Information in brief: Reimbursements for travel costs
Kela pays reimbursement under the Health Insurance Act for travel costs in connection with illness, pregnancy or childbirth. This text contains information about the current situation and recent developments, and discusses the research and statistics available concerning reimbursements for travel costs.
Expenditure on reimbursements for travel costs is down slightly
In 2022, Kela’s expenditure on reimbursements for travel costs came to 307 million euros, slightly down from the 311 million euros in 2021. Reimbursements were paid to 600,000 persons, compared to 583,000 in the year before.
The Government made some changes to the provisions governing the reimbursements. The rules governing the maximum fare for taxi journeys were revised and the reimbursement tariff for ambulance journeys was increased in response to higher fuel prices. The reimbursement rate for using one's own car was raised - after a wait of several decades.
About 4.1 million trips were reimbursed in 2022 as in 2021. Because of the higher reimbursement rate on trips that involved the use of one’s own car, such trips were more likely to exceed the copayment threshold. As a result, the number of trips using one’s own car showed the largest increase, rising 8% over the previous year. The steepest decline was seen in trips made using a bus, which decreased 25 percent from 2021.
The number of taxi journeys remained about the same, but the reimbursement expenditure decreased by about 6% despite the higher tariff. The average reimbursement for a taxi journey declined from 63 to 59 euros. A new contract period for taxi operators began on 1 January 2022, which led to lower prices. Ride-sharing in taxi journeys resumed in autumn 2022 after a COVID-induced break.
Significant regional differences
There are large differences in the reimbursements for travel costs between wellbeing services counties. The largest reimbursement bill in a single county was nearly 40 million euros, while the smallest was 5 million euros. Taxis and ambulances account for the majority of the costs in all regions.
Reimbursements for travel costs are used not only by residents of less populated areas: Helsinki, the Finnish capital, with the wide range of services and public transport options available there, ranks in the middle of the wellbeing services counties. The total reimbursement bill in Helsinki came to 15 million euros. In Helsinki, ambulance journeys account for a larger share of the reimbursements than in the other regions.
The average reimbursement rates varied significantly across the regions: the highest rates were seen in Lapland and Kainuu and the lowest in Uusimaa and Päijät-Häme.
In 2022, the average per-trip reimbursement in Lapland was 130 euros and in Helsinki, 20 euros. The differences are largely explained by the distances travelled.
The regions also differ in terms of the share of the population that received reimbursements for travel costs. In Lapland, Kainuu and Etelä-Savo, more than 15% of the population received reimbursements, while in Uusimaa, Varsinais-Suomi and the Åland Islands, less than 10% of the population did.
Older adults are the largest category of recipients
Older adults predominate among recipients of reimbursements for travel costs. Before 2012, the number of reimbursed trips was highest among people between ages 15 and 64, but since then, over-65s have been the largest group of recipients. The onset of the COVID-19 epidemic in spring 2020 caused a steep decline in the number of trips, which lasted for a few months.
Since 2006, the majority of the reimbursements have been paid to persons aged 65 and over. Older adults are more likely than young people to use a taxi, and significantly more likely to use an ambulance, leading to a wider gap in the number of trips and the amount of costs.
Trends are influenced by changes in legislation
The number of trips and the reimbursement expenditures both decreased in the early 2010s. This was largely explained by the introduction of higher copayments: in 2013–2016, Parliament made three changes that nearly tripled the copayment for a one-way trip from 9.25 euros to 25 euros. As a result, part of the trips were no longer covered for reimbursement.
Trips to COVID testing and vaccination sites were reimbursed as an exceptional measure.
At the beginning of 2023, Parliament made cuts to the reimbursements for private medical treatment, which also impacted the reimbursements for travel costs. In private-sector medical care, reimbursements for travel costs are linked to the recipient’s eligibility for Kela reimbursements for the treatment costs, which means that if the treatment itself is not reimbursable, the travel costs related to it will also not be reimbursed.
However, trips made to and from a private treatment provider only account for a small share of the total number of trips, so the overall impact of the 2023 cuts will be limited.