Information in brief: Reimbursements for travel costs
Kela pays reimbursements for travel costs to healthcare or rehabilitation. This text contains information about the current travel cost reimbursement policy and recent developments. At the bottom of this page are links to statistics and studies on reimbursements paid, among other things.
Reimbursements for travel costs remained unchanged in 2023
Kela paid a total of EUR 309 million in reimbursements for travel costs in 2023. The amount paid increased by EUR 2 million compared to previous year.
The increase is mainly due to an increase in mileage allowances for people using their own cars.
A total of 592,000 people received reimbursements for travel costs, which is about the same as in previous years. A total of 4.27 million journeys were reimbursed, more than 100,000 more than the previous year.
The number of customers reaching the maximum annual copayment limit is increasing
The maximum annual copayment for travel costs (EUR 300 per calendar year) was reached by nearly 80,000 people in 2023. This was more than ever before under the current maximum copayment, which was introduced in 2016, and almost 3,000 more people than in the previous year.
The maximum copayment can be reached with as little as 12 one-way journeys, i.e. six visits to a treatment or rehabilitation facility. For many, the limit is quickly reached: in January 2024, more than 3,000 people had already paid their annual contribution of EUR 300 for their travel within one month, and by mid-February, 6,000 people had already reached the maximum limit.
An increasing number of journeys made using customers’ own cars are eligible for reimbursement
In the summer of 2022, reimbursements of travel costs for people using their own cars were increased for the first time in 30 years, from 20 cents to 33 cents per kilometre. As a result, more journeys became eligible for reimbursement. Reimbursements were claimed for slightly more car journeys than in the previous year: 1.22 million compared to 1.18 million in the previous year, and 640,000 journeys were reimbursed, which is almost 40% more than in 2022. The vast majority of journeys made using customers’ own cars were therefore still below the copayment limit. In this case, however, they counted towards the annual copayment limit.
Reimbursement expenditure for journeys made by customers’ own cars rose from EUR 7 million to EUR 12 million. Nearly 50,000 people were reimbursed, 10,000 more than the previous year.
The majority of journeys and reimbursement costs come from taxi fares
72% of journeys that were reimbursed were travelled by taxi. Taxi journeys also account for the majority of reimbursement costs.
The years 2022 and 2023 were part of the same tendering period, so the rates remained unchanged. Taxi reimbursements remained almost the same as the previous year. EUR 183 million were paid in 2023 and EUR 182 million in 2022. The average cost of a taxi journey covered by health insurance was EUR 71.10 and the average reimbursement was EUR 59.80 in 2023. This compares to an average cost of EUR 70.80 and an average reimbursement of EUR 59.40 in 2022.
The number of taxi journeys covered by health insurance was 3.1 million in both 2022 and 2023. In 2023, 426,000 people were reimbursed for taxi fares. In the previous year, the number of recipients was slightly lower, at 423,000.
The number of ambulance journeys decreased for the first time in 10 years
For the first time in 10 years, the number of ambulance journey and related reimbursements decreased. There were 453,000 reimbursed journeys compared to 495,000 in 2022. Reimbursements paid amounted to EUR 79.6 million, compared with EUR 83.6 million in the previous year. The average reimbursement for ambulance journeys increased from EUR 169 to EUR 176 per trip. The growth is partly explained by an increase in the ambulance journey tariff in summer 2022. Invoicing is based on this tariff.
290,000 people were reimbursed for ambulance journeys in 2023, compared to 314,000 in 2022.
There was wide variation between regions, but in most regions, numbers were down on the previous year, in some cases by as much as ten per cent. This change may be partly explained by the introduction of wellbeing services counties starting in 2023.
Ambulance journeys are reimbursed by the service provider, and it is possible that at the end of 2022 the service providers may have brought forward their claim for Kela reimbursement due to an organisational change, i.e. the start of wellbeing services counties, in which case the previous year's journeys would not have been reimbursed in the following year as much as in previous years. This would lead to an increase in the number of journeys reimbursed in 2022 and a decrease in 2023, adding to the difference between the years. Kela's statistics are based on the date of reimbursement, not the date of travel.
