The prior authorisation must be form E 112 or S2. Other prior authorisations are not accepted in Finnish public health care for the Kela reimbursement of treatment costs.
Those with prior authorisation (form E 112 or S2) from another EU or EEC country or Switzerland pay the same client fee for Finnish public health care as municipal residents.
Prior authorisation is a payment commitment between countries. which is based on EU decrees issued on the coordination of social security systems. What it means is that the party granting the authorisation undertakes to reimburse the costs of treatment to the country that provides the treatment. Kela takes part in the invoicing and reimbursement of the costs.
- Public health care providers can apply for reimbursement for treatment provided under prior authorisation from Kela. The reimbursement must be applied on form Y 31 within 12 months of the end of the month during which the costs were incurred. A copy of the prior authorisation (form E 112 or S2) must be appended to the application.
- Kela will charge the costs from the country that granted the prior authorisation.
Patients who seek treatment in Finland under prior authorisation are treated in public health care according to the same treatment practices and time limits as Finnish residents.
Kela only reimburses to public health care treatment costs with prior authorisation
In Finland, prior authorisation (form E 112 or S2) granted by another country does not ensure Kela’s involvement in cost management in anything other than public health care.
Kela will not reimburse costs if the patient has been treated in private health care under the prior authorisation unless the treatment in question constitutes services purchased by public health care. However, the private treatment provider and the party granting the authorisation can make a mutual agreement on the invoicing and payment of the costs.
Patients are entitled to Kela reimbursements for medical treatment retroactively
Persons who have been granted prior authorisation for treatment in Finland and who have received treatment in Finnish private health care can receive reimbursements for private medical treatment from Kela retroactively. Based on private authorisation, the service provider cannot compensate the costs directly.
Reimbursement for treatment costs can be applied for from Kela on form SV 127 within six months of incurring the costs. A copy of the prior authorisation must be appended to the application. Reimbursements for medical costs and travel costs are applied for on form SV 178 and form SV 4, respectively
It may also be more affordable for a patient to apply for cost compensation directly from his/her own health insurance institution. The person should find out where he/she should apply for compensation.
Finnish public and private health care providers are obliged to accept patients seeking treatment from another EU country in the same way as Finnish residents. Persons who come to Finland for treatment from an EEC country or Switzerland and have prior authorisation (form E 112 or S2), can be admitted for treatment if the provider has available capacity.