How does the state health insurance system work?

Finland finances its healthcare system out of taxes and like many European countries, faces a dual problem of an ageing population who are most likely to need medical treatment, and a smaller percentage of tax-payers as a consequence. This inevitably impacts on the healthcare system, which has become overstretched and underfunded.

Finland’s municipalities run the healthcare system and clients are put into one of two groups:

  • group 1 patients can choose their GP within the area in which they live
  • group 2 patients can go to whichever doctor or specialist they please

The funding for this system comes from taxes collected by the municipal authorities, but they can ask for both user fees and state subsidies if the tax revenue is not sufficient to fund healthcare, so you might find yourself having to pay a relatively small sum for your care. For a doctor’s visit, for example, you could be charged around €20, but these fees are capped by the municipality and can only be charged three times per year.

Everyone is covered under the NHI, which is run by the Social Insurance Institution (SII). Your national insurance payments will cover a range of things such as health insurance, unemployment benefit and maternity leave.

When you sign up under the national scheme (sairausvakuutus) with the Social Insurance Institution of Finland (Kela), you will be issued with a Kela card (Kela-kortti). You will need to take this with you when you visit your GP or go to a pharmacy to pick up a prescription.

Kela also covers sickness benefit, so if you are unable to work due to illness or an accident, you can claim cover for 300 working days. The amount paid will depend on your income.

You can use your EHIC card in Finland if you are from an EU member state, but remember that this is not supposed to be a substitute for health insurance: it is only for emergencies.

In some areas of the country, a telemedical service is available in English.

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Who is eligible for state healthcare?

Everyone is eligible if they have a ‘municipality of residence’ (kotikunta). If you are not sure whether you qualify for this, you can check with a local register office (maistraatti). If you are not covered by Kela, you may still be treated, although the healthcare system may recover the costs from you later on.

Kela regards residency as permanent on the basis of:

  • return migration to Finland
  • employment in Finland lasting at least two years
  • marriage or a close family relationship with a person already residing in Finland

How do you apply to join the state health insurance system?

Your employer should register you if you are working in Finland. If you are self-employed or not working, you will need to check with your local municipal authority.

What is covered by the state health insurance system?

Kela covers:

  • visits to the doctor
  • hospital treatment
  • maternity care
  • part of your prescription fees
  • part of your dental treatment

This operates on a co-pay system: you will have some upfront costs when seeking treatment, but reimbursements are automatically applied on the spot. In some cases — for example, if you have paid upfront for private treatment, some of which Kela covers — you will need to apply for reimbursement separately. To do this, you will need:

  • an itemised statement of fees
  • documentary evidence for any tests or treatments
  • proof of payment

Are retirees covered by state medical insurance?

If you retire to Finland and register with Kela once you have organized your residency, you will be eligible for full coverage.

Are students covered by state medical insurance?

International students are generally not covered by the scheme, unless they come from other Nordic countries. They will need to be recorded in the Finnish population register. If you are an international student, you may need private cover.

Will your family be covered by your insurance?

If your dependents also have municipality of residence, they will be eligible to sign up with Kela. If you are uncertain about their status, check with your local register office.

Is dental treatment covered by state health insurance?

Part of your dental treatment may be covered by Kela. Basic treatment is covered, as are x-rays if they are ordered by your dentist. You might need to pay for treatments from the hygienist.

What are the contribution rates for state health insurance?

Employees’ medical insurance contribution is 1.53%, provided that the annual taxable income exceeds €14,020 (otherwise 0.00%; no cap). For employers it is 0.86%, which goes into the Finnish tax system; employees’ payments go to the insurers. Foreign employers are also liable.

Why buy private health insurance?

The private medical sector in Finland is very small, and if you are planning on using it, be aware that private care can be expensive.

Long waiting times and an overstretched system are the two main reasons why people take out private cover.

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What is covered by private health insurance?

Private insurance will cover the full range of primary healthcare and hospital treatment, as well as:

  • dental treatment
  • occupational healthcare
  • physiotherapy
  • elective cosmetic treatment

How much does private health insurance cost?

As with all private cover, this will depend on personal factors such as age and any pre-existing conditions. The more expensive the package, the more coverage you will be eligible for. Check, too, whether your employer has a contract with a private provider.

For those seeking international private medical insurance (iPMI) cover for multiple countries including Finland, numerous variables can have an impact on the cost.

The most important variables are:

  • age (the higher the more expensive)
  • area of cover (i.e. in addition to Finland, which other areas is coverage required in? If those other areas include any of the US, the Caribbean, Singapore, China, Hong Kong or Dubai this can significantly increase the overall price)
  • product choice (higher end insurance products are more expensive)

Other variables include:

  • deductibles
  • co-insurance
  • payment frequency
  • gender
  • nationality
  • country of residence

As so many variables have an effect on the cost of international private medical insurance in Finland it becomes very difficult to give accurate estimates without knowing the full details of the coverage required. However, as a very rough guide, using a standard profile of a 40 year old British male with no deductibles, no co-insurance, a middle tier plan/product, all modules included and worldwide coverage excluding the US, a ballpark price of around £4,000/$5,000 might be expected. Were coverage to be expanded to include the US then the premium could increase to almost double that amount.

Which companies offer private health insurance?

Some of the big international providers cover Finland, including:

  • AXA
  • Bupa Global
  • Cigna Global
  • Foyer Global
  • Pacific Prime

For international students, cover is also provided by:

  • Atlas Travel
  • Europe Travel
  • Student Secure

Glossary of health insurance terms

henkilötunnus(Fin) / personbeteckning (Swe) – personal ID code

Kela - Social Insurance Institution of Finland

Kela-kortti – Kela card

kotikunta - municipality of residence

sairaalat - district hospitals

sairausvakuutus - the national health insurance scheme

terveysasemat - municipal health centres

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