Health insurance / pre-existing conditions

tohlw · Post by **tohlw** » Wed Mar 29, 2017 6:51 pm

Hi - I know there are hundreds of threads on health insurance already, but I can't quite work out the answer to my specific question: hoping you can help.

I'm a UK citizen, and I'm used to how the NHS works. I've been offered a job in Finland - a permanent job, and we expect to stay at least 3 or 4 years. My prospective employer is offering private health insurance, for me & my family - excluding pre-existing conditions.

I believe that this is required because KELA won't cover us for the first couple of years - is that right?

However, between us as a family, we do have pre-existing conditions. I'm not sure I quite understand how things will work if during the first couple of years something happens which can be ascribed to a pre-existing condition.
a) KELA does not give us any rights to public healthcare
b) it's excluded from our private cover.

Am I running the risk of a massive healthcare bill if something pre-existing triggers in the next couple of years?

Thanks for your advice.

**Sponsor:**

Rosamunda · Post by **Rosamunda** » Wed Mar 29, 2017 9:27 pm

Normally employers have to give what is loosely referred to as "occupational healthcare" to their employees. This means that if you get sick you book an appointment with the practice that your employer has nominated. This would be a private provider. Usually, this does not include family members (but sometimes it does) and is only valid for fairly routine visits. Private healthcare - on top of basic occupational healthcare - would be considered a perk (it is not routine here). Apparently, this is what you are being offered and like most schemes (eg BUPA in the UK) it will not cover pre-existing conditions.

However, if you have a permanent contract here, I see no reason why you would not be covered by Finnish national health service. Maybe someone else can confirm. Sometimes there are special arrangements for "experts" coming in with a special contract (usually max 18-24 mths) whereby a reduced tax rate is applied but those are exceptional. As far as I know, there are no "pre-existing conditions" disclosure requirements with KELA. You would be entitled to the same treatment as any citizen/permanent resident here - but in public healthcare.

harryc · Post by **harryc** » Thu Mar 30, 2017 8:45 am

""This means that if you get sick you book an appointment with the practice that your employer has nominated. This would be a private provider."

Has something changed? In the 'old days' the employer coulld somehow register employees with the local Terveysasema (public health) - they got the same medical service as anyone else but their records etc. were handled a bit differently - and there might have been some attention to whteher there sickness or injury was work-related in case there were endangering circumstances in the employment that the government might want to pay attention to.

In any case there was no connection witj private health clinics and the company was doing everything 'legally' - as I can recall filling out forms and having someone from the NHS call on a regular basis.

tavastia · Post by **tavastia** » Thu Mar 30, 2017 9:37 am

If you get permanent contract Kela will cover everything, it does not matter your preconditions.

Upphew · Post by **Upphew** » Thu Mar 30, 2017 11:48 am

harryc wrote:""This means that if you get sick you book an appointment with the practice that your employer has nominated. This would be a private provider."

Has something changed? In the 'old days' the employer coulld somehow register employees with the local Terveysasema (public health) - they got the same medical service as anyone else but their records etc. were handled a bit differently - and there might have been some attention to whteher there sickness or injury was work-related in case there were endangering circumstances in the employment that the government might want to pay attention to.

In the old days employers had their own doctors and nurses

I think that most municipalities have spun off their occupational healthcare (that they must provide) to separate companies. So basically you go to same local Terveysasema, but the bill is sent from company to another instead of from health care center to patient.

harryc · Post by **harryc** » Thu Mar 30, 2017 12:35 pm

In the old days employers had their own doctors and nurses

Small companies don't have own doctors and nurses now or in the past.

++++

As far as I recall, companies could just as well use terveysasemas as well as private health companies - I don't recall that the company paid anything for the public service other than thru the corporate tax they paid. I don't know what the system is now but I shoould think the company is not liable for health costs unless the company is the scene of an accident - and then they supposedly have some kind of obligatory insurance. Dunno.

tohlw · Post by **tohlw** » Mon Apr 03, 2017 4:44 pm

Thanks all for replies, particularly Rosamunda.

I'm not sure how I'd got myself confused with KELA entitlements, but I've checked again & it's all fine as far as I can tell.

I'm intending to move for more than 4 months, as are my family (the rest of whom all have Finnish citizenship anyway) therefore we are all permanent residents, therefore we are entitled to KELA. The private insurance ought to cover most events but anything pre-existing that is not covered will be covered by KELA reimbursements - so, more expensive than the UK, but no major financial risks if there's a medical emergency.

betelgeuse · Post by **betelgeuse** » Mon Apr 03, 2017 8:07 pm

tavastia wrote:If you get permanent contract Kela will cover everything, it does not matter your preconditions.

This seems to be recurring misunderstanding on this forum. Kela only covers things like drugs and sickness allowance. They do partly reimburse occupational healthcare but primary healthcare is provided by the municipality. It's having municipality of residence, not having a Kela card that entitles to healthcare in Finland as much of the world understands it.

Rosamunda · Post by **Rosamunda** » Mon Apr 03, 2017 9:46 pm

betelgeuse wrote:
tavastia wrote:If you get permanent contract Kela will cover everything, it does not matter your preconditions.
This seems to be recurring misunderstanding on this forum. Kela only covers things like drugs and sickness allowance. They do partly reimburse occupational healthcare but primary healthcare is provided by the municipality. It's having municipality of residence, not having a Kela card that entitles to healthcare in Finland as much of the world understands it.

I guess we just assume that if the person has a job contract, sooner or later they will have some kind of permanent abode. I think most people know that healthcare is provided by the local municipalities (it's spoken about on a quasi daily basis in the media) so it's just a short-cut to say that "KELA" covers everything.

It is a valid point, though, that if somebody is working for a Finnish company but not "officially" living in Finland, they are not entitled to healthcare.

betelgeuse · Post by **betelgeuse** » Tue Apr 04, 2017 6:45 am

Rosamunda wrote:It is a valid point, though, that if somebody is working for a Finnish company but not "officially" living in Finland, they are not entitled to healthcare.

"If you work in one EU country and live in another, you are entitled to medical treatment on both sides of the border."

http://europa.eu/youreurope/citizens/he ... dex_en.htm

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