Health care of undocumented persons
There are people residing both legally and illegally in Finlandthat are referred to as undocumented persons. Undocumented personsrefer to several different groups of people that have differenttypes of needs for health care services. It is estimated that thereare approximately three thousand undocumented persons inFinland.
Who is undocumented?
An undocumented person usually refers to:
- a person residing in Finland without a residency permit that has come from a non-EU country or outside of the European Economic Area or Switzerland. The person's residency permit has expired or entry / residency in the country is not legal.
- A person that has come to Finland to study or for another reason from outside of the EU, European Economic Area or Switzerland. The person has received a residency permit based on private health insurance, but the coverage has expired or it is not comprehensive.
- A person that has come to Finland from outside of the EU, European Economic Area or Switzerland and residency proceedings are still in progress or unclear.
- A EU citizen who is in the country legally, but does not have health insurance coverage for illness or health care.
A person is not automatically an undocumented person, if he orshe does not have a residency municipality or health insurancecoverage in Finland. In this context, undocumented persons do notrefer to individuals in Finland on short-term tourist or businesstrips (3 months).
Who does care have to be given to?
In Finland, the Municipality of Residence Act determines if aperson is to be granted health care services by the public healthsystem. Providing health insurance coverage is determined based onthe Health Insurance Act.
A person may, however, be entitled to public health careservices and/or health insurance medical care compensation, if EUlegislation or an international social security agreement sorequires. A home municipality or health insurance is not requiredin such cases.
According to the Health Care Act, public health care must alwaysprovide urgent treatment to all that need it.
Urgent care refers to:
- sudden illness, injury, worsening of a long-term condition or decrease in ability to function that requires immediate assessment and treatment. In these cases, treatment cannot be delayed without the sickness or injury worsening.
- urgent oral care, mental health care, substance abuse care and psychological care.
The patient will pay for the treatment, if he or she does nothave a residency municipality in Finland or is not entitled to usepublic health care services based on EU law or an internationalsocial security agreement.
Payment is handled after urgent care is administered.
Providing non-urgent care
Some undocumented persons also have the need for non-urgenthealth care services. However, the person is not entitled to usepublic health care services if he or she does not have a residencymunicipality in Finland or EU legislation or an internationalsocial security agreement does not apply.
If an undocumented person is given treatment through publichealth care, he or she pays the full cost of the treatment.
The National Institute for Health and Welfare investigated theorganising of health care services
The National Institute for Health and Welfare (THL) wascommissioned by the Ministry of Social Affairs and Health toinvestigate the healthcare for undocumented persons residing in thecountry without a residency permit or health insurance. Finland isnot currently providing proper healthcare for undocumentedpersons.
The report also indicates that further work is required toestablish, among other things, the means for recognizingundocumented persons in the healthcare system, how medicationexpenses for outpatients will be reimbursed, and how, from theperspective of public health, to ensure the prevention ofcommunicable diseases via provision of vaccines.
Health insurance of students from third countries
Students that come to Finland to study from outside of the EU,European Economic Area, or Switzerland are required to have validprivate health insurance. The student is responsible for obtaininghealth insurance coverage.
If the estimated duration of the studies in Finland are lessthan two years, the student is usually not assigned a residencymunicipality. In this case, the student must acquire private healthinsurance, which covers treatment and drug costs up to EUR100,000.
If the studies in Finland are estimated to last at least twoyears, the student is usually granted a residency municipality. Inthis case, the student must have private health insurance, whichcovers drug costs up to EUR 30,000.
Students from third countries are always entitled to use studenthealth care services, in accordance with the Health CareAct.
Taneli Puumalainen, Senior Medical Officer, THL, tel. +358(0)29524 6080, [email protected]
Ilmo Keskimäki, Research Professor, THL, tel. +358 (0)295 247256, [email protected]