Medicines included in the reimbursement scheme
You can be reimbursed for the cost of medicines that are included in the reimbursement scheme and have been prescribed to you for the treatment of an illness.
You are usually reimbursed for your medicine purchases directly at the pharmacy after you have reached the annual maximum on medicine expenses. The reimbursement is deducted from the price of the medicine at the pharmacy.
If the medicine you are buying is included in the reference price system, the reimbursement is based on the medicine’s reference price. If a medicine costs more than its reference price, you will not get a reimbursement for the part that exceeds the reference price.
Emollient creams and clinical nutrients are not included in the reference price system. You will always get a reimbursement for their full price.
You will also get a reimbursement for the dispensing fee (EUR 2.39) that the pharmacy adds to the prices of medicines.
Medicines in the basic reimbursement category
A medicine can be reimbursed at the basic rate, if the Pharmaceuticals Pricing Board (Hila) has confirmed its status as reimbursable at the basic rate. The basic rate of reimbursement is 40% of a medicine’s sales price or reference price.
If Hila has decided that a medicine can be reimbursed at the basic rate only when it is prescribed for certain medical conditions, you must apply for entitlement to reimbursement separately from Kela.
How to apply for entitlement to limited basic reimbursement for a medicine.
Medicines in the special reimbursement category
Some medicines are reimbursable at a special rate that is higher than the basic rate. You must apply for entitlement to reimbursement at a special rate separately from Kela.
How to apply for entitlement to reimbursement at a special rate.
A medicine can be reimbursed at a special rate, if the Pharmaceuticals Pricing Board (Hila) has confirmed its status as reimbursable at a special rate.
- The lower rate of reimbursement is 65% of a medicine’s sales price or reference price.
- The higher rate of reimbursement is 100% of a medicine’s sales price or reference price. However, you will always pay a EUR 4.50 copayment for each medicine you buy.
Reimbursable clinical nutrients
A clinical nutrient can be reimbursed, if the Pharmaceuticals Pricing Board (Hila) has confirmed its status as reimbursable. The reimbursement is 40% or 65% of the product’s sales price.
You can be reimbursed for the cost of a clinical nutrient only if Kela has granted you an entitlement to reimbursement.
How to apply for entitlement to reimbursement for clinical nutrients.
Medicinal Products Database
See the prices and reimbursement statuses of medicines and their generic alternatives.
Reimbursements for a maximum of three months’ supply of medicine
You can get a reimbursement for a maximum of 100 days’ (approximately 3 months) supply of a medicine when making a purchase. The pharmacy will calculate a 3 months’ supply of the medicine based on the dosage in your prescription.
However, the amount of the medicine may also be less than that depending on the package sizes your medicine is available in.
Example 1
The prescribed dose of your medicine is 1 tablet once a day. The medicine is sold in package sizes of 100 tablets and 30 tablets. You can get a reimbursement for a maximum of 100 tablets at a time.
Example 2
The prescribed dose of your medicine is 0.5 tablet once a day. The medicine is sold in package sizes of 100 tablets and 30 tablets. You can get a reimbursement for a maximum of 30 tablets at a time.
Reimbursements for a maximum of one months’ supply of expensive medicines
If you are purchasing an expensive medicine, you can get a reimbursement for a maximum of 1 months’ supply of the medicine at a time.
A medicine is considered expensive if it is available in a package that costs more than EUR 1,000.
When can you buy more reimbursable medicine?
You can get a reimbursement for a new batch of medicine after you have used nearly all of your previously bought medicine.
When buying more medicine, the earliest you can get a reimbursement for a new batch is
- 3 weeks before the previous batch runs out, if you purchased a 3 months’ supply last time
- 2 weeks before the previous batch runs out, if you purchased a 2 months’ supply last time
- 1 week before the previous batch runs out, if you purchased a 1 month’s supply or less last time.
Based on the dosage in your prescription, the pharmacy calculates whether enough time has passed since your previous purchase and whether you can receive a direct reimbursement for a new batch of medicine.
Why all medicines are not reimbursable
Kela only reimburses medicines that are included in the medicine reimbursement scheme.
A medicine cannot be reimbursed, if the pharmaceutical company
- has not applied for its inclusion in the reimbursement scheme
- has not applied for an extension to its inclusion in the reimbursement scheme
- has applied for its inclusion in the reimbursement scheme, but Hila has rejected the application
- has withdrawn it from the reimbursement scheme.