EU legislation and international conventions on social security affect which country is responsible for a person’s treatment costs. In Finland, Kela determines which country covers the costs of a patient’s treatment.
The treatment costs can be charged between countries retroactively. Kela manages the charging and payment of costs between countries and reimburses municipalities and joint municipalities for public health care treatment costs through state compensations.
- Example 1. Niilo lives in Finland and travels to Estonia for work. Estonia covers the costs Niilo’s medical treatment. Since Niilo lives in Finland, his municipality of residence is in Finland. Niilo is treated in the same way as any other residents of Finland but Kela reimburses the costs of Niilo’s treatment to the municipality of residence or joint municipal authority. In addition to this, Kela invoices the treatment costs from Estonia.
- Example 2. Mert lives in Estonia and works as a bus driver in the Helsinki Metropolitan Area in Finland. The local registry office will not record a Finnish municipality of residence for Mert as his home is in Estonia and he lives in Helsinki in a dwelling provided by his employer. However, Mert is covered by employment pension and health insurance in Finland and he has a Kela Card. Finland covers the costs Niilo’s medical treatment. Mert can access all public health care services in Finland and receive reimbursements from Kela for the costs of private health care. In addition to this, Finland pays compensation to Estonia if Mert uses health care services in Estonia.
If a person coming to Finland from abroad suffers a traffic accident in Finland or the need for treatment is due to an occupational accident in Finland or an occupational disease that occurred under a Finnish employer, the insurance company should primarily reimburse the costs of treatment. The matter should be clarified with the insurance company, the Finnish Motor Insurers’ Centre (LVK) or Workers Comensation Center (TVK).
Payments charged from the patient
The client fee for municipal residents is charged from people coming from abroad if a Finnish municipality of residence for them has been entered in the Population Information System or if they present an appropriate certificate of right to treatment to the treatment provider. The case can be one of the following:
- A person from an EU or EEC country or Switzerland is staying in Finland temporarily, requires medically necessary treatment and demonstrates his/her right to it with a European Health Insurance Card granted by another country.
- Nordic residents can demonstrate their right to treatment with a passport or personal identification.
- Australian residents can demonstrate their right to treatment with an Australian passport.
- A person who is working in Finland but does not have a municipality of residence in the country demonstrates his/her right with a certificate of entitlement to medical care in Finland granted by Kela.
- The person has prior authorisation (form S2) from another EU or EEC country or Switzerland for treatment to be provided in Finland.
Those who do not have a certificate of right to treatment must primarily obtain the certificate themselves from their health insurance institution. If necessary, Kela’s Centre for International Affairs can look into the right to treatment of persons coming to Finland for treatment from abroad.
The actual costs of treatment can be charged persons coming from abroad in the following cases:
- They do not present a valid certificate of right to treatment for the treatment.
- They have received emergency treatment and have come to Finland from a country other than an EU or EEC country, Switzerland or Australia.
- They have come to Finland for the express purpose of seeking treatment or accessing other health care services.
Kela pays state compensation for the treatment costs of persons coming from abroad
In some cases, Kela pays state compensation for a patient’s treatment costs to municipalities or joint municipal authorities providing public health care services .