It may also be the case that there were in fact been fewer journeys than in the previous years. Emergency response centres are now able to determine in more detail when an ambulance is dispatched. Recently, more attention has been paid to emergency transport despatch policy in the media,, and Kela has also updated its guidelines on when it is more appropriate to use a taxi than to call an ambulance.
In this discussion, the main concern is the optimal use of emergency care resources, but from a health insurance perspective, cost is also a key factor, as the price of different modes of transport vary considerably: In 2023, Kela paid an average of EUR 176 for an ambulance journey, while the cost of a journey in a stretcher-accessible taxi was EUR 114 and the fare for a regular taxi was only EUR 64, just over a third of the cost of an ambulance journey. The maximum price referred to in the Government decrees for 2023 as the starting fare for a taxi journey is approximately EUR 6, while for medical transportation it is EUR 73 plus a surcharge of around EUR 39 for the second ambulance driver, plus the distance from and to the place where the vehicle was dispatched, i.e. not only for the distance travelled with the patient on board, as is the case with taxis.
The above describes ambulance journeys that transport patients to treatment units. In addition, Kela paid reimbursements for 48,000 ambulance journeys in which the patient did not need to be transported, as paramedics were able to treat the person on site. The number of these journeys also declined somewhat from the previous year.
In addition, there were 78,000 ambulance transfers, i.e. situations where a patient was transferred from the first point of care to another unit without being checked in, e.g. a patient admitted to the emergency department of a health centre was found to need treatment at the emergency department of a specialised hospital.
Significant regional differences
There are large differences in the amount of travel costs reimbursed by health insurance between wellbeing services counties. The reimbursements paid to residents of a wellbeing service county in mainland Finland varied from EUR 5 million to EUR 33 million. The majority of travel costs in all wellbeing service counties are incurred by travel in taxis and ambulances.
Reimbursements are not confined to less densely populated areas: at EUR 14 million, Helsinki, despite its wealth of service providers and good public transport, is in the middle category among counties in terms of travel reimbursements. In Helsinki, the proportion of reimbursements for ambulance services is higher than in other areas.
The average reimbursements paid for travel costs vary significantly by region: the highest average reimbursements were paid in Lapland and the Åland Islands, while the lowest were paid in the three wellbeing services counties within Uusimaa and in Southwest Finland.
In Lapland, the average reimbursement per journey in 2023 was EUR 113, and in the Vantaa and Kerava wellbeing services county it was EUR 52. The difference in the level of reimbursement is explained by factors such as distance and demographics.
Elderly people are the largest category of recipients
Elderly people predominate among recipients of reimbursements for travel costs. In almost half (46%) of the journeys reimbursed by Kela in 2023, the customer was 70 years or older.
Before 2012, most reimbursements for travel costs were for people aged 15-64, but since then, people aged 65+ have made up the largest group of recipients. In the spring of 2020, the COVID-19 pandemic reduced the travel for a few months.
The number of journeys and reimbursements paid decreased in the early 2010s. The change is largely explained by increases in the maximum copayment limit: between 2013 and 2016, Parliament almost tripled the copayment limit for a one-way journey in three increments from EUR 9.25 to €25. As a result, some journeys were excluded from the reimbursement.
In 2021-2023, travel reimbursements were also exceptionally paid for travel to COVID-19 vaccinations and tests.
Since 2006, the majority of reimbursements have been paid to people over the age of 65. Older people are more likely than younger people to use taxis and especially ambulances, widening the difference between the number of journeys made and the cost.
Trends in reimbursements for travel costs are driven by changes in legislation and the service network
The first year of operations for wellbeing service counties did not bring significant changes in terms of reimbursements for travel costs. Among other things, wellbeing service counties have recently published their service network plans, which include the closure of health centres in favour of remote and mobile services. On the other hand, changes have also been planned in the hospital and emergency care network. These also have an impact on patient travel, so it is useful to monitor travel reimbursement trends.
Travel distance and journey times, as well as public transport connections, can be viewed using the route finder on Kela’s website.
