Applying for entitlement to reimbursement of medicine expenses

Customers need a medical certificate issued by a doctor on form B to apply for an entitlement to reimbursement of medicine expenses at the special rate, to limited reimbursement, or to reimbursement for clinical nutrients.

How to apply

  1. Submit the medical certificate to Kela as soon as possible. You can also ask your doctor to send the certificate directly to Kela, PL 10, 00056 KELA. No separate application is required. If you are a member of a workplace sickness fund, submit the certificate to your fund.
  2.  Visit the OmaKela e-service to see if the medical certificate has arrived at Kela and if you have been granted an entitlement to reimbursement. In the menu on the left-hand side of the screen, you can see an item titled “Lääkkeiden erityiskorvausoikeudet” if the certificate has arrived at Kela or you have previously been issued decisions on reimbursement entitlement. Click it for more information.

Decision on reimbursement entitlement and new Kela card

The entitlement to reimbursement can be granted on medical grounds.

Once your application has been dealt with, you will receive a decision in the mail. If you are granted an entitlement to reimbursement, you will later also be mailed a new personal Kela card marked with a number indicating your entitlement.

The number begins with

  • 1 if you are entitled to reimbursement at the higher special rate (100%)
  • 2 if you are entitled to reimbursement at the lower special rate (65%)
  • 3 if you are entitled to limited basic reimbursement (40%)
  • 5 or 6 if you are entitled to reimbursement for clinical nutrients (40% or 65%).

Reimbursement at the pharmacy

The pharmacy confirms your entitlement to reimbursement by consulting Kela electronically. If you have been granted entitlement to reimbursement and meet the initial deductible, you will get the reimbursement due to you right away at the pharmacy. You get the reimbursement even if you do not yet have a new Kela card.

Retroactive entitlement to special reimbursement

The general rule is that you get a reimbursement for medicines purchased on or after the first date of your entitlement.

However, under certain conditions, you may be able to get a reimbursement for medicines purchased before that date. In that case, you can get a special reimbursement for a medicine or a reimbursement for a clinical nutrient that you purchased after your illness was diagnosed. The amount you purchase may not exceed the amount you need for three months’ use.

If you purchased a reimbursable medicine or clinical nutrient before Kela granted you the reimbursement entitlement, you can apply to Kela for a reimbursement. Apply within 6 months of the purchase. Kela may contact you or pay the reimbursement automatically if it finds, based on the medical certificate B, that you are entitled to a special reimbursement for previously purchased medicines.

Retroactive entitlement to basic reimbursement

The general rule is that you get a reimbursement for purchases made on or after the first date of your entitlement. However, under certain conditions, you may be able to get a reimbursement for medicines purchased before that date.

If you purchased a medicine covered by rules for limited basic reimbursement before being granted an entitlement to reimbursement, you can apply to Kela for a reimbursement. Apply within 6 months of the purchase.

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