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Statistical information on cross border health care 2019

Statistics provided by the Contact Point for Cross-Border Health Care in Finland and Kela (the Social Insurance Institution of Finland) include information on cross-border healthcare, European Health Insurance Card (EHIC), medical care costs incured abroad and their reimbursements, and prior authorisations for seeking treatment abroad.

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Statistical information on cross border health care 2019

  1. 1. Statistical information on cross-border health care in Finland 2019 April 28th, 2020
  2. 2. Table of contents 1. Medical costs incurred in EU and EEA countries and in Switzerland and their reimbursements 2. Top 5 countries: medical costs and their imbursements when seeking treatment independently 3. Medical costs incurred outside EU and EEA countries and Switzerland and their reimbursements 4. Top 5 countries: Medical costs incurred outside EU and EEA countries and Switzerland and their reimbursements 5. Prior authorisation provided in Finland for treatment provided in an EU or EEA country or in Switzerland and information on the costs 6. Amounts Kela has invoiced EU and EEA countries and Switzerland for treatment provided in Finland on the basis of prior authorisation (€) 7. State reimbursement for costs of treatment and urgent social services 8. Debts and receivables for medical costs between Finland and other EU and EEA states and Switzerland 9. Numbers of European Health Insurance Cards (EHIC) issued by Kela 10. Contact Point for Cross-Border Healthcare 2
  3. 3. 1. Medical costs incurred in EU and EEA countries and in Switzerland and their reimbursements Number of resolutions Costs € (paid by customer) Paid reimbursements € 2019 2018 2017 2019 2018 2017 2019 2018 2017 Physiotherapy 48 81 81 10, 905.45 21,385.58 16,886.37 2,920.1 3,079.6 2,846.00 Dentist’s fees 4,177 5,828 6,376 1,773,334.44 2,257,354.32 2,277,408.59 203,48.18 281,326.99 305,339.84 Medicines 1,834 1,930 1,796 201,157.96 231,579.47 222,539.49 72,199.15 78,808.46 86,774.32 Doctor’s fees 1,540 2,086 2,114 492,396.2 707,626.56 548,380.99 68,684.04 88,070.67 85,213.61 Travel 908 1,135 1,361 351,869.21 244,368.91 310,352.20 154,203.69 89,447.46 106,698.96 Examination and care 2,264 3,187 3,234 182,177.99 390,322.85 224,199.64 52,835.13 74,386.01 72,481.29 Necessary treatment 4,300 4,132 7,098 3,070,038.92 2,385,105.27 4,874,782.06 2,411,939.45 1,840,262.33 4,025,266.16 • The costs mentioned in the table have been incurred from either sudden illness or seeking treatment independently. • Sudden illness means that the need for treatment has occurred during a stay abroad. • Seeking treatment independently means that the customer has travelled abroad with the purpose of receiving treatment and they do not have prior authorisation pursuant to EU regulations. • Costs of necessary treatment are linked to situations of sudden illness. The treatment costs have been reimbursed in accordance with the customer fee of Finnish public health care (Act on Cross-Border Health Care). • Physiotherapy, dentist’s fees, medicines, doctor’s fees, travel and examination and care may relate to situations of either sudden illness or seeking treatment independently. The reimbursement has been paid in accordance with the Health Insurance Act. • The number of resolutions means the number of decisions given to customers. One resolution or decision may include one or more procedures, examinations, treatments, medicines or travels. Kela does not keep statistics of the numbers of people. • The statistics are compiled according to the resolution date. Reimbursement must be sought within half a year of paying the costs. Therefore, the treatment relating to the statistics may have been given the year before. • More information: https://www.kela.fi/web/en/from-finland-to-another-country-medical-care-abroad Source: Kela 3
  4. 4. 2. Top 5 countries: medical costs and their imbursements when seeking treatment independently Year 2019 Country Costs € Reimbursements € 1. Estonia 2,033.000 283,000 2. Spain 289,000 27,000 3. Hungary 152,000 6,000 4. Germany 99,000 10,500 5. Belgium 90,000 3,700 Year 2018 Country Costs € Reimbursements € 1. Estonia 2,581.000 371,000 2. Germany 485,000 14,000 3. Spain 331,000 33,000 4. Hungary 224,000 8,000 5. Sweden 95,000 2,000 • The costs are the price charged to the customer abroad for which they have applied to Kela for reimbursement. • The costs have been incurred from seeking treatment independently abroad, i.e. the treatment has been sought without prior authorisation. • Kela reimburses the costs of seeking treatment independently if the treatment has been provided in an EU or EEA country or in Switzerland. • Treatment costs are reimbursed in the same manner