The use of public healthcare services is subject to a customer fee, the maximum amount of which has been determined in legislation. A municipality cannot unilaterally decide to charge you fees that are higher than the maximum limits defined within legislation. If no maximum amount has been set, the fee for a service may be at most equal to the costs incurred by the provision of the service.
The customer fees are confirmed annually by the municipality or joint municipal authority that maintains the public healthcare unit in question. The municipality or joint municipal authority will decide whether the maximum fee or a lower fee is charged for the service. The municipality may also decide that a customer fee will not be charged. The municipality or joint municipal authority may decide that customer fees are not collected. The municipality or joint municipal authority may also lower the customer fee on a per-case basis or decide to not collect it when collecting the said fee would endanger the livelihood of you or your family.
There is an annual maximum amount set for customer fees from public healthcare and your deductibles for medicine purchases and medical care related travel costs.
Customer fee for residents of a municipality
When the Register Office records a place of domicile for you, you receive the right to use all public healthcare services. You will receive the services for the same customer fee as the other residents of the same municipality. The customer fee charged for treatment is the same for all residents regardless of their citizenship or the country that they arrived in Finland from.
You will usually receive an invoice for the customer fees to your home address. Alternatively, you can receive an invoice for the customer fee at the place of treatment. In some public healthcare units you can pay the customer fee directly in cash or with a debit card.
As a rule, healthcare customer fees are fixed. The customer fee for public healthcare will not vary according to the actual cost of the healthcare service that you use or the treatment that you receive.
Free healthcare services
Legislation also defines free public healthcare services for which a customer fee will not be charged.
The customer fee is not collected for the following basic healthcare services:
- Health inspections and health advisory
- Birth control advisory and other services promoting sexual health
- Maternity and child health clinic visits
- School and student healthcare
- Vaccinations that are a part of the national vaccination programme
- Laboratory and X-ray examinations with a referral from public healthcare
- Sailor healthcare organised by Hamina, Helsinki, Kemi, Kotka, Oulu, Pietarsaari, Pori, Rauma, Savonlinna, Turku and Vaasa
- Medical care services provided within basic healthcare:
- Disease research, medical or dental diagnostics, treatment, treatment supplies required for treating a chronic illness in accordance with a treatment plan and the necessary medical rehabilitation
- Preventing and curing illnesses and relieving pain
- Guidance that supports the patient’s commitment to treatment and self-care
- Early identification of health problems, treatment and guidance for follow-up treatment for patients that require special support, research and care.
- Mental health work
- Guidance and advisory related to factors that may protect an individual’s mental health or endanger it, as well as the necessary psycho-social support for an individual and their family
- Coordination of psycho-social support for individuals and communities in sudden, shocking situations
- Mental health services referring to research, treatment and medical rehabilitation of mental health disorders.
- Medical rehabilitation, including:
- Advisory and guidance related to rehabilitation
- Assessment of ability to function and ability to work as well as need for rehabilitation
- Rehabilitation research
- Therapies aimed at improving and maintaining ability to function and other actions taken in order to promote rehabilitation
- Assistive devices and their fitment, renewal and maintenance
- Adaptation coaching
- Rehabilitation periods during inpatient and outpatient care.
- Emergency medical treatment which is the responsibility of the hospital district (with the exception of medical transport)
- Treatment provided in a psychiatric outpatient unit
- Treatment and upkeep provided for respiratory arrest patients and transport related to the treatment
- Vaccinations according to the
- Communicable Diseases Act
- Research of hazardous communicable diseases
- Treatment and prescribed medicines
- Isolation of infected patients or suspected carriers of the disease
- Research and treatment of HIV infections, gonorrhoea and sexually transmitted chlamydia infections
- Medicines prescribed for the treatment of patients with a reportable communicated disease.
- Examinations and care for donors of human organs, tissues or cells
- For persons under the age of 18
- Dental care
- Medical care and upkeep when the number of treatment days exceeds seven per calendar year
- Medical rehabilitation provided in series and hyposensibilisation, speech and voice therapy, radiation therapy, cytostatic therapy and other corresponding therapies
- Continuous dialysis treatment.
- The transport of an admitted patient from a health centre or hospital to another place of treatment or home care when the transport is done using a medical transport vehicle and according to a doctor’s orders
- Treatment materials and supplies intended for the treatment of a chronic illness.
There is a maximum amount for public healthcare customer fees
There is a maximum amount for public healthcare customer fees. The amount is reviewed once every two years.
The following are included in the maximum amount:
- Fees for outpatient doctor services at health centres
- Physiotherapy fees
- Serial treatment fees
- Hospital clinic fees
- Day surgery fees
- Short-term inpatient care fees at healthcare and social care facilities
- Fees for overnight treatment and day treatment
- Rehabilitation fees.
The following are not included in the maximum amount:
- Dental care fees
- Medical transport fees
- Fees for doctor’s certificates
- Fees for laboratory and imaging examinations made with a referral from a private doctor.
You need to follow the amount of your customer fees over the course of the calendar year. If the amount of your customer fees exceeds the maximum amount, you will receive a certificate for this from the municipality’s or joint municipal authority’s unit that produces health services included in the maximum amount.
After the maximum amount has been exceeded, the services included in the maximum amount are usually free until the end of the calendar year. If you have paid more than the maximum amount for these services during the calendar year, you are entitled to receive a refund for the payments exceeding the maximum amount.
Public and private healthcare can invoice a visit that has been reserved but not used.
In public healthcare, the maximum amount of the fee that can be charged for an unused reservation has been defined by legislation. In 2017, the maximum fee is EUR 51.40. The fee can be charged for patients over the age of 15. The obligation to pay concerns the following healthcare services:
- Consultations with a doctor at a health centre
- Dental examination and care
- Outpatient care within specialised medical care
- Expensive imaging examinations, such as X-ray, ultrasound or magnetic imaging.
The fee must not be charged if the treatment personnel find that an acceptable reason exists for the lack of cancellation. These include the following:
- The lack of cancellation is due to the customer’s high age, level of development, state of mind or other similar specific feature or carelessness, thoughtlessness or unawareness related to it
- The customer or their next of kin has tried to cancel the reservation but has been unsuccessful due to a reason attributable to the place of treatment, for example when the clinic has been exceptionally closed or the telephone service has been congested.
Within private healthcare, the customer is usually requested to cancel their reservation at the latest 24 hours before the reserved time. Doctors and other healthcare professionals who operate as private practitioners can individually decide whether unused reservations are invoiced. They will define the amount of payment individually.
Private healthcare and pharmacy costs and travel costs
When using private healthcare services, you will be responsible for the price invoiced by the service provider. The price charged for the use of the services is usually based on market price. The service provider will usually collect the charges at the place of treatment or provide you with an invoice. You can receive reimbursement for private medical care immediately when making the payment, if
- you have a Kela Card
- the healthcare service provider has an agreement with Kela concerning direct reimbursement
- you are paying the costs directly to the service provider.
There is an annual threshold for your out-of-pocket medicine expenses. In 2017, the maximum amount is EUR 605,13. After this threshold has been met, you will only pay a deductible of EUR 2.50 per medicine. Medicine expenses are reimbursed after a EUR 50 initial deductible has been met.
If your costs for treatment-related travel exceed the annual threshold for travel expenses, EUR 300 per calendar year, Kela will reimburse the remainder of the travel costs in their entirety.