Healthcare and social welfare for illegal residents 

Illegal residents mean persons who have no right of residence in Finland according to the Aliens Act. An asylum seeker’s residence in Finland is considered unauthorised when a decision to reject the asylum application becomes legally effective or a decision has been made to remove the asylum seeker from the country. Such persons are then no longer covered by reception services.

Municipalities must always check with the reception situation centre of the Finnish Immigration Service to find out whether an individual has a right of residence in Finland. Municipalities are also obliged to refer illegal residents to the system of voluntary return.  

Healthcare

Right to get urgent care

According to the Health Care Act, public healthcare must always provide urgent care to all who are in need of it, irrespective of whether they have or have not the right to health services on the basis of residence in a municipality or on some other grounds.

Urgent cases mean cases involving:

  • an injury, a sudden onset of an illness, a long-term illness suddenly getting worse, or a deterioration of functional ability where immediate intervention is required. In these cases, starting the treatment cannot be postponed without aggravating the illness or injury.
  • urgent oral healthcare, mental healthcare, substance abuse care and psychosocial support.

The assessment of need for urgent care is usually made by the unit providing 24-hour healthcare. Healthcare professionals assess whether patients are in need of urgent care. Their assessment is a medical assessment based on the health of the patient and on national clinical guidelines.

Patients who have no residence permit or municipality of residence in Finland must pay themselves the costs of urgent care in full.

Municipalities can decide to grant illegal residents access to even other services than urgent care.

Provision of non-urgent care

Some illegal residents need also non-urgent care. Municipalities are not obliged to provide public healthcare services to persons who have no municipality of residence in Finland unless they are covered by EU legislation or an international social security agreement.

Illegal residents who receive non-urgent care in public healthcare must pay themselves the costs of care in full.

Social welfare

Illegal residents who need indispensable assistance urgently should primarily be referred for a needs assessment to the authority responsible for social welfare in the municipality. Municipalities must always check with the reception situation centre of the Finnish Immigration Service to find out whether an individual has a right of residence in Finland. Where possible, municipalities should also ensure that illegal residents who receive emergency accommodation are provided with food and possible other acute assistance.

According to the Social Welfare Act, every person residing in the municipality has, in an emergency situation, the right to receive social services based on their individual needs in a way which does not endanger their right to receive indispensable subsistence and care. In other than urgent cases, services will be provided for persons who have a municipality of residence in Finland. Those in need of urgent social services under the Social Welfare Act should turn to their temporary municipality of residence.  

Organisation of temporary accommodation and other urgent social welfare

Temporary accommodation under the Social Welfare Act is organised for persons who need short-term urgent assistance. The organisation of temporary accommodation is associated with different kinds of crises, and the aim is to find a solution that best suits each person’s situation. At the same time the person’s need for other urgent social welfare should be assessed. A social welfare professional will assess what kinds of urgent services the person needs. 

One possible form of services is emergency accommodation which can be arranged also for persons without a residence permit. Urgent social welfare in connection with indispensable care can also include food, clothing and necessary medication. Even regarding urgent socials services the client must be given an appealable decisions and instructions concerning claim for a revised decision.

Children residing illegally in the country have the right to receive services under the Child Welfare Act.

Division of duties between municipalities and Kela

Municipalities have the main responsibility to provide urgent assistance to illegal residents. If someone contacts a Kela office on their own initiative, Kela must first check the Register of Aliens to see whether they have a residence permit and then decide whether they are entitled to social assistance. Clients in need of urgent assistance are referred by Kela to the municipality where an overall assessment of their need for assistance will be conducted. Primary forms of assistance include food and other material assistance gives as part of emergency accommodation. Kela is also obliged to refer illegal residents to the system of voluntary return.

Municipalities’ right to reimbursement

Kela reimburses municipalities or joint municipal authorities for the costs of providing urgent medical care to persons who have no municipality of residence in Finland and who could not pay the costs themselves. The right to reimbursement is based on the Act on Cross-Border Health Care (1201/2013).

A condition for the reimbursement is that the municipality or the joint municipal authority has tried to recover the costs of medical care from the client or elsewhere (such as an insurance company).

The State will only reimburse the costs of urgent medical care. Municipalities that have decided to allow illegal residents access to a wider selection of services are also responsible for the all costs incurred in the services.

Municipalities can also decide not to recover the actual costs of urgent medical care of illegal residents, but then they are no longer entitled to reimbursement from the State.  

Referring persons to the voluntary return system

Municipal authorities must refer illegal residents to contact immigration authorities. In the system for voluntary return, aliens applying for international protection can receive reasonable compensation for their relocation costs as well as financial aid if they leave Finland voluntarily.

Further information

Henna Leppämäki, Senior Specialist 
Ministry of Social Affairs and Health, Department for Clients and Services in Healthcare and Social Welfare / APO, Service System Unit / PAL Telephone:0295163132   Email Address:

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