as treatment given in Finnish private health care. • Medicine expenses are reimbursed in the same manner as medicines purchased in Finland. • Travel costs are reimbursed in the same way as if the customer had travelled to the health care unit closest to their home address where they would have received the necessary treatment. • The statistics are compiled according to the resolution date. Reimbursement must be sought within half a year of paying the costs. Therefore, the treatment relating to the statistics may have been given the year before. • The majority of the reimbursements for health care costs are reimbursements for dental care provided in Estonia. More detailed information on the treatment is not available. • More information: kela.fi/web/en/medical-treatment-in-international-situations-seeking-treatment-abroad Source: Kela 4
  5. 5. 3. Medical costs incurred outside EU and EEA countries and Switzerland and their reimbursements Number of resolutions Costs € (paid by customer) Paid reimbursements € 2019 2018 2017 2019 2018 2017 2019 2018 2017 Physiotherapy 34 29 63 11,661.6 6,724.73 33,901.24 637,99 607,00 2,202.98 Dentist’s fees 48 96 94 23,749.14 55,187.42 39,237.31 2,112.97 4,528.93 4,542.39 Medicines 424 532 860 56,784.64 63,898.64 65,803.78 9,837. 24 9,528.05 12,880.12 Doctor’s fees 1,078 1,141 2,436 689,657.86 547,656.68 1,609,308.97 65,627.73 59,174.57 125,430.29 Travel 63 98 82 125,282.87 14,391.24 59,382.20 0 0 4,669.65 Examination and care 744 691 1,532 478,254.6 371,289.22 1,344,983.98 34,462.51 29,520.98 94,738.50 • The costs have been incurred from sudden illness. • Sudden illness means that the need for treatment has occurred during a stay abroad. • The reimbursement has been paid in accordance with the Health Insurance Act. • The number of resolutions means the number of decisions given to customers. One resolution or decision may include one or more procedures, examinations, treatments, medicines or travels. Kela does not keep statistics of the numbers of people. • The statistics are compiled according to the resolution date. Reimbursement must be sought within half a year of paying the costs. Therefore, the treatment relating to the statistics may have been given the year before. • More information: kela.fi/web/en/medical-treatment-in-international-situations-medical-treatment-abroad Source: Kela 5
  6. 6. 4. Top 5 countries: Medical costs incurred outside EU and EEA countries and Switzerland and their reimbursements Year 2019 Country Costs paid by customer (€) Reimbursements (€) 1. Thailand 1,296.000 40,000 2. USA 991,000 13,000 3. Turkey 330,000 15,000 4. Peru 97,000 4,000 5. Russia 82,000 3,000 Year 2018 Country Costs paid by customer (€) Reimbursements (€) 1. Thailand 683,000 36,000 2. USA 668,000 10,000 3. Turkey 217,000 13,000 4. China 204,000 4,300 5. Dominican Republic 68,000 3,000 Source: Kela 6
  7. 7. 5. Prior authorisation provided in Finland for treatment provided in an EU or EEA country or in Switzerland and information on the costs Year Resolutions Granted Denied Not processed Amount paid by hospital districts for treatment covered by the prior authorisation, €* 2019 176 102 69 5 659,419 2018 215 103 104 8 468,966 2017 200 106 82 12 213,332 2016 246 126 113 7 510,160 2015 197 98 97 2 567,239 • Under certain conditions, Kela may grant prior authorisation for treatment in EU or EEA countries or Switzerland. Prior authorisation is not granted for treatment outside the EU. • Kela grants prior authorisation according to the statement by public health care. • When a patient receives treatment abroad on the basis of prior authorisation, the country providing the treatment invoices Kela for the actual costs of treatment and collects a client fee from the patient. Kela pays the costs and invoices them to public health care. • The prices of treatment may vary considerably: a single treatment may cost between 100 and 100,000 euros. Therefore, the amounts in euros depend on what treatment has been given each year. • Prior authorisations have mainly been granted for the care of pregnancy, childbirth, eye disease and cancer. Most prior authorisations have been granted for treatment in Estonia, followed by Sweden. • More information: kela.fi/web/en/medical-treatment-in-international-situations-seeking-treatment-abroad *Refers to the year when public health care has paid Kela the costs of treatment covered by the prior authorisation. The patient living in Finland has received the treatment abroad earlier, possibly the preceding year. Source: Kela 7
