Reimbursable costs

Public healthcare costs
Private healthcare costs
Other reimbursable costs

Public healthcare costs

The sickness fund 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 sickness 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, 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, ask them to deduct the Kela reimbursement from the price, and then apply for sickness fund´s reimbursement. The sickness fund does not reimburse treatment for cosmetic reasons or dental care products.

Doctor’s fees

The sickness fund and Kela together reimburse 70% of doctors’ consultation fees, procedure fees, and statement fees when the statement is issued for a benefit under the Health Insurance Act or for Kela’s rehabilitative psychotherapy.To receive the reimbursement, the visit must take place at a contract provider.As an exception to this, visits to ophthalmologists, urologists, and gynecologists may also take place at non-contract providers. If you use a non-contract provider, ask them to deduct the Kela reimbursement from the price and then apply for the sickness fund's reimbursement. In connection with surgeries, procedures and examinations, the service provider may also charge a facility fee. The sickness fund does not reimburse facility fees under its regulations.If you are planning a surgery or any other more expensive procedure with a private service provider, we recommend checking with the sickness fund in advance, to confirm if the procedure is reimbursable.

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, you will receive the 70% reimbursement directly at the point of service. Discounts offered by the fund’s contract providers for insured members are listed in sPoint. If you use a non-contract provider, ask them to deduct the Kela reimbursement from the price and then apply for sickness fund´s reimbursement. In connection with procedures and examinations, the service provider may also charge a facility fee. The sickness fund does not reimburse facility fees under its regulations.

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, you will receive the 70% reimbursement directly at the point of service. If you use a non-contract provider, ask them to deduct the Kela reimbursement from the price and then apply for sickness fund´s reimbursement.

Nurse’s care

The sickness fund reimburses 70% of fees for care provided by a nurse. You may choose your service provider. If you use a contract provider, you will receive the 70% reimbursement directly at the point of service. If you use a non-contract provider, apply for the sickness fund´s reimbursement yourself.

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, and Kela-reimbursement is also provided. 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, you will receive the 70% reimbursement directly at the point of service. Discounts offered by the fund’s contract providers for insured members are listed in sPoint. If you use a non-contract provider, ask them to deduct the Kela reimbursement from the price (the year's first four visits) . Then apply for sickness fund´s reimbursement. If it is not possible to deduct the Kela reimbursement from the price, ask your physiotherapist to give you the Kela form sv 3fs (Statement of treatment provided by a physiotherapist). Attach the form to your application.

Short-term psychotherapy

The sickness fund reimburses 70% of short-term psychotherapy provided by a psychologist or psychotherapist, up to €800 per calendar year. For 2025 and 2026, 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, 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. When applying for reimbursement yourself, attach the referral/guidance to the first reimbursement application for the treatment period. From the public JulkiTerhikki register you can verify, that your treatment provider is psychologist or psychotherapist.

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% of the following expenses, up to a maximum total of €280, every second calendar year: glasses, sunglasses, or contact lenses prescribed by a doctor or optician, optician’s eye examinations, and corrective eye surgeries. The date shown on the optician´s sales receipt or, if payment is made by invoice, the invoice date, is considered as the purchase date.

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 reimbursed by Kela. Reimbursement is paid only after the annual initial deductible (70€) has been reached. The fund has contracts with nearly all pharmacies in Finland, so you can receive direct reimbursement at the pharmacy. If direct reimbursement is not possible, apply for reimbursement from the sickness fund yourself. Reimbursement is paid for up to a three‑month 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.

Which costs are reimbursed?