You can be reimbursed for medicines purchased abroad in the following cases:
- you suddenly fall ill abroad
- you seek treatment in another EU or EEC country or Switzerland
- you purchase medication in another EU or EEC country or Switzerland
To receive reimbursement, your municipality of residence must be in Finland and you must have Finnish health insurance. Medicine costs incurred abroad can also be reimbursed to persons who do not live in Finland but are covered by health insurance in Finland through their work. A family member of a person working in Finland, who lives in another EU country, may also be eligible for reimbursement.
Medicines prescribed by a doctor can be reimbursed
In order to receive reimbursement, you must have purchased the medication with a prescription. In addition to this, the medicine must correspond to a product reimbursable in Finland. The equivalence is assessed based on the pharmaceutical form, active substance and potency.
The amount of the reimbursement is affected by the price and package size of the medication purchased abroad as well as the package size and price of the corresponding product approved for reimbursement in Finland, or its reference price.
- If the corresponding medicine belongs to the reference price system in Finland, the reimbursement will be based on the purchase price or the confirmed reference price for the medicine in Finland, at maximum.
- If the corresponding medicine belongs to the reference price system in Finland, the reimbursement will be based on its purchase price or, at the most, its confirmed price in Finland.
- If the medicine or active substance would not be reimbursed if purchased in Finland, corresponding medication purchased abroad will not be reimbursed either.
Special reimbursement can be paid for medication purchased abroad if you have been granted a right to special reimbursement and if a corresponding medicinal product has been approved for special reimbursement in Finland.
Medicines purchased online or by post will not be reimbursed through health insurance.
Medicines purchased in an EU or EEC country or Switzerland
If you receive medically necessary treatment in another EU or EEC country or Switzerland during your temporary stay, you should also be able to obtain medication with your European Health Insurance Card in the same way as local residents.. If you pay the medicine expenses yourself, you can apply for compensation from Kela or the health insurance institution of the country in question.
If you apply for the retroactive reimbursement of medicine purchases from Kela, you can opt to base your claim either on Finnish legislation or the reimbursement specified by the legislation in the country where the treatment was provided.
- If you select the latter, Kela will enquire about the amount of the reimbursement from the country in question.
- If you opt for the reimbursement as specified by Finnish legislation, the medication you have purchased at a pharmacy will be reimbursed in accordance with the Health Insurance Act. Medicines provided at a hospital in connection to treatment will not be reimbursed separately. They are considered to be part of the treatment costs.
If you have travelled to another EU or EEC country or Switzerland for treatment without prior authorisation (E 112 or S2) from Kela, you are liable to pay the treatment and medicine expenses in full. Retroactive reimbursement for these costs can be applied for from Kela in accordance with the Health Insurance Act. In practice, the reimbursement cannot exceed what you would get for a corresponding medicinal product in Finland.
If Kela has granted you prior authorisation (form E 112 or S2) for treatment in another EU or EEC country or Switzerland, you will normally not need to pay for medication administered in connection to your treatment.
- However, if you pay the treatment and medicine expenses yourself, Kela will reimburse no more than the cost of the corresponding treatment through the public health care system in your municipality of residence.
- If you have been granted prior authorisation and you have only paid for medicine expenses, the reimbursement based on the Health Insurance Act will cover the costs you would have incurred purchasing corresponding medicines at a pharmacy in Finland.
Medicines purchased in other countries
Kela will only reimburse medicine costs incurred outside EU and EEC countries and Switzerland if you have fallen suddenly ill or if you have been in need of treatment due to a chronic disease, pregnancy or childbirth.
Medicine expenses will not be reimbursed if you have travelled outside the EU, EEC or Switzerland for the express purpose of treatment.
Applying for reimbursement
You can apply for the reimbursement of medicine expenses incurred abroad from Kela on form SV 128. The application must be lodged within six months of incurring the costs.
Copies of the payment receipts and prescriptions and an account of the treatment provided must be appended to the application. The appendices can also be delivered through Kela’s e-Services system.