Reimbursable costs

Reimbursable Costs

Public Healthcare Costs
Private Healthcare Costs
Other Reimbursable Costs

Public Healthcare Costs

The sickness fund (SAKA) reimburses 70% of public healthcare client fees (e.g., hospital outpatient fees, health center fees, series treatment fees, day surgery fees, dental visit and procedure fees, and daily care fees). First, pay the invoice to your Wellbeing Services County or HUS, then apply for reimbursement by submitting the invoice to the fund. The invoice must include your name, date of visit, and the treatment charged.

Private Healthcare Costs

Dental Care

The sickness fund reimbursement, together with the Kela reimbursement, covers 70% of dental care costs, up to €900 per calendar year. You may choose your service provider. If you use a contract provider (link to contract providers to be added), you will receive the 70% reimbursement directly at the point of service. Discounts offered by the fund’s contract partners for insured members are listed in sPoint. If you use a non-contract provider, you first pay the full amount, deduct the Kela reimbursement, and then apply for the additional benefit from the sickness fund afterwards. The sickness fund does not reimburse treatment for cosmetic reasons or dental care products.

Doctor’s Fees

The sickness fund (SAKA) reimburses: a) 70% of the fees charged by the doctor for appointments and procedures. To receive this reimbursement, the visit must take place at one of the fund´s contract partners. The list of contract partners is published on the fund’s website. As an exception, the additional benefit is also paid for services obtained from providers other than contract partners, if the fees are charged by specialist in ophthalmology, urology, or gynaecology. b) 70% of statement fees charged by a doctor when the statement has been written for a benefit under the Health Insurance Act or Kela’s rehabilitation psychotherapy.

Examinations

The sickness fund reimburses 70% of the cost of examinations prescribed by a doctor or dentist to treat or diagnose a disease, with the following clarifications and exceptions:

MRI (magnetic resonance imaging) requires a referral from a specialist.
Pregnancy ultrasound examinations are not reimbursed.

You may choose your service provider. If you use a contract provider (link to contract providers to be added), you will receive the 70% reimbursement directly at the point of service. Discounts offered by the fund’s contract partners for insured members are listed in sPoint. If you use a non-contract provider, you first pay the full amount and then apply for the additional benefit from the sickness fund afterwards.

Light Therapy

The sickness fund reimburses 70% of the cost of light therapy prescribed by a doctor for chronic skin diseases, up to 15 sessions per calendar year. You may choose your service provider. If you use a contract provider (link to contract providers to be added), you will receive the 70% reimbursement directly at the point of service. Discounts offered by the fund’s contract partners for insured members are listed in sPoint. If you use a non-contract provider, you first pay the full amount and then apply for the additional benefit from the sickness fund afterwards.

Nurse’s Care

The sickness reimburses 70% of fees for care provider by a nurse.

Physiotherapy

The sickness fund reimbursement, together with the Kela reimbursement, covers 70% of physiotherapy costs, up to a maximum of €800 per calendar year. For the first four visits, no referral is needed. From the fifth visit onwards, a referral from HOK-Elanto’s occupational physiotherapist or a doctor is required. You may choose your service provider. If you use a contract provider (link to contract providers to be added), you will receive the 70% reimbursement directly at the point of service. Discounts offered by the fund’s contract partners for insured members are listed in sPoint. If you use a non-contract provider, you first pay the full amount, deduct the Kela reimbursement, and then apply for the additional benefit from the sickness fund afterwards. When applying for reimbursement yourself, attach the referral/guidance to the first reimbursement application for the treatment period.

Short-Term Psychotherapy

The insurance fund reimburses 70% of short-term psychotherapy provided by a psychologist or psychotherapist, up to €800 per calendar year. For 2025, the reimbursement is 80%, with a maximum of €1,000. A referral or guidance from HOK-Elanto’s occupational health team doctor, nurse, or psychologist is required. You may choose your service provider. If you use a contract provider (link to contract providers to be added), you will receive the 70% reimbursement directly at the point of service. Discounts offered by the fund’s contract partners for insured members are listed in sPoint. If you use a non-contract provider, you first pay the full amount, deduct the Kela reimbursement, and then apply for the additional benefit from the sickness fund afterwards. When applying for reimbursement yourself, attach the referral/guidance to the first reimbursement application for the treatment period. You can verify a social welfare or healthcare professional’s registration in the public JulkiTerhikki register.

Other Reimbursable Costs

Glasses, Contact Lenses, Corrective Eye Surgery

Reimbursement is available after you have been insured for one year. The sickness fund reimburses 70%, up to €280 every other calendar year, for the following costs: glasses, prescription sunglasses, contact lenses, optician’s eye examination, and corrective eye surgery. (The purchase date is the date on the receipt or invoice.)

Medicines

The sickness fund and Kela together reimburse 70% of the cost of medicines prescribed by a doctor or dentist, if the medicines are also covered by Kela. Reimbursement is paid only after the annual initial deductible has been reached. The fund has agreements with nearly all pharmacies in Finland, so you can receive direct reimbursement at the pharmacy by presenting your Kela-card. If direct reimbursement is not possible, you can apply for reimbursement from the fund yourself. Reimbursement is paid for up to three months’ supply of medicines at a time.

Orthopedic Insoles and Medical Compression Stockings

The sickness fund reimburses 70% of the cost of medical compression stockings or orthopedic insoles prescribed by a doctor or physiotherapist, up to €120 every other calendar year.