Kela will provide reimbursement for the following costs of private medical care:
- Doctor and dentist fees
- Costs of examinations and treatment ordered by a doctor
- Costs of prescribed medicines
- Costs of travel related to the treatment of illness.
The reimbursement of fees, examinations and treatments is based on a reimbursement tariff that indicates the amount of reimbursement. Usually, your costs will exceed the reimbursement tariff.
Reimbursements for private medical care are commonly referred to as Kela reimbursements.
Starting 1 March 2016, Kela will begin to provide reimbursement also for medical care delivered as a remote service using online video technology.
You will receive direct reimbursement with a Kela Card
Most often, you will receive reimbursement at the clinic by showing your Kela Card. Direct reimbursements are used for doctor, dentist and dental hygienist fees and for reimbursing the costs of examinations and treatment. In this case, the service provider will directly deduct the amount of reimbursement paid by Kela from the fee to be invoiced. You will also receive reimbursement for medicine purchases at a pharmacy.
If you pay the entire invoice to a healthcare service provider yourself, apply for reimbursement from Kela within six months of making the payment
- on form SV 127 for the costs of fees, examinations and treatment
- on form SV 4 or by using Kela’s e-services for the costs of travel, accommodation and accompanying persons
- on form SV 178 for medicine costs
- on form SV 128 for treatment, medicine and travel costs incurred abroad.
The forms can be found at www.kela.fi/lomakkeet.
Kela confirms the tariffs for reimbursement of private medical care costs
Kela confirms the tariffs for reimbursement of private medical care costs. They are based on the nature of the examination or treatment, the amount of work required and the costs incurred, the treatment value of the reimbursed service and the funds available for the reimbursement.
Reimbursements for the costs of private medical care are not available for the following, for example:
- Office fees collected by private institutions
- Operating theatre fees
- Hospital treatment day fees
- Clinic fees
- Preventive care fees (with the exception of dental care).
In 2016, 3.8 million customers received at total of EUR 1.84 billion in reimbursements of the costs of private medical care pursuant to the Health Insurance Act. The average compensation was approximately
- 73% of the customer’s medicine costs
- 18% of the customer’s doctor’s fees
- 16% of the customer’s dental care fees
- 15% of the customer’s examination and treatment costs
- 86% of the customer’s travel costs.