File your claim within 6 months of the original expense.

Reimbursable costs:

• 100% of doctors’ fees, excluding dentists’ fees and fees for surgery or a similar procedure performed in a private health clinic.
• 100% of Kela-reimbursed medicine, clinical nutrients, any equivalent products and emollient creams prescribed by a doctor. Prescription drug costs included in the initial deductible are also reimbursed, even if no reimbursements are made under the Health Insurance Act.
• Examinations prescribed by a doctor:
  • Laboratory and pathology 100%
  • Radiological examinations 100%
  • MRI scan 70%
• Hospital fees 100%
  • Outpatient clinic, day surgery and daily hospital fees (max. 180 days per member)
• Health center fees 100%
  • Annual fees, appointment fees and daily hospital fees
• Physiotherapy, massage, naprapathy, osteopathy and chiropractic treatments, as well as chiropody treatments provided by a podiatrist 70% (by doctor’s referral)
  • 20 treatment sessions per calendar year
    Pensioners are reimbursed 50% for the above-mentioned treatments.
• Psychotherapy 100% (reimbursed by Kela)
  • Copayment of psychotherapy sessions reimbursed by Kela
• Travel expenses reimbursed by Kela 100%
  • the nearest place of care using the cheapest means of transport. Travel costs by special means of transport are reimbursed if they are necessary due to the nature of the illness or the traffic conditions. The need for special transport must be certified by a doctor or hospital. (Always order a taxi for a journey reimbursed by kela from a specific regional phone number)
• Accommodation costs reimbursed by Kela 100%
  • only accommodation allowance as specified in the Health Insurance Act is reimbursed, and this applies if the member has had to stay overnight in an accommodation establishment or in accommodation provided for patients by a medical or research institution during a reimbursable trip.
• Facility fees max. €200 per reimbursement (private health clinics)
  • Office fees will NOT be reimbursed.
• Medical aids prescribed by a doctor max. €170 per reimbursement
  • dressings, support equipment and prostheses
• Fund member’s funeral allowance for relatives/estate €1,010

After one year of membership:

• Up to a maximum of €450 for the cost of dental care over two years.
  • A member shall pay for the treatment received in full and then apply for reimbursement from the sickness fund.
    For a pensioner, the reimbursement is €225 over two years.
• Eyeglasses or contact lenses €450 over two years, or for laser eye surgery, up to a maximum of €900 (2×450) per reimbursement, provided that spectacles are not replaced for five years after the operation.
  • A member shall pay for the eyeglasses, contact lenses or vision correction surgery in full and then apply for reimbursement from the sickness fund. For a pensioner, the reimbursement is €225 over two years, or €450 for eye surgery under the same terms and conditions as for other fund members.
• Eye test by an optician 100%

After five years of membership:

• Up to a maximum of €550 over five years for the cost of dentures or their repair.

According to the Fund’s rules, reimbursable examinations and treatment procedures must be provided by a health care professional who is registered in the Central Register of Health Care Professionals maintained by the Finnish National Authority for Medicolegal Affairs, or the procedures and treatments must be performed at such a unit providing private health care services as referred to in Chapter 3 Section 3 Paragraph 1 of the Health Insurance Act.                                   

Office fees charged by a private medical center or institution are NOT reimbursed.

The Sickness Fund has signed a direct compensation agreement with:

• Pharmacies in Vaasa and its nearby region, Yliopiston Apteekki pharmacies (detailed list on the Fund’s website)
• Mehiläinen throughout Finland
• Terveystalo, throughout Finland
• SynLab, throughout Finland

These abovementioned places will provide, free of charge, such medicines that are prescribed by a doctor and are reimbursed by KELA, treatments and examinations prescribed by a doctor, and doctors’ fees. Always present your KELA-card when visiting these places.

If you do not present your KELA-card, you must pay the entirety of the fees yourself. The service providers are NOT ALLOWED to deduct the KELA-reimbursement.

More information: General-guidelines-17.01_2022