Retired members and external members
Compensation is claimed by presenting the receipt for the deductible, indicating your name, the purchased service and the sum. If required, request an additional statement.
For the reimbursement of medicine expenses, a statement about your medicine purchases issued by the pharmacy is required.
Compensation paid to retired members and external members as an additional benefit includes, for example:
60% of the doctor’s fee if the treatment was necessary to cure an illness other than a dental one.
If you have an operation or a comparable procedure in a private medical centre, always contact the sickness fund first. To receive an additional benefit from the sickness fund for these procedures, you must always have the Board of Directors’ prior consent before the procedure. Reimbursement claims submitted after the event are not accepted.
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Public health care
Public health care fees are reimbursed in accordance with the rules without out-of-pocket costs.
- health centre fees
- outpatient clinic fees
- treatment visit fees
- day surgery fees
- hospital bed fees
- certificates issued for the purposes of a benefit under the Health Insurance Act
Hospital, health centre hospital and rehabilitation facility bed fees are reimbursed up to 100 days during the entire retirement period.
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Physician-prescribed medication, clinical nutritional supplements, products corresponding to these and basic creams when compensation has also been granted based on the Health Insurance Act such that the compensation is calculated based on the price used to calculate the compensation under the Health Insurance Act.
In 2023, the sickness fund also compensates its members for the initial deductible under the Health Insurance Act, EUR 50/year.
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60% of laboratory analyses and pathological examinations prescribed by a doctor and their related sampling.
60% of radiological examinations prescribed by a doctor, with the exception of MRI, for which the reimbursement is 55%. Not reimbursed are other procedures carried out in connection with these examinations, unless the Board considers it reasonable in individual cases to compensate these costs in full or in part.
The facility fee collected in connection with the examinations referred to above is compensated up to a maximum of EUR 50.00.
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50% of physiotherapy prescribed by a doctor and physiotherapeutic examinations prescribed by a doctor, however, up to a maximum of 8 treatment sessions per calendar year.
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50% of psychotherapy prescribed by a physician, however, up to a maximum of 4 treatment sessions per year. The treatment provider must be registered with JulkiTerhikki.
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Expenses for eyeglasses are compensated up to the maximum amount of EUR 205.00 and the compensation can be paid every three years.
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Expenses for dental care are compensated up to the maximum amount of EUR 190.00 per calendar year.
The maximum amount of compensation for prosthetic treatment is double the usual compensation, however, such that the fund member will have no right to compensation for dental treatment during the calendar year following the year in which the compensation was paid.
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Assistive devices prescribed by a doctor are compensated up to the maximum amount of EUR 100 per calendar year.
The lease for therapeutic equipment, such as a CPAP machine, is not reimbursed.
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70% of foot care prescribed by a doctor is reimbursed. Foot care covers treatment by a podiatrist who has completed a podiatrist’s vocational degree, the maximum being three treatment sessions per calendar year.
You can check whether a podiatrist is qualified in JulkiTerhikki (valvira.fi)
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At the death of a retired member or a member on unpaid leave, no funeral grant is paid.