Kela to provide reimbursement for fertility treatments again
Parliament has approved the reintroduction of Kela reimbursement for fertility treatments administered by private healthcare providers. The amendment will enter into force on 1 May 2025. The aim is to improve the status of individuals and couples who have been unable to conceive due to medical reasons.
Summary
Kela will provide reimbursement for fertility treatments administered by private healthcare providers.
Reimbursement will be available for medical examinations and treatments performed or prescribed by a gynaecologist or an obstetrician.
A list of reimbursement rates for eligible examinations and treatments is available on the Kela.fi website (linkki).
Reimbursement is available if
- the person is under 43 years of age
- infertility is caused by a medical condition.
Reimbursement may be granted on a case-by-case basis to persons aged 43 or over, on the basis of a medical statement.
Reimbursement is not available
- for fertility treatments administered for other than medical reasons
- administrative or processing fees
- Kanta fees
- clinical or outpatient fees.
Other costs eligible for reimbursement
Following the amendment, Kela will grant reimbursement for travel costs incurred in connection with fertility treatments administered by private healthcare providers if the treatment provided is also subject to reimbursement from Kela.
Reimbursement from Kela will be available for medication used in fertility treatments if the medication is covered by the reimbursement system and
- the prescription has been issued to a person who is under 43 years of age
- infertility is caused by a medical condition
- the reimbursement status of the medicine has been confirmed by the Pharmaceuticals Pricing Board and is valid.
Reimbursement may be granted on a case-by-case basis to persons aged 43 or over, on the basis of a medical statement.
The change will take effect on 1 May 2025. Kela reimbursements can be claimed for treatment costs that have been incurred on or after 1 May 2025.
The reimbursement is usually deducted from the price of treatment at the place of care (direct reimbursement). Direct reimbursement for medicine purchases is provided at the pharmacy. If the amount of direct reimbursement was not deducted when the payment was made, the customer can apply for reimbursement from Kela later.
Parliament has approved the introduction of Kela reimbursement for fertility treatments administered by private healthcare providers.
Kela will start to provide reimbursement for the costs of fertility treatments as of 1 May 2025 in cases where infertility is caused by a medical condition and the applicant is under the age of 43. If the applicant is older than this, Kela will assess on a case-by-case basis whether reimbursement can be granted, basing its decisions on medical statements.
Reimbursement will be available for medical examinations and treatments performed or prescribed by a gynaecologist or an obstetrician in the context of fertility treatments. Reimbursement will not be available for fertility treatments administered for reasons other than a medical condition.
The aim is to give people who need fertility treatments due to medical reasons better access to treatment in private healthcare, where the age limits for treatment may be higher than in public healthcare. This will give more people access to fertility treatments, which may, in turn, help boost birth rates.
Kela’s list of reimbursement rates shows the amount and grounds for reimbursement
Reimbursement will be granted only for medical examinations and treatments conducted as part of fertility treatments, but not for any administrative or processing fees, Kanta fees or clinical or outpatient fees.
The grounds and maximum amounts of reimbursement (i.e. reimbursement rates) are set down by government decree. Kela confirms the reimbursement rates and publishes a list of the rates.
"Kela has previously reimbursed costs incurred for fertility treatments, most recently in 2022. At the time, Kela reimbursed about 13% of the cost of the treatments, and reimbursements were paid to 6,622 people. This time around, the reimbursement rate will be significantly higher than in 2022," says Merja Larikka, Senior Coordinator.
Reimbursement also available for medication and travel
Kela grants reimbursement for the costs for medication used in fertility treatments when infertility is due to a medical condition and the medication is covered by the reimbursement system. The conditions for reimbursement are that the medication has been prescribed to a person under the age of 43 and that the reimbursement status of the medication has been confirmed by the Pharmaceuticals Pricing Board and is valid. Reimbursement may be granted on a case-by-case basis to persons aged 43 or over, on the basis of a medical statement.
Following the amendment, Kela will grant reimbursement for travel costs incurred in connection with fertility treatments administered by private healthcare providers if the treatment provided is also subject to reimbursement from Kela.