Legislative amendment on cross-border healthcare to take effect in May

Contrary to what has been reported in this article, prior authorisation under the directive will not be introduced from 2024, as there are currently no measures in the service choices in health care that would qualify for it. For more information, see the Kela press release.

The President of the Republic of Finland has ratified an amendment regarding the act on cross-border healthcare. The amendment will take effect on 1 May 2023.

For example, the amendment will change reimbursement procedure in cases where a person independently seeks treatment in an EU or EEC country, Switzerland and the United Kingdom. In the future, the reimbursement cannot be higher than the cost of the corresponding treatment in Finland in your own wellbeing services county. Kela will obtain the necessary information from your wellbeing services county. In some cases, the amendment may result in an increased reimbursement. However, you will always be obliged to pay the client fee that Finnish public healthcare services would have charged for the corresponding treatment.

Reimbursement model to be implemented retroactively

Once the amendment enters into force, the changes to granting reimbursements will take effect retroactively as of 1 January 2023. If you have sought treatment abroad in 2023, the reimbursements will be granted under the new legislation.

If you seek treatment abroad without prior authorisation, you must first pay the costs yourself and apply for reimbursement from Kela afterwards. The reimbursements will require a referral, if one would have been necessary for the corresponding treatment in Finland. The treatment must also be part of the range of public healthcare services in Finland.

The amendment will also involve the introduction of a new prior authorisation pursuant to the Patient Directive in 2024.

You can enquire about the reimbursement sum in advance

As a result of the amendment, you will now be able to enquire about the possible reimbursements for your treatment. Kela will reimburse the costs based on its estimations if the eventual treatment matches the details you provide in your notification. The advance notification procedure will be introduced on 1 May 2023. The form to be used for the notification will be released later.

Reimbursements for sudden illness will not change

The amendment will apply to situations where a person independently seeks treatment in another country and applies for reimbursement on the treatment afterwards. As such, reimbursements will not change in situations in which you fall ill during a trip or travel for treatment under a prior authorisation pursuant to EU Regulation 883/2004.

If you require treatment during a trip in an EU or EEC country, Switzerland or the United Kingdom, you can access it with a European Health Insurance Card and will only need to pay the local client fee. If, for some reason, you have to pay all of the costs yourself, you can apply for reimbursement from Kela or the health insurance institution of the country in question afterwards.

Contact Point provides advice

The Contact Point for Cross-border Healthcare provides general advice in matters related to cross-border healthcare. However, we do not process personal data or accept applications.

We will update the website once the amendment enters into force in May.

Further information

Kela: Changes to reimbursement of costs for treatment abroad