Kela: Agreement between Finland and Estonia on population data exchange may affect entitlement to medical care in Finland

Finland and Estonia have signed a new agreement on population registration and electronic exchange of population data. With the new agreement, a person cannot be left without a permanent place of residence. However, it is no longer possible to register a permanent address in both countries at the same time. In future, a person can have a municipality of residence either in Finland or in Estonia, but not both.

The agreement and related legislative amendments entered into force on 1 May 2024. In Finland, the Digital and Population Data Services Agency (DVV) is responsible for the exchange of information. DVV has informed about the matter on its website (dvv.fi).

Right to public healthcare based on municipality of residence

People whose municipality of residence is in Finland will receive public healthcare in Finland and pay a municipality-specific client fee for the treatment. Even if their municipality of residence is in Estonia, they may still be entitled to Finnish public healthcare. 

The right to medical care can be checked from Kela. Kela does not check the information automatically; you must apply for the right to medical care yourself.

The entitlement to medical care can be applied for by a person who has a municipality of residence in Estonia and who

• works in Finland,
• works in both Finland and Estonia and has an A1 certificate issued by the Finnish Centre for Pensions,
• studies in Estonia and is covered by health insurance in Finland, or
• is retired and only receives a pension from Finland.

If the conditions are met, Kela will grant a certificate of entitlement to medical care in Finland. With the certificate, the person can prove that they are entitled to receive public healthcare services for the price of a client fee.

Examples of situations where you can apply for entitlement to medical care

Alice works in Finland

Alice is an Estonian who works in Finland. As a rule, Alice lives in Estonia, and she has chosen to keep her municipality of residence in Estonia. Because she works in Finland, Alice is entitled to Finnish public healthcare services. Since Alice does not have a municipality of residence in Finland, she must apply for entitlement to treatment from Kela. Alice is issued a certificate of entitlement to medical care in Finland. By showing it, she will receive public medical care in Finland at the same price as those who have a municipality of residence in Finland.

Reino works in both countries

Reino has a home in both Finland and Estonia because he works in both countries. The Finnish Centre for Pensions has granted Reino an A1 certificate. Reino used to have a municipality of residence in Finland and Estonia, but he now registers his permanent address in Estonia. If Reino wants to use Finnish public healthcare services for the price of a client fee, he must apply for entitlement to medical care from Kela. Reino will be issued a certificate of entitlement to medical care in Finland. By showing it, he will receive public medical care in Finland at the same price as those who have a municipality of residence in Finland.

Pentti studies in Estonia and is covered by health insurance in Finland during his studies

Pentti is studying a 5-year degree in Estonia. He is covered by health insurance in Finland for the duration of his studies in Estonia. Pentti decides to register his permanent address in Estonia. Pentti is still entitled to the services of Finnish public healthcare. If he wants to use public medical care services when visiting Finland, he must apply for entitlement to medical care from Kela. He is issued a certificate of entitlement to medical care in Finland. By showing it, he will receive public medical care in Finland at the same price as those who have a municipality of residence in Finland.

Marja is a pensioner who only receives a pension from Finland

Marja decides to move to Estonia after retiring and to register her permanent address in Estonia. She only receives a pension from Finland, and due to the pension payment, Finland is responsible for the costs of her medical care. When Marja moves to Estonia, Kela will give her a decision on the entitlement to medical care and will provide her with a European Health Insurance Card with a lime green back. With this card, Marja can use public medical care services in Finland at the same price as those who have a municipality of residence in Finland.

Read more:

• Medical care in Finland (kela.fi)
• How to apply for entitlement to medical care (kela.fi)

Source: Kela.fi (in Finnish)