Reimbursements for medicine expenses
Kela provides reimbursements for the costs of medicinal products, clinical nutrients and emollient creams that have been prescribed for the treatment of an illness. On this website, the word medicine is used to refer to all of these products.
The initial deductible is 50 euros
Kela will provide reimbursements for your medicine expenses after you have paid the annual initial deductible of EUR 50. You pay full price for your medicines until the initial deductible is met.
Children and youth are exempt from the initial deductible. The initial deductible is applied from the beginning of the year in which a young person reaches the age of 19.
Government proposes changes to initial deductible on medicine expenses
The Government proposes to increase the initial deductible on reimbursements for medicine expenses from EUR 50 to EUR 70. In addition, the initial deductible would be tied to the National Pensions Index, so that it would be index adjusted every year in future. Read more about the proposed changes to the initial deductible.
Direct reimbursement
The reimbursement is usually provided to you directly at the pharmacy. Pharmacies have up-to-date information about how much you have paid towards the initial deductible and the annual maximum.
Amount of the reimbursement
The amount of the reimbursement depends on the medicine you are buying and the reimbursement entitlements you have been granted.
There are three reimbursement categories: the basic rate of reimbursement, the lower special rate of reimbursement, and the higher special rate of reimbursement.
Annual maximum limit on out-of-pocket costs
The annual maximum limit on out-of-pocket costs refers to the maximum amount that you have to pay for your reimbursable medicines in one year. The initial deductible also counts towards the annual out-of-pocket maximum. In 2024, the annual maximum is set at 626.94 euros.
Once you have reached the annual maximum limit, you can get an additional reimbursement. The additional reimbursement means that you will pay only a EUR 2.50 copayment for each reimbursable medicine you buy for the rest of the year.
If the price of the medicine you have been prescribed exceeds its reference price and you refuse to substitute it with a cheaper generic alternative, you have to pay the amount that exceeds the reference price in addition to the EUR 2.50 copayment.
Read more
- about the annual maximum limit on out-of-pocket costs
- about generic substitution and reference prices.
