National health insurance

Society pays part of pharmaceutical expenses

Society participates in the patients’ pharmaceutical expenses by reimbursing a part of the medicine purchases.

You can be reimbursed for the medicines you purchase once you have met the initial deductible, which is EUR 50 per calendar year. The initial deductible is applied from the beginning of the year in which you reach the age of 19.

The medicines reimbursement system has three steps:

  • The basic reimbursement is 40 percent of the retail price of the medicine. 
  • The medicines in the lower special reimbursement category entitle the patient to receive a 65 percent reimbursement on the retail price of the medicinal product. 
  • For the medicines in the upper special reimbursement category, the patient only pays a 4,50 euro patient co-payment.

The law prescribes the diseases that entitle the patients to receive the lower or upper special reimbursement upon an application made for the medicine by the company.

The ceiling of medicine costs prevents unreasonably high expenses

Every year, the State determines the so-called ceiling of medicines costs. If the medicine expenses paid by the patient in a year exceed a certain sum, they will pay only the 2.50 euro patient co-payment for the medicines purchased during the remaining part of the year. This ensures that the medicine expenses of those who use a lot of medicines or are on expensive medications will remain at a reasonable level.

Year 2018 the ceiling of medicines costs is at 605,13 euro.

The health insurance is funded by the State and the insured. Each insured person pays a health insurance premium withdrawn from their pay. This payment is used to cover not only the medicines reimbursements but also travelling expenses related to medical care, the private doctor’s fees and examinations.

Read more: Medicine Reimbursement, Unhealthy Health Costs

Statistics:

Health Insurance Financing 2017
Health Insurance Benefit payments 2017
Reimbursement Trend
Public Share of Medicine Costs in Some EU-Countries
Special Reimbursement Indications in Finland
Time from Marketing Authorisation to Basic Reimbursement 
New Product Basic Reimbursement Process
From Marketing Authorisation to Basic Reimbursement - 3  Year Moving Average