1. What is the Patient Directive?

The EU Directive on Patient Rights in Cross-Border Health care reinforces the patients’ right to seek health care services in another EU country. In addition to this, the Patient Directive secures the right of a patient to receive retroactive reimbursement for treatment administered in another EU country on the same grounds as if the corresponding treatment had been provided in the patient’s home country.

The Patient Directive obliges the EU countries to accept patients coming from other EU countries in search of treatment. The EEC countries and Switzerland do not apply the Patient Directive, which means that they are not obliged to accept patients from EU countries. The Patient Directive is applied to health services regardless of how they are produced or organised.

The application area of the Patient Directive includes all types of health services, with the exception of long-term care, organ donations and transplants, and vaccinations. Furthermore, Finland does not apply the Patient Directive to occupational health care services or school and student health care services, which means that people cannot come from other countries to access these services. In addition to this, the Patient Directive does not apply to social services.

  1. Which countries can I go to for treatment and what sort of treatment can I seek?

You can freely seek treatment in any foreign country. You can also go to another country to be treated for a long-term sickness.

You can seek both basic and specialised medical care services in another EU country. Correspondingly, a person covered by the health insurance scheme in another EU country can freely come to Finland to seek treatment or utilise the public and private health care services.

If you seek treatment abroad, you must normally first pay the costs of the treatment yourself. You can apply for retroactive reimbursement from Kela. If you do not want to cover the costs yourself, you can apply for prior authorisation for treatment to be provided in another EEC country or Switzerland. The authorisation is a commitment to cover the treatment costs, which means that the patient must only pay for the possible health care client fee charged in the country where the treatment is provided. The authorisation is usually granted in exceptional situations if the treatment required by the patient cannot be arranged in Finland. Abroad, the treatment is provided and the decisions concerning the treatment are made in accordance with the legislation of each respective country. The range of health care services can vary between countries, i.e. care that is not arranged in Finland may be available abroad.

Should you decide to seek treatment abroad, it is a good idea to ensure in advance that the health care service provider has a permit for the operations.

  1. Where do I get information on treatment possibilities abroad?

As a rule of thumb, you should investigate the treatment possibilities yourself and determine how to get treatment in your desired country.

At least one contact point for cross-border health care operates in each EU country. The purpose of the contact points is to provide information on respective countries with regard to health care services, practices of seeking treatment, patient rights as well as appeal and rectification procedures. The contact points also provide general information on treatment and cost reimbursement arrangements between countries.

In each EU and EEC country and Switzerland, the authorities responsible for the statutory health insurance and the health insurance institutions are also obliged to provide patients with information on health care services in their countries.

Contact information for contact points and health insurance institutions.

  1. Can a foreign hospital refuse to accept a patient?

Service providers operating in EU countries can restrict the admission of patients seeking treatment from abroad only if this compromises the availability of treatment to the country’s own patients. Such a situation can arise if, for example, the number of patients coming from abroad exceeds the capacity of the receiving hospital to provide treatment to local residents.

Prior notification must be given on any restriction on the admission of patients coming for treatment from abroad. You check any possible restrictions with the national contact point of your country of destination.

  1. What do I do if the treatment requires more than one visit and some of the treatment is provided abroad?

If part of the treatment is provided abroad, other treatment arrangements and follow-up treatment should be agreed upon before seeking treatment abroad. If no advance agreements regarding follow-up treatment are made, you must, after returning to your home country, contact the health centre in your municipality of residence or a hospital to agree upon the follow-up treatment. In Finland, treatment is always provided in accordance with Finnish practices even if part of the treatment has been provided abroad.

  1. Can a patient be sent abroad for treatment?

If the patient consents to the arrangement, he/she can be sent abroad for treatment. However, all patients must always be treated in mutual understanding. Furthermore, patients are always entitled to decline specific treatments.

  1. Do I need a referral to seek treatment abroad?

The procedure for seeking treatment is determined in accordance with the legislation of the country providing the treatment. If a referral is needed for treatment, you are required to have one.

A doctor operating in Finland cannot write a referral directly to a health care operating unit in another country. If you seek treatment abroad, you must normally deliver the referral or doctor’s statement written in Finland, as well as any other patient documents, to the treatment provider.

  1. Where do I get information on treatment quality abroad?

The national contact point of the country providing the treatment is obliged to issue information on any requirements related to the quality of health care services in the country in question. The health care service providers, in turn, are obliged to give information on the quality of treatment in their own organisations.

The availability of information on quality varies between countries. Some countries produce a more extensive range of information than others. You can ask about the availability of information on treatment quality from the contact points of the various EU countries.

  1. When is the European Health Insurance Card required? What if I lose the card?

You need the European Health Insurance Card, if you suddenly fall ill in another EU or EEC country or Switzerland and you are staying in the country temporarily, such as on a holiday. In these cases, the European Health Insurance Card should ensure that you receive medically necessary treatment for the local client fee. The European Health Insurance Card can be used to access the statutory public health care services of another EU or EEC country or Switzerland.

You can apply for the card through Kela’s e-Services, or by calling the Kela customer service number 020 692 203 (Mon–Fri 8 am–6 pm) or on form SV 193.

If you are in treatment abroad and require a card, please contact Kela’s Centre for International Affairs at + 358 (0)20 63 40 200. The centre will provide you with a certificate that serves as a temporary substitute for the card.

  1. How many people come to Finland to seek treatment?

As of yet, information on the exact numbers is not available. The European Commission has investigated the willingness of Europeans to travel abroad to access health care services. The analyses have shown that Finns have little desire to seek treatment abroad.

The willingness to seek treatment abroad is most likely curbed by the fact that the patient must first pay the treatment and travel costs in full and apply for reimbursement retroactively. Limited language proficiency, long distances and health issues may also be factors causing the lack of interest.