Changes to reimbursements for private medical expenses

Parliament has approved a legislative amendment that will do away with most reimbursements for examinations and treatments ordered by doctors practising in the private sector.  The amendment will also change clients’ right to reimbursement for travel costs. Kela will continue to pay reimbursements for appointments with doctors in the private sector.  The reimbursements for the costs for private dental care will also remain unchanged. The changes will take effect on 1 January 2023.

Parliament has approved an amendment to the Health Insurance Act ending reimbursements for most of the examinations and treatments performed in the private medical sector.  

Kela will continue to provide reimbursements for private examinations and treatments needed for mental health and oral health and ordered by a psychiatrist, an oral and maxillofacial surgeon or a dentist. Reimbursements will also be available for tests performed by a psychologist. Other treatments and examinations will no longer be covered by Kela reimbursements. Procedures performed by physicians, with certain exceptions, will also be excluded from reimbursement.

All GP and specialist consultations will be reimbursable at a standard fixed rate. However, the reimbursements will be higher in the case of treatments provided by a psychiatrist or specialist dentist. Kela has confirmed the euro amounts of the reimbursement tariffs later on the basis of a Government decree.

As of the beginning of 2023, reimbursements will no longer be made for the costs of medical care provided in a country other than an EU/EEA country, Switzerland, Great Britain or Northern Ireland. 

How the reimbursements from Kela will change

As of 1.1.2023, reimbursements from Kela will change as follows for the most common medical examinations and treatments:

• Kela provides partial reimbursement for appointments with gynaecologists. However, reimbursement will no longer be available for ultrasound examinations or cervical smear tests carried out by a gynecologist.
• Kela provides partial reimbursement for appointments with ophthalmologists.  From now on, however, reimbursement will not be available for costs related to ophthalmological examinations. 
• The reimbursement paid by Kela for a 30-minute appointment with a psychiatrist is 16.50 euros. Kela also provides partial reimbursement for the cost of laboratory tests prescribed by a psychiatrist. 
• Kela will not reimburse the costs of physiotherapy that has started on or after 1 January 2023, or physiotherapy that continues beyond that date. 

The change also affects reimbursement for travel costs

The changes to reimbursement of the costs of private medical treatment also affect the client’s right to reimbursement for travel costs in connection with private medical treatment. Kela will pay reimbursement for travel costs in connection with private medical treatment only if the treatment provided is also subject to reimbursement from Kela. However, if a client seeks treatment using a payment voucher or service voucher from a wellbeing services county, travel costs will be reimbursed to the place where the client has acquired treatment. In such a case, the client needs a certificate on the SV 67 form in order to receive reimbursement for travel costs. The certificate must show that the treatment provided is given on the basis of a payment voucher or service voucher.

Additional information

Reimbursements for medical expenses | Our Services | Kela

Updated 22 December 2022:  Additional information link and reimbursement rate added.