Reimbursement of medicines purchased abroad
Whether you can get a reimbursement for any medicines you buy abroad depends on such things as whether you bought them to treat an unforeseen illness or as part of a decision to travel abroad to obtain treatment. Seeking treatment abroad means that you travel from your country of residence to another country in order to use health care services provided there.
Your right to reimbursement will also be affected by which country it is you travel to.
Sudden illness abroad
If you are living temporarily in another EU/EEA country, Switzerland, the United Kingdom or Northern Ireland and you must see a doctor because of an unexpected illness, you can apply for a reimbursement from the local health insurance institution. Carrying a valid European Health Insurance Card with you will make this easier.
If you do not apply or are not eligible for reimbursement in the country where you received treatment, you can apply for reimbursement from Kela afterwards. Based on your choice, the reimbursement will be paid according to either Finnish legislation or the legislation of the country where you received treatment. When the other country in question is another Nordic country, the reimbursement will always be paid according to the legislation of the country where you received treatment.
If you choose to be reimbursed according to Finnish legislation
Kela will reimburse you for up to 3 months’ supply of medicine at a time.
If the medicine is expensive, Kela will reimburse you for up to 1 month’s supply at a time. A medicine is considered expensive if it is available in a package that costs more than EUR 1,000.
All medicines purchases that are reimbursed according to Finnish legislation count towards the initial deductible and the annual maximum limit on out-of-pocket costs.
If you choose to be reimbursed according to the legislation of the country where you received treatment
Kela will ask the country in question to specify the amount of the reimbursement and then pays that amount to you.
Medicine purchases that are reimbursed according to the legislation of the country where you received treatment do not count towards the initial deductible or the annual maximum limit on out-of-pocket costs.
Sudden illness while staying in a country other than an EU/EEA country, Switzerland, the United Kingdom or Northern Ireland
If you are staying temporarily in any country that is not an EU/EEA country, Switzerland, the United Kingdom or Northern Ireland, and you find yourself having to purchase medication for an illness, you cannot get reimbursement from Kela.
Seeking treatment abroad
If you travel to another EU/EEA country, Switzerland, the United Kingdom or Northern Ireland to buy medicines that you need for the treatment of an illness, you cannot apply for reimbursement from the social insurance institution of the country in question. However, you can later apply for a reimbursement from Kela instead.
You can be reimbursed for up to three months' worth of medication at one time. If the medicine is expensive, the maximum amount of medicine you can get a reimbursement for is what you would need for one month’s treatment. A medicine is considered expensive if it is available in a package that costs more than EUR 1,000.
Kela does not reimburse medicines that were purchased from abroad online or through mail order.
Amount and payment
Kela provides reimbursement only for medicines that have been prescribed for the treatment of an illness and are equivalent to medicines reimbursable in Finland. Whether a medicine is equivalent is determined by reference to the dosage form (for example, a tablet or a solution), as well as the pharmaceutical substance and its strength. The amount of the reimbursement is affected by the price and package size of the medicine purchased abroad and by the package size and price (or reference price) of the equivalent medicine available and reimbursable in Finland.
Kela will pay the reimbursement once the initial deductible has been met.
- If the equivalent medicine is included in the Finnish reference price system, the reimbursement will be based on the medicine’s sales price or reference price.
- If the equivalent medicine is not included in the Finnish reference price system, the reimbursement will be based on the medicine’s sales price or the price confirmed for it in Finland.
- If the equivalent medicine has been confirmed as reimbursable under a special rate of reimbursement, and you are entitled to a special rate reimbursement for medicines purchased abroad.
- If you have reached the annual maximum limit on out-of-pocket costs, you can get the additional reimbursement for medicines purchased abroad.