Reimbursements for medicine expenses

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You can be reimbursed for medicines, clinical nutrients and emollient creams prescribed to you for the treatment of an illness. Reimbursements are only available for products confirmed as reimbursable by the Pharmaceuticals Pricing Board (Hila), which operates in connection with the Ministry of Social Affairs and Health.

Usually the reimbursement is provided to you directly at the pharmacy.

Reimbursement after meeting the initial deductible

You can be reimbursed for the medicines you purchase after you have met the initial deductible, which is 50 euros per calendar year.

Children and adolescents are exempt from the initial deductible. It is applied from the beginning of the year in which you reach the age of 19 years.

Direct reimbursement

You can usually get a reimbursement directly at the pharmacy. The pharmacy contacts Kela electronically to check your eligibility. The pharmacy also has up-to-date information about your progress towards meeting the initial deductible.

You can only be reimbursed for necessary medicine costs. This means that you can buy medicine for no more than 3 months of treatment at one time. If the medicine you have been prescribed is particularly expensive, you can, at one time, only buy one package of that medicine, equivalent to no more than 1 month of treatment, for which you are reimbursed directly. Particularly expensive medicines refer to medicines the retail price of which, including value-added tax, exceeds €1,000 for one package. You can get a new reimbursement only after you have used nearly all of the previous batch of medicine.

Reimbursement categories

The rate of reimbursement depends on the reimbursement category to which the product you are buying belongs. There are three categories:

  • Basic rate of reimbursement 40%
  • Lower special rate of reimbursement 65%
  • Higher special rate of reimbursement 100%. A copayment of €4.50 per medicine and per purchase is charged.

The reimbursement is deducted from the price of the medicine. If the medicine is included in the reference price system, you will not be reimbursed for the part of the price that exceeds the reference price.

Annual maximum limit on out-of-pocket costs

Any prescription medicine costs you pay yourself count towards an annual maximum limit on out-of-pocket costs. The initial deductible also counts towards the annual out-of-pocket maximum.

In 2017 the annual maximum is set at €605,13. If you exceed the annual maximum, you can get an additional reimbursement, which means that for the rest of the year, you only pay a €2.50 copayment for each reimbursable medicine.

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Last modified 02/01/2017
Updated 01/01/2017