Annual maximum limit on out-of-pocket costs
The part of the price of reimbursable prescription products that you pay yourself counts towards your annual maximum limit on out-of-pocket costs. If the medicines you buy are not covered by the reimbursement system, they also do not count towards the annual maximum.
In 2020, the annual maximum is set at €577.66. If you reach it, you become entitled to an additional reimbursement for your medicine costs. That means that you only pay a €2.50 copayment for your medicines for the rest of the year. You cannot be reimbursed for a new batch of medicine until you have used nearly all of the previous batch at the indicated dosage.
Purchases covered by the reimbursement system count towards the annual maximum
Any purchases of medicines, clinical nutrients and emollient creams covered by the reimbursement system count towards the annual maximum. The initial deductible also counts towards the annual out-of-pocket maximum. However, should the price of the medicine exceed the reference price, the exceeding part does not count towards the annual maximum.
Additional reimbursement directly at the pharmacy
Kela keeps track of your progress towards reaching the annual maximum based on information received from pharmacies. From the beginning of 2020 the pharmacy has up-to-date information about your progress towards meeting the initial deductible. You get an additional reimbursement directly at the pharmacy. You must not apply to Kela for an additional reimbursement.
If you have not had additional reimbursement at pharmacy in 2019, you must apply to Kela for an additional reimbursement.
You can track your up-to-date progress towards reaching the annual maximum through Kela's online customer service (in Finnish and Swedish) by selecting Sairaanhoitokorvaukset > Lääkkeiden omavastuukertymä. You see the cumulative amount of medicine purchases for which you have been paid a reimbursement.