Reimbursements for medical expenses
Kela reimburses part of the costs for visits to a private doctor due to illness, pregnancy or child-birth. You can also receive reimbursement for remote consultations. At the most, the reimbursement equals the reimbursement rate.
The reimbursement rates
You can get reimbursement for
- a visit to a general practitioner or specialist, EUR 30
- a videoconference with a general practitioner or specialist, EUR 25
- a remote consultation with a general practitioner or specialist (phone or chat), EUR 8
- a visit to a psychiatrist, EUR 30-40 (depending on the duration of the visit)
- a videoconference with a psychiatrist, EUR 30
- a remote consultation with a psychiatrist (phone or chat), EUR 12.
You can also get reimbursement for examinations and treatments in private medical care that have been prescribed by
- a psychiatrist
- an oral and maxillofacial surgeon
- a dentist.
If the examination or treatment is prescribed by some other doctor, reimbursement from Kela is not available. However, this does not apply to examinations by a psychologist. Reimbursement from Kela can be paid for these examinations regardless of who has prescribed them.
The amount of the reimbursement depends on the reimbursement rate for the examination or treatment. At the most, the reimbursement equals the reimbursement rate. Kela will confirm the euro amounts of the reimbursement tariffs later on the basis of a Government decree.
- Reimbursement for the doctor's fee when visiting a gynaecologist 30 euros. No reimbursement is paid for ultrasound examinations and Pap tests.
- Reimbursement for visit to an ophthalmologist 30 euros. You have to pay for eye examinations yourself in full.
- Reimbursement for a 30 minute visit to a psychiatrist 35 euros. You also get reimbursement for laboratory examinations prescribed by the psychiatrist.
When are reimbursements not available?
Reimbursements for medical expenses are not paid if you have a referral from a public healthcare provider to a private dentist, psychiatrist or psychologist. In this case, the costs for the examinations are paid by you yourself or the wellbeing services county.
Kela does also not pay reimbursements for costs for public healthcare services or for administrative fees or outpatient charges in private medical care.
Kela reimburses part of the costs for statements and certificates written by a private doctor, if the statement or certificate has been written for the application for a benefit under the Health Insurance Act. Such benefits include reimbursement for medicines at a special rate and sickness allowance. At the most, the reimbursement equals the reimbursement rate. The reimbursement rates are listed in the list of reimbursement rates.
Kela does not pay reimbursement for medical certificates issued for the following purposes:
- renewal of driving licence
- application for a place of study
- medical examination when starting a new job
- application for a pension or rehabilitation
You can get direct reimbursement for the medical costs when you present your Kela card at the place of care. In that case, the place of care deducts the reimbursement directly from the price. You can also claim the reimbursement from Kela later. You can get direct reimbursement from places of care that have an agreement on direct reimbursement with Kela.
Compensations from insurance providers
If you have a private medical or accident insurance policy, you can claim compensation from your insurance provider along with the reimbursement available from Kela. In case of a traffic accident or an industrial accident, you should claim compensation directly from the insurance provider.
Reimbursement of travel to private healthcare
Visits to a private healthcare provider are reimbursed only if the treatment or examination provided there is reimbursable under National Health Insurance.
However, if a you seek treatment using a payment voucher or service voucher from a wellbeing services county, you will get a reimbursement for travel costs to the healthcare provider who treated you. Travel costs will also be reimbursed to rehabilitation arranged by Kela. .