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Maximum payment limit

A maximum payment limit has been specified for some client fees chargeable for social and health care services.

After the yearly payment limit (683 € in 2019) is reached a resident of the municipality has the right to apply for a certificate. After the certificate has been issued, qa part of the services are free until the end of the year. For short-term institutional care the hospital day fee drops to about half of the normal fee.

The accumulation period of the maximum payment limit is a calendar year. The services included in calculating the maximum payment limit are listed at the end of this page.

Notice! In order to get the certificate the client needs to contact us by phone, e-mail or normal mail.
  
What to do?

  • Keep your invoices that are part of your maximum payment limit in the order of visit/treatment times.
  • If you reach the maximum payment limit concerning invoices of the Department of Social Services and Health Care, please contact the invoicing service desk of the City of Helsinki, tel. 09 3102 5300 (on weekdays between 9:00 and 15:00), talpa.maksukatto@hel.fi (Invoicing).
  • If the maximum payment limit concerning a HUS invoice has been reached, you can call the number on the invoice or send copies of the invoices to the address on the invoice.
  • The patient invoicing services of HUS hospitals can be reached on weekdays between 9:00 and 15:00 by calling the service number 09 471 785 50.
  • If you have paid too much in patient and client fees, the balance of the correct invoice total will be paid to your bank account provided, or it will be reimbursed in the next invoice. The bank account number must be presented in writing.

Client/patient responsibility

As you are responsible for checking when you reach the client payment limit, we have drawn up these brief instructions for your help.

The most important thing is to keep the invoices/receipts and when you come for treatment, please inform us that you have been issued the free card.

Payments included in the maximum payment limit

Health care fees:

  • Health centre fees
  • Fees for outpatient clinics
  • Day Surgery fee
  • A fee for a treatment series1
  • Individual physiotherapy fee (not provided at home)
  • Night and day care fee2
  • Rehabilitation
  • A hospital day fee for short-term institutional care
  • A day hospital fee for psychiatry2

1In treatment series where the treatment is given during two calendar years, the treatment and the fees are entered according to the treatment year.

2The hospital fee for psychiatry and the night and day care fee are included in the maximum pay limit, but the fee for it does not change after the pay limit is reached.

Social Welfare Fees:

  • A hospital day fee for short-term institutional care
  • Night and day care fee2
  • Rehabilitation care given to a handicapped person or rehabilitation given as specialist care to a mentally handicapped person

Fees not included in the maximum payment limit

Fees for health care:

  • Fees for home nursing arranged by the health centre
  • Fees for hospital care provided at home
  • Fees for dental care
  • Fees for long-term institutional care
  • Fees for a doctor’s certificate
  • Fees for ambulance transport
  • Fees for occupational health care
  • Fees for unused or uncancelled services
  • Fees chargeable for psychiatric residential rehabilitation when living in publicly subsidised accommodation
  • Fees for family care
  • Fees in a special payment class
  • Interest on arrears and collection fees

 Fees for social services:

  • Fees for home service and its support services
  • Fees for long-term institutional and family care
  • Fees for old people’s day activities
  • Fees for short term service housing according to the Social Welfare Act
  • Fees for children’s daycare, family care, residential services, transport services for the  seriously handicapped and other invoices except those mentioned in the list of the maximum payment limit
  • Late charges and collection fees

Other fees not included in the maximum payment limit

  • Fees charged for services arranged during the statutory time off for a family caregiver
  • Fees based on care compensated on the grounds of Acts on Accident Insurance, Farming Entrepreneurs’ Accident Insurance, Military Injuries, Traffic Insurance, Patient Injury, or other act comparable with them.
  • Fees for payment of which living allowance has been granted

The Social Insurance Institute of Finland, (Kela) monitors the maximum payment limit of medicinal expenses.

The maximum payment limit does not include fees for services which the client/patient has acquired from a private service provider.

Contact Information for Client Invoicing

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