If customers want to seek treatment abroad, they must independently investigate what kind of care is available in the target country and what the seeking of treatment requires in practice. The customers are also responsible for having their patient documents translated and delivered to the treatment provider.
Country-specific information about health services helps customers choose the place of treatment.
More detailed information on seeking treatment abroad can be found on Kela’s website.
Seeking treatment with or without prior authorisation
Finnish residents have the right to receive prior authorisation, i.e. a payment commitment, 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. If the patient is granted prior authorisation, they must only pay the local client fee for the treatment.
Customers can apply for prior authorisation from Kela. Kela always requests a statement from public health care for advance authorisation applications. For a patient living in Helsinki, for example, the statement is requested from HUS. Based on the statement, Kela issues the patient a negative or positive decision. The public health care statement binds Kela’s decision. Further information on seeking treatment abroad and the statements of public healthcare can be found on Kela’s website.
A public health care unit may also recommend that a patient seek medical care at a specific treatment facility abroad. Public health care may submit a statement to Kela regarding prior authorisation without the customer applying for an authorisation from Kela.
Before travelling abroad to obtain treatment, a patient must determine with the foreign treatment provider whether it may receive a prior authorisation issued by Kela. Prior authorisation may also be applied for retrospectively.
If a customer wants to seek treatment without prior authorisation, Kela may reimburse the costs of non-emergency treatment given in an EU or EEA country or in Switzerland. The preconditions for reimbursement are that Finland is responsible for the patient’s medical care costs and the treatment is eligible for compensation in Finland as well. The patient can apply for reimbursement from Kela later on. Reimbursement is paid in accordance with the Health Insurance Act and Kela’s tariffs for reimbursement (in Finnish). Reimbursement must be applied for within six months of the expense incurred.
Seeking treatment abroad as an outsourcing service
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 can be applied for from Kela within six months of the expense incurred.