  8. 8. 6. Amounts Kela has invoiced EU and EEA countries and Switzerland for treatment provided in Finland on the basis of prior authorisation (€) Year Amount invoiced by Kela, €* 2019 195,009 2018 535,735 2017 326,055 2016 426,841 • Another EU or EEA country or Switzerland may grant a patient prior authorisation for treatment to be provided in Finland. • If a customer has prior authorisation, they pay the client fee for treatment in Finnish public health care. The state that granted the prior authorisation is responsible for the actual costs of treatment. • If a patient has received treatment in Finland with prior authorisation, public health care invoices the actual treatment costs to Kela. Kela pays the costs and invoices them to the state that granted the prior authorisation. • There is no information on the numbers of patients that have come to Finland with prior authorisation. Finland charges Estonia and Sweden the most on the basis of prior authorisation. • More information: www.kela.fi/web/en/medical-treatment-in-international-situations-who-pays-your-care *Refers to the year when Kela has invoiced the costs of seeking treatment in Finland from abroad. The treatment has been given to the patient from abroad earlier, possibly the preceding year. Source: Kela 8
  9. 9. 7. State reimbursement for costs of treatment and urgent social services Year Number of invoices Reimbursements € 2019 25,644 20.63 million 2018 23,898 19.59 million 2017 27,663 21.04 million 2016 21,340 17.82 million 2015 22,744 16.57 million • The purpose of state reimbursement is to compensate: • public healthcare for treatment costs when treatment has been given to persons who 1) do not have a municipality of residence in Finland or who 2) have a municipality of residence in Finland but whose medical care costs are covered by another EU or EEA country or Switzerland; • for costs of emergency social services to municipalities that have provided food, medicine or emergency accommodation to a person who has received a negative asylum decision. • Kela pays the state reimbursement four times a year on the basis of applications. • More information: www.kela.fi/web/en/medical-treatment-in-international-situations-who-pays-your-care Source: Kela 9
  10. 10. 8. Debts and receivables for medical costs between Finland and other EU and EEA states and Switzerland Year Number of invoices sent by Finland Reimbursements received, € million Number of invoices received by Finland Reimbursements paid, € million 2019 10,690 9,49 M€ 40,192 24,33 M€ 2018 9,934 10,08 M€ 35,685 18,08 M€ 2017 8,831 4,79 M€ 30,754 8,85 M€ 2016 7,173 6,00 M€ 33,193 13,45 M€ 2015 7,080 3,74 M€ 24,270 16,67 M€ • The table shows the costs that EU and EEA states and Switzerland charge for medical care given to people. The cost include 1) actual medical care costs and 2) flat-rate amounts (calculated costs). • Flat-rate amounts may be charged for a person permanently residing abroad whose medical costs are covered by a state other than the state of residence. For example, a Finnish pensioner residing in Spain who receives a pension only from Finland and has moved permanently to Spain. Finland pays Spain €XX/month/person in reimbursements for medical care for this pensioner. • Reimbursements for treatment costs are paid directly between the states. The patient pays the local client fee but not the actual treatment costs. • The costs are invoiced at a different time to when the actual treatment is given. The patient may have received the treatment several years earlier. • More information: www.kela.fi/web/en/medical-treatment-in-international-situations-who-pays-your-care Source: Kela 10
  11. 11. 9. Numbers of European Health Insurance Cards (EHIC) issued by Kela Year Number of European Health Insurance Cards 2019 2,078, 088 2018 1,977,781 2017 1,869,780 2016 1,755,847 2015 1,578,400 • Kela issues a European Health Insurance Card to people who have health insurance in Finland or whose treatment costs are the responsibility of Finland. • The card is applied for from Kela, and it is valid for two years at a time. If the justifications for issuing the card are met, a new card is mailed automatically when it has been ordered once. • With the card, a patient can receive necessary treatment in EU and ETA countries and in Switzerland during a temporary stay, for example, when travelling. For the patient, the treatment costs the amount of the local client fee. • More information: www.kela.fi/web/en/european-health-insurance-card Source: Kela 11
  12. 12. 10. Contact Point for Cross-Border Healthcare in Finland The Contact Point for Cross-Border Healthcare provides advice on using health services in Finland and abroad. Each EU country has a contact point. In Finland, the contact point is located within Kela. The contact point provides service as follows: Website www.eu-healthcare.fi www.eu-terveydenhoito.fi www.eu-halsovard.fi www.eu-dearvvasvuodadiksun.fi viittomakieli.eu-terveydenhoito.fi teckensprak.eu-halsovard.fi E-mail: yhteyspiste(at)kela.fi Twitter: @rajayhteyspiste Facebook: @rajayhteyspiste 12

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