Private insurance policies may provide additional coverage for using the health care services in the country of destination. The EU legislation secures the right to receive treatment and reimbursements for costs in the EU and EEC countries and Switzerland. The international social security agreements Finland has entered into also grant rights for treatment in Australia and Quebec, Canada in certain situations. This means that the legislation grants the clients rights with regard to public health care and that Kela can retroactively reimburse treatment costs incurred elsewhere.
The coverage of a private insurance policy depends on the insurance terms
Private insurance policies are offered by domestic and foreign insurance companies. There is variation in their coverage and pricing. The policies often employ a variety of methods to compensate for costs arising from using health care services abroad in the event that the policyholder falls ill while abroad or travels to another country to receive treatment.
The policyholder and the insurance company agree upon the terms of the insurance in an insurance contract. The Insurance Contracts Act sets the general framework for the contracts, but the scope of the coverage and many details of the terms are specific to each insurance company.
The Finnish Financial Ombudsman Bureau FINE provides advice and assistance in insurance-related matters.
Private medical expenses insurance
Medical expenses insurance policies are sold by insurance companies, which use a variety of product names for them: sairausturva (sickness coverage), aikuisturva (adult coverage) and terveysvakuutus (health insurance). Some of the policies cover both accident and medical expenses, but some only cover the latter. Medical expenses insurance policies usually end when the policyholder reaches the age of 60 to 100, and they are normally not granted for people above the age of 65.
Medical treatment costs are usually reimbursed through the medical expenses insurance to a maximum of the actual costs incurred. The compensation of the treatment costs normally requires that the treatment of the sickness or injury has been necessary and required from the perspective of common medical views.
All medical expenses insurance or the types of compensation they cover may not be valid abroad. The insurance terms may, for example, limit the payment of sickness-based compensation to treatment provided in Finland.
The medical expenses insurance policies may also involve restrictions. There may be differences between companies and products with regard to the compensation of care related to pregnancy and childbirth, dental care, physical treatment costs, bandaging, aids, various therapies and travel costs.
Compensation is usually not paid for treatment that is not considered necessary in light of common medical views. Such treatments include alternative treatments.
Taking out a travel insurance policy that covers personal injury is recommended if you will be travelling abroad. Travel insurance policies are offered by private insurance companies. The travel insurance policies can vary greatly between companies on a base level and with regard to their terms and conditions.
Travel insurance normally compensates for the treatment costs of sickness or injury to the extent specified by the insurance terms. The terms of the travel insurance may restrict your right to compensation in situations where the need for treatment has been caused by the following:
- previously discovered sickness or pregnancy
- an incident related to a dangerous or risky sport activity or other exercise, such as situations related to diving, climbing and aviation
- you have travelled abroad for the express purpose of seeking treatment
Some travel insurance policies cover travel costs incurred abroad. Travel costs may also be incurred if you required transport from your country of destination to Finland. The insurance company may require special arrangements for the compensation of such travel costs – for example, you may need to contact the insurance company beforehand or have the company handle the transport.
Travel insurance policies specify separately whether or not costs related to the storage, transport and burial of a deceased person are compensated. In addition to this, the policies usually separately define how costs incurred by the family member or other person escorting the body are compensated.
If your insurance company has contracted doctors or other partners in the country where you are staying, it may advise you to contact a doctor covered by the contract directly. By using such services, you will often receive treatment at a lower price or free of charge, and the insurance company will charge the costs directly to the treatment provider.
When going on a trip
- If you do not have travel insurance, it is advisable to take out a policy before your trip.
- Familiarise yourself with the content and validity of the insurance policy before the trip.
- If you will be travelling with children, check whether or not the insurance covers them, too.
- Find out how you can contact the insurance company in an emergency.
- Take with you a certificate or other travel insurance document received from the insurance company.