Kela coverage for newcomers to Finland

Kela, the Social Insurance Institution of Finland, provides basic social security for people living and working in Finland. For an American moving over, Kela decides whether you are covered by Finnish national health insurance, whether you can get a Kela card, and which other benefits you can claim. Coverage is not automatic just because you hold a residence permit, so it pays to understand how Kela makes its decision and what you need to file.

Citizenship does not matter, your situation does

Kela states plainly that your citizenship does not affect your right to Kela benefits. What matters is whether you live in Finland permanently or work there. There is one condition for Americans: if you need a residence permit from the Finnish Immigration Service to stay or work in Finland, you must get it before you can qualify for Kela benefits.

When coverage can start

According to Kela, when you move to Finland you can usually qualify for benefits and a Kela card starting from the day of the move, if you meet either of these criteria:

• Kela considers you to be living in Finland on a permanent basis; or
• you work in Finland.

The benefits differ between the two. Kela notes that you can qualify for more benefits if you live in Finland permanently than if you only work there.

How Kela decides you live in Finland permanently

InfoFinland, the public authorities' information service, explains that Kela always first assesses whether you are moving to live in Finland permanently, as defined by the social security legislation. Kela may consider your move permanent, for example, if:

1. you are a returnee coming back to Finland from abroad;
2. you have a permanent employment contract, or similar agreement, for work in Finland;
3. you are married to, or in another close family relationship with, a person who already lives permanently in Finland.

If you need a residence permit, Kela usually requires that it is valid. Kela makes an overall assessment of your situation, so provide clear documents: your employment contract, your residence permit and evidence of your home in Finland.

Once Kela decides you live in Finland permanently, your entitlement continues as long as your primary residence and home are in Finland and you spend most of your time there, or you have another reason for permanent residence such as family ties or work. If you start working in another country or go abroad for more than six months, your right to Kela benefits may end.

Short contracts and students

If Kela decides your move is not permanent, you usually have no right to Kela benefits, but you may qualify for some based on work. InfoFinland states that if your salary is at least EUR 800.02 a month, you will normally be entitled to some Kela benefits even on a short employment contract, regardless of weekly hours. What you receive also depends on the country you move from.

For students from outside the EU and EEA, Switzerland and Britain, InfoFinland says that if your studies last at least two years, you may be entitled to some Kela benefits. Shorter programs generally do not qualify, so American students on short courses should rely on private insurance.

How to notify Kela

Kela does not find you automatically. The steps:

1. Tell Kela you moved. Submit a notification of your move in the OmaKela e-service, which is available in Finnish and Swedish.
2. Apply for what you need. Apply for benefits and a Kela card in OmaKela. Each benefit has its own form.
3. Include your children. If children under 18 move with you and you are their parent or guardian, include them in your notification. Your partner must submit a separate notification.
4. No OmaKela access? Send your application forms and form Y 77e, Moving to Finland or employment in Finland, by mail to Kela, PL 10, 00056 KELA, with supporting documents.

Kela warns that processing can take longer if it needs information from social insurance institutions in other countries. File early, ideally right after you register as a resident.

What the Kela card does

The Kela card proves your right to Kela reimbursements for health costs. Practical points from Kela:

• You usually do not need to show it, because your right to reimbursement can be checked electronically when you show an official ID card or driver's license.
• You need it at a private doctor or dentist who cannot check your information electronically.
• With proof of your right, a private clinic can deduct the Kela share directly from your bill, called direct reimbursement. If that is not possible, you can apply for reimbursement from Kela afterwards.
• The Kela card is not an official ID card, there is no electronic version, and Kela photocards are no longer issued.
• The Kela card does not affect your right to use public healthcare, and it does not prove your right to other Kela benefits.

InfoFinland adds that with a Kela card you are reimbursed for expenses at pharmacies and many private clinics, paying only the deductible.

Kela and public healthcare are different things

A common confusion: public healthcare in Finland depends on having a municipality of residence, kotikunta, not on Kela. InfoFinland explains that you are entitled to public health services if you have a municipality of residence. Without one, you may have a right to treatment, for example based on work, but you must apply for it separately. In an emergency you will be treated in public care either way, though the costs can be billed to you afterwards.

Kela reimbursement covers a small part of private care costs for people under Finnish national health insurance. Private care is considerably more expensive than public care for the patient.

Medicines

Medicines are sold only in pharmacies in Finland. InfoFinland notes that if you are covered by Finnish national health insurance, Kela pays part of the price of many prescription medicines, but not over-the-counter ones. A prescription written abroad is not valid in Finland, except Nordic and EU cross-border prescriptions, so a US prescription must be replaced by a Finnish doctor. Bring your old prescriptions to the appointment so the doctor can take them into account.

The US and Finland agreement

Finland has social security agreements with several countries, including the United States. InfoFinland notes these agreements primarily apply to pensions. The US Social Security Administration's totalization agreement with Finland covers social security taxes and pension credits, not your Kela health coverage, so do not count on it for medical care.

Benefits and your permit

Kela points out that receiving Kela benefits may affect eligibility for Finnish citizenship or residence permits. If your permit depends on supporting yourself, check how a benefit would interact with it before you apply.

Quick checklist

• Valid residence permit in hand.
• Registered as a resident with a municipality of residence.
• Move notification filed in OmaKela, children included.
• Kela card applied for if you will use private care.
• Private insurance kept until Kela confirms coverage.

Common questions

Can Americans get a Kela card? Yes. Citizenship does not affect Kela benefits. You need a valid residence permit if one is required, and Kela must consider you a permanent resident or a worker in Finland.

When does Kela coverage start? Usually from the day of the move, if Kela considers you a permanent resident or you work in Finland.

What salary qualifies a short-term worker for Kela benefits? InfoFinland states that a salary of at least EUR 800.02 a month normally gives some Kela benefits even on a short contract.

Is a US prescription valid in a Finnish pharmacy? No. Prescriptions from outside the Nordic countries and the EU cross-border system are not valid in Finland.