Reimbursements for private medical care
On this page:
Government planning changes to reimbursements from Kela
The Government is planning a number of changes to reimbursements from Kela. The plan is for the changes to enter into force in stages during 2025. Read more about the planned changes to Kela reimbursements.
Can you get reimbursement for private medical care?
Kela reimburses part of the costs for visits to a private doctor due to illness, pregnancy or child-birth. You can also receive reimbursement for remote consultations.
You can get the reimbursement already at the place of care. The reimbursement is deducted directly from the price of the treatment. You can get direct reimbursement from places of care that have an agreement on direct reimbursement with Kela. If this is not the case, you can claim reimbursement from Kela afterwards.
You can get reimbursement for the costs for statements and certificates written by a private doctor, if the statement or certificate has been written for the application for a benefit under the Health Insurance Act. Such benefits include reimbursement for medicines at a special rate and sickness allowance. At the most, the reimbursement equals the reimbursement rate (pdf, in Finnish).
You cannot get reimbursement for medical certificates issued for the following purposes:
- renewal of driver’s licence
- application for a place of study
- medical examination when starting a new job
- application for a pension or rehabilitation.
You can get reimbursement for trips to private-sector providers if the treatment provided is reimbursable by Kela or if you have a payment voucher or service voucher for the treatment from your wellbeing services county.
In case of a traffic accident, an occupational disease or an industrial accident, you should claim compensation directly from the insurance company.
You can seek medical care in another EU or EEA country, Switzerland, Great Britain or Northern Ireland and get reimbursement for the costs for the treatment.
You can also get reimbursement if you need emergency medical care in another EU or EEA country, Switzerland, Great Britain or Northern Ireland.
If you have a private medical or accident insurance policy, you can claim compensation from your insurance provider along with the reimbursement available from Kela.
You cannot get reimbursement for
- costs for public healthcare services
- costs when you have a referral from the public healthcare provider to a private dentist, psychiatrist or psychologist (in this case, the costs for the examinations are paid by you yourself or the wellbeing services county)
- medical certificates issued for the following purposes:
- renewal of driver’s licence
- application for a place of study
- medical examination when starting a new job
- application for a pension or rehabilitation
- for instance office charges and outpatient clinic charges, facility charges or Kanta charges.
Costs for private medical care have no cap on out-of-pocket costs
The costs for private medical care have no cap on out-of-pocket costs, i.e. annual deductible. The user fees in public healthcare services have a cap on out-of-pocket costs per calendar year, but the costs for private medical care are not included. Read more about the cap on out-of-packet costs (stm.fi, in Finnish).
Note, however, that travel costs and medicine costs have a cap on out-of-pocket costs.
How much is reimbursed?
You can get reimbursement for the costs for private medical care at the most according to the relevant reimbursement rate. Different treatments and examinations have their own reimbursement rates (pdf, in Finnish).
The costs for visits to a general practitioner or specialist are reimbursed as follows:
- visit at a doctor’s surgery EUR 30
- video conference EUR 25
- phone conference or chat service EUR 8.
The costs for visits to a psychiatrist are reimbursed as follows:
- visit at the psychiatrist’s office EUR 30-40 (the reimbursement rate depends on the length of the visit)
- video conference EUR 30
- phone conference or chat service EUR 12.
You can also get reimbursement for examinations and treatments in private medical care that have been prescribed by
- an obstetrician/gynaecologist (infertility treatment)
- a psychiatrist
- a dentist
- a specialist dentist
- an oral and maxillofacial surgeon.
If the examination or treatment is prescribed by some other doctor, reimbursement from Kela is not available. This does not, however, apply to examinations by a psychologist. Reimbursement from Kela can be paid for these examinations regardless of who has prescribed them.
Claiming reimbursement for costs for private medical care
Usually you get a reimbursement for the cost of examinations and treatments ordered by a doctor in private practice directly at the place of care. If this is not the case, you can claim reimbursement from Kela afterwards.
- Fill in the form Medical care expenses incurred in Finland, SV 127e (PDF).
- Save the blank form to your device. Do not fill in the claim directly in the browser, because some of the information may not be saved that way.
- Open the form with Adobe Reader and fill it in.
- Save the completed form to your device. Note that the claim must be in PDF format.
- The claims form includes information on the supporting documents you need to send.
- Send the claim via the OmaKela e-service:
- Log in to the OmaKela e-service (available in Finnish and Swedish) and select Tee hakemus (File a claim).
- Select Sairaanhoito, hammashoito, matkat ja lääkkeet.
- Select Sairaanhoito-, hammashoito- tai lääkekorvaus – tee hakemus.
- Select the claim on your device and press Lähetä (Send).
- When you send your claim online, you do not need to sign it.
- If you have supporting documents, send them via OmaKela after you have submitted your claim. If they are paper documents, you can photograph or scan them.
- Visit OmaKela to see if your claim has been decided, how much you will get and when the reimbursement will be paid. You will also see reminders of, for instance, supporting documents missing from your claim. The decision notice will also be sent to your home address unless you have opted out of paper mail.
If you cannot use OmaKela, send your claim to Kela by post. Save the form Medical care expenses incurred in Finland, SV 127e (PDF) to your device and fill it in after saving it. Print out the form and send it and any supporting documents to Kela, PL 10, 00056 KELA.
When to claim
You must claim reimbursement within 6 months from the date of paying the costs.
