Costs of seeking care in another EU country will be smaller
The Government proposes amendments to the Act on Cross-Border Health Care and the Health Insurance Act. A so-called gatekeeper model would be introduced for reimbursing of costs. It would take into account the new national service system created with the health and social services reform.
Persons seeking care in another EU country would get health services on the same reimbursement grounds as in Finland. Moreover, no prior authorisation or notification would be necessary for direct-choice services referred to in the Freedom of Choice Act. Reimbursement for other health services would be subject to a prior assessment of need for care or referral.
Persons seeking care in another EU country would still be obliged to pay their care and travel costs first themselves. Costs would be reimbursed retroactively up to an amount corresponding with the costs of organising the same care in the health services of the county where the person is a resident. Persons seeking care in another EU country would still have to pay themselves for the client fee charged from patients receiving the same or corresponding care in Finland.
The Act would apply only to health services. The basic principle is that the costs of health services received abroad would be reimbursed only when the service is included in the Finnish selection of health services. This would mean health services which, if delivered in Finland, would be the responsibility of the counties.
In future the county with responsibility for organising services would be responsible for the costs of health services delivered to its residents in another EU or EEA country or Switzerland. The proposed amendments would safeguard a higher reimbursement when individuals purposely seek health services in another EU country.
People seeking care in Finland must have access to the same services as Finnish residents
Health service providers would be obliged to accept as client people from other EU or EEA countries or Switzerland without discrimination on the same grounds as Finnish residents. The normal client fee and a fee based on the price of product could be charged from people seeking care in Finland.
Counties could receive compensation from the state for costs incurred from certain health services delivered to non-Finnish residents. These would include involuntary treatment following a mental examination, necessary care for pregnant women, certain examinations relating to child protection services, and isolation, care and medication under the Infectious Diseases Act.
The Government submitted a proposal on the amendments to Parliament on Thursday, 1 June 2017. The Act is meant to enter into force on 1 September 2019.
Kirsi Ruuhonen, Ministerial Adviser, tel. +358 2951 63239 (until 5 June 2017)
Merituuli Mähkä, lawyer, tel. +358 2951 63575