Little change in reimbursements for travel costs despite COVID-19

Despite the COVID-19 pandemic which began in the spring of 2020, the number of trips reimbursed under the National Health Insurance saw little change in 2020. The number of trips for which clients used a taxi, as well as the number of such clients, plummeted in March–June 2020, but returned to the previous year’s level. 

Following the introduction of the Act on Transport Services, Kela-subsidised taxi services and taxi dispatch centres underwent a competitive tender process in July 2018. Information about taxi trips collected by dispatch centres usually reaches Kela with only a few weeks’ delay. This makes it possible to track the number of trips for which clients use a taxi and how they are distributed in the population in close to real time. 

Based on address data associated with trips made by taxi, it is possible to look at the share of region-to-region trips for which clients used a taxi. Nationwide, the share of such trips is about 6%, but an analysis of individual regions shows wide differences. In regions with a university hospital, service use occurs mainly within the region, and the percentage of interregional trips is as low as two percent. In contrast, in such regions as Kainuu, Keski-Pohjanmaa, Etelä-Savo and Kanta-Häme, nearly one in five trips for which clients used a taxi ended in another region.   

Higher copayment rates have reduced the number of Kela-subsidised trips

The number of trips for which Kela paid a reimbursement has declined significantly since 2012. This can be explained by higher copayments: in 2013–2016, the copayment was increased three times, going up from 9.25 euros to 25 euros.

As a result, certain low-cost trips, especially those for which clients use their own car or public transport, are no longer covered. Conversely, the share of trips made by taxi has increased.  

Reimbursements for travel costs are typically paid to the elderly, and trips to or from hospital are the most common type of reimbursed travel. Among those who use a lot of travel services are such groups are dialysis and cancer patients. Many young persons travel to a rehabilitation provider for example to attend Kela-subsidised physical therapy. 

In 2020, half of the one-way trips reimbursed by Kela cost up to 50 euros. The cost varies depending on the type of transport used. The least expensive options are using one’s own car or public transport, while the costliest modes of transport are helicopter or ambulance transport.

The expenditure on reimbursements for travel costs is highest in Pohjois-Pohjanmaa and Uusimaa, which has a relatively large population. However, on a per-client basis, the largest reimbursements are paid in sparsely populated areas, especially Lapland and Kainuu.

Kela provides reimbursement for healthcare-related travel costs

Kela pays reimbursements for travel costs related to trips made to a healthcare or rehabilitation provider in connection with illness, pregnancy, childbirth or rehabilitation. Clients can get a reimbursement for using a taxi if that is their only alternative taking into account their health or difficult travel arrangements.

Statistics

• Statistics on reimbursements for medical expenses
• Recipients of reimbursements for travel costs (Kelasto) 

Research (in Finnish)

