The government has taken a pilot project allowing people aged 65 and over to book a private healthcare appointment and pay only a deductible that is equal to the client fee charged for public healthcare services.
The President on Friday approved the legislative amendments enabling the pilot project, Ministry of Social Affairs and Health in a press release.
The temporary amendments to the Acts will enter into force on September 1, 2025 and will continue until the end of 2027.
The pilot is based on developing the reimbursements paid by the Social Insurance Institution of Finland (Kela).
“This pilot is about improving the availability of healthcare services and increasing freedom of choice for older adults. We want to give those aged 65 and over quicker access to a doctor,” said Minister of Social Security Sanni Grahn-Laasonen.
Appointments with private general practitioners will be reimbursed for persons aged 65 and over so that the amount paid by the client is no more than the fee charged for a doctor’s appointment in primary healthcare about EUR 28.
Kela will reimburse service providers for the amount exceeding the deductible.
Reimbursement can be paid a maximum of three times per calendar year for doctor’s appointments, examinations and tests in the private sector.
Because the proposal enters into force in September, reimbursement can be paid for two appointments in autumn 2025.
People belonging to the age group in question can be reimbursed for the most common tests and examinations, such as blood tests, urine tests, EKG and thorax x-ray.
Kela will confirm a list of reimbursable tests and examinations separately. For laboratory tests and samples that are based on a referral from a general practitioner and included in the pilot, reimbursement will be paid for half of the maximum fee confirmed by Kela.
The pilot includes a price cap to determine the maximum fees that can be charged for appointments, examinations and tests included in the pilot.
The purpose of the price cap is to prevent prices from rising and to keep the costs payable by clients reasonable.
The deductible paid by the client for a healthcare appointment may also be less than EUR 28 if the service provider offers the service at a price below the maximum price.
Provisions on the grounds for the maximum fees charged for appointments with general practitioners and for examinations and tests will be laid down by government decree, which has just been sent out for comments.
Kela is responsible for determining and confirming the maximum fees for doctors’ appointments, examinations and tests.
It will also publish a list of doctors’ fees and examinations and tests prescribed by doctors that are reimbursable and of their reimbursement rates.
The precondition for reimbursement is that the private healthcare service provider and Kela have concluded a contract on service provision.
The pilot aims to develop the Kela reimbursement system as part of the entire service structure within healthcare and social welfare, to improve clients’ freedom of choice and the availability of primary healthcare services, and to ease the burden on public healthcare.
- Private
- Healthcare
- 65+ people
Source: www.dailyfinland.fi
