrals written within the EU should be valid in different countries. You are responsible for the translation of any necessary patient information.

How do I ensure safety?

Safety is also a concern when travelling outside Finland to use healthcare services. It is therefore important that you ascertain in advance that the clinic you have chosen has the appropriate licences and provides reliable services.

If a treatment injury occurs abroad, the related complaints or claims must be handled in that country, as Finnish patient insurance does not cover treatment provided abroad. Each EU country has its own contact point for cross-border healthcare, where you can inquire about the country’s practices regarding patient safety.

Receiving follow-up treatment in Finland

If you need follow-up treatment in Finland, you can receive it as usual in the public healthcare of your wellbeing services county. Access to further treatment is not restricted by the fact that you were originally treated abroad. However, the possible need for further treatment should be investigated well in advance and agreed with healthcare.