Special reimbursements for medicines

A higher rate of reimbursement is available for certain medicines used in the treatment of severe, long-term diseases. The diseases for which special reimbursements are availabe are specified by Pharmaceuticals Pricing Board. The medical criteria required for entitlement to a special reimbursement are set out by Kela in its decisions.

In order to be reimbursed at the pharmacy, you must submit Medical Certificate B to Kela. An application is typically not required. The medical certificate must either be based on examinations performed by a specialist-level health care unit or have been issued by a specialist.

The entitlement to special reimbursements can be granted for a specified period or indefinitely. Once the entitlement has been granted, you will receive in the mail a new Kela card indicating your new entitlement and when it will expire. The equivalent information can also be added to your new Kela photocard.

Kela provides special reimbursements for medicines purchased after the Medical Certificate B arrived at Kela and you were granted the entitlement to special reimbursements. With certain diseases, before qualifying for special reimbursement, you must first undertake lifestyle changes, whose effect on your illness is monitored. Also, with certain diseases you must first spend 6 months on regular medication before entitlement to special reimbursements can be granted.

Updated 02/14/13