Service choices in healthcare

Service choices in healthcare refer to publicly-funded healthcare services. Service choice is applied in public healthcare, private healthcare entitling to reimbursement under the health insurance scheme, and in situations where patient seeks treatment in another EU or EEA country or in Switzerland.


As a general rule, service choices in healthcare comprise medically and dentally justified

  • disease prevention
  • examinations to detect an illness
  • treatment
  • rehabilitation

The aim is to use only examination, treatment and rehabilitation methods that are effective, reasonable in terms of cost and safe in the Finnish healthcare system. For this reason, the service choice excludes procedures that

  • involve an unreasonably high risk for the patient’s life or health

or

  • whose effect is limited or whose costs are unreasonably high in view of the health benefits to be gained and the therapeutic value.

Why is service choice provided for by law?

The background to legislation on service choice lies in the EU Directive on Patient Rights in Cross-Border Healthcare, whose provisions came into effect in Finland at the beginning of 2014. Under the Directive, a person seeking treatment in another member state is entitled to reimbursement only for examinations or treatment which is included in the choice of services provided by the Finnish healthcare system. The same service choice is applied both in the country of residence and in cross-border situations when a Finnish patients seeks treatment in another EU country or when a patient from another EU country seeks treatment in Finland.

Although the background to the legislation on service choice lies in the Directive, specification of service choice affects Finnish health services. Publicly-funded healthcare services have not previously been comprehensively specified in Finland.

Range of services determined by the Council for Choices in Health Care (COHERE Finland)

The Council for Choices in Health Care, established under the Ministry of Social Affairs and Health, determines the range choice of services in healthcare. It´s task is to

  • Issue recommendations regarding what health and medical care procedures, examinations and treatment and rehabilitation methods should be included in or excluded from the service options.
  • Monitor and evaluate the service choices in healthcare
  • Issue opinions at the request of Kela and other authorities on the application of the service options and on the principles to be used in defining them
  • Participate in public debate and cooperation with regard to the service choice
  • Monitor international development and participate in international cooperation
  • Deal with other matters designated to it by the Ministry of Social Affairs and Health.