Kela retrospectively reimburses the costs of non-urgent medical care obtained in another EU/EEA country or Switzerland to patients who obtain such medical care, provided that Finland is responsible for the patient’s medical care costs.
Patients who have paid the costs of medical care obtained abroad themselves may apply for reimbursement retrospectively using the form SV 128. Reimbursement must be applied for within six months of the expense incurred.
- A patient who does not want to pay the medical care costs himself/herself may apply for advance authorisation from Kela using the form SV 129. If the patient is granted advance authorisation, he/she must pay the local client fee for the treatment.
- A treatment provider may also send patients abroad to obtain medical care by purchasing it as an outsourced service.
Kela does not reimburse patients who wish to receive medical treatment abroad for medical care obtained outside the EU/EEA or Switzerland. Kela only reimburses medical care obtained outside the EU when patients are forced to seek treatment due to illness, pregnancy or birth during a temporary residence abroad.
The patient must investigate the available care abroad himself/herself
Patients who seek medical care abroad must primarily investigate independently what kind of care is available and how to obtain it. The patients are also responsible for having any documents translated and delivered to the treatment provider.
A public health care unit may also recommend that a patient seek medical care at a specific treatment facility abroad. In such cases, the patient must be instructed to apply for advance authorisation from Kela using the form SV 129. Public health care may also directly contact Kela’s Centre for International Affairs. Before travelling abroad to obtain treatment, a patient must determine with the foreign treatment provider whether it may receive an advance authorisation issued by Kela (S2).
Each EU country has a contact point for cross-border health care, which provides information about the country’s health services and how to seek treatment there. Country-specific information about health services is also available on this website.
Advance authorisation equals commitment to pay
Finnish residents have the right to receive advance authorisation for treatment given in an EU/EEA country or Switzerland if their need for treatment is medically justified and it is not possible to provide the necessary treatment in Finland’s public health care within a medically justified amount of time. Another precondition is that the treatment that is obtained abroad must be included in the Finnish health care service range.
- An advance authorisation is a commitment to pay; it is the basis according to which the costs incurred by the treatment are reimbursed to the country which provided the treatment.
- Kela administers reimbursements for treatment provided between countries based on advance authorisation.
- The costs of treatment provided based on advance authorisation is always ultimately the responsibility of the patient’s municipality of residence or hospital district’s joint municipal authority, which Kela invoices.
- Advance authorisation can be applied for from Kela with the form SV 129. The authorisation is granted with the form S2. The authorisation may also be applied for retrospectively.
There is no obligation to grant advance authorisation if the treatment in question is not part of the Finnish health care service range or if the treatment can be provided in Finland within a medically justified amount of time. Even if the preconditions for granting authorisation are not met, the authorisation may also be granted at special discretion for linguistic or cultural reasons, for example.
Kela always requests a statement from the public health care of the patient’s municipality of residence for advance authorisation applications. Based on the statement, Kela issues the patient a negative or positive decision. The public health care statement binds Kela’s decision.
Advance authorisation applications are processed by Kela’s Centre for International Affairs. You may contact Kela’s Centre for International Affairs if you have questions about advance authorisation or the statement for the advance authorisation application.
Outsourced service from abroad
If necessary, public health care may outsource the medical care needed by a patient from abroad.
- Only a treatment provider may direct a patient to outsourced treatment.
- The organiser of the outsourced service is responsible for the costs of the examination, medical care and possible rehabilitation and for the practical arrangements.
- Medical care obtained as an outsourced service must meet all the requirements that would be required if public health care provided the equivalent service itself.
When medical care is obtained abroad as an outsourced service, patients pay the client fee of their municipality of residence for the medical care. Kela may reimburse patients for travel costs to the treatment facility retrospectively. Reimbursement may be applied for from Kela using the form SV 128 within six months of the expense.