• Sairausvakuutuksen lääke- ja matkakorvausten vuotuiset omavastuukatot. Laskelmia vuotuisten omavastuukattojen yhdistämisestä ja liukuvasta vuosikatosta. (Maximum annual deductibles for medicines and travel costs under National Health Insurance. Calculations on the effect of combining the maximum annual deductibles and of introducing a flexible maximum deductible) 
• Sairausvakuutuslain ja vammaispalvelulain mukaisia matkoja on mahdollista yhdistellä. (Trips covered by the Health Insurance Act and the Disability Services Act can be combined) Suomen Lääkärilehti 2020; 75 (13): 827 – 832. 
• Sairausvakuutuksen korvaamien taksimatkojen yhdistelyllä saavutettavien säästöjen arviointi. Paikkatietoanalyysi Tampereen yliopistollisen sairaalan erityisvastuualueella tehdyistä taksimatkoista vuonna 2015.  (Evaluation of savings achieved by using ride sharing in taxi journeys reimbursed under National Health Insurance. A geographic data analysis of taxi journeys made in 2015 within the special responsibility area of the Tampere University Hospital)
• Kun vain lähdettäisiin ajoissa. Matkakorvausten käyttäjien kokemuksia sairausvakuutuksen korvaamista matkoista.  (As long as we leave in good time. Clients having received reimbursements for travel costs and their experiences with trips covered out of National Health Insurance)
• Kuka ei tilaa taksimatkaansa Kelan tilausvälityskeskuksesta? Rekisteriselvitys sairausvakuutuksen korvaamista taksimatkoista vuonna 2015.  (Who do not contact Kela's dispatch centre to book a taxi? A register survey of taxi trips reimbursed under National Health Insurance in 2015.)
• Sairausvakuutuksen matkakorvausten alueelliset erot. Menetelmällinen tarkastelu kiireettömistä kuljetuksista vuonna 2014.  (Regional differences in reimbursements for travel costs provided under National Health Insurance. A methodological analysis of non-emergency transport in 2014)
• Sairausvakuutuksen matkakorvaukset liittyvät etenkin erikoissairaanhoitoon. Rekisteritutkimus vuonna 2012 tehdyistä matkoista.  (Reimbursements for travel costs provided under National Health Insurance are typically associated with specialised medical care. A register-based study of trips made in 2012)
• Kelan matkakorvausten kohdentuminen vammaispalvelulain ja sosiaalihuoltolain mukaisiin kuljetuksiin oikeutetuille. Rekisteritutkimus Oulusta vuodelta 2013. (The targeting of Kela’s reimbursements for travel costs to those entitled to transport services under the Disability Services Act or the Social Welfare Act. A register study conducted in Oulu in 2013) 
• Hemodialyysikäynteihin liittyvät sairausvakuutuksen matkakorvaukset 13 miljoonaa euroa vuonna 2012.  (Reimbursements for travel costs paid under National Health Insurance in respect of hemodialysis sessions totalled 13 million euros in 2012)
• Kenelle korvataan? Sairauden vuoksi tehtyjen matkojen korvaaminen.  (Reimbursement of healthcare-related travel costs)

Research blog (in Finnish) 

• Mitä jos sairausvakuutuksen lääke- ja matkakatto olisivatkin yhdessä? (What if we combined the out-of-pocket maximums for medicine and travel costs?)
• Liukuva lääke- ja matkakatto voisi auttaa alkuvuoteen kasautuviin suuriin sairauskuluihin (Introducing a sliding scale for the out-of-pocket maximums for medicine and travel costs could help reduce the accumulation of out-of-pocket expenses in the first months of the year)
• Taksimatkojen yhdistely tuottaa säästöjä etenkin kaupungeissa (Ride-sharing in taxi services reduces costs especially in cities and towns) 
• Tuttu taksi tuo luottamusta – omavastuu jo kipurajoilla (A familiar taxi driver provides assurance to clients, but copayment rates are about as high as they can be)
• Maakuntien sote-eurot vertailussa – Uusimaa painii yksin omassa sarjassaan (Comparison of social and healthcare spending by Finnish regional governments: Uusimaa is in a league of its own)
• Matkakorvausten käytössä suuret alueelliset erot (Large regional differences in the take-up of reimbursements for travel costs)
• Sääntelyn purku voi tehdä taksimatkasta kalliimman (Deregulation can make taxi fares more expensive)
• Uppoavatko matkakorvaukset soten rahapussin pohjalle – pääseekö Lapissa enää hoitoon? (Will reimbursements for travel costs be passed over in the social welfare and healthcare reform, and will Lapland residents still be able to access care?)
• Kelan välityskeskukset – kustannussäästöjä, mutta millä kustannuksella? (Kela's taxi dispatch centres produce savings, but at what cost?
• Matkakorvaukset kohdentuvat pienelle joukolle (Reimbursements for travel costs are concentrated among a small group of recipients)
• Yhteiskunnan tukemat henkilökuljetukset kaipaavat yhteistyötä – havaintoja muista Pohjoismaista (Cooperation is needed in government-subsidised transport services – Observations from other Nordic countries)
• Matkakorvaukset osana monikanavarahoitusta (Reimbursements for travel costs as part of multi-channel financing)

Contact information

• Päivi Tillman, Senior Researcher, tel. 020 634 1924
• Tuomas Sarparanta, Statistician, tel. 020 634 1535
• Päivi Rastas, Statistician, tel. 050 308 8930

email: firstname.lastname@kela.fi

More information on reimbursements for travel costs

• Reimbursement of travel costs