In English
Cable Sickness Fund
Information sheet
Table of Contents
1. Introduction and Contact details. 1
3. Reimbursements and directions for applying. 2
3.2. Clinics, GP´s appointments and hospital costs. 3
3.3. Private clinics & doctors, laboratory and radiological examinations. 3
3.4. Physiotherapy and Chiropractic. 4
3.5. Medicines and medicinal products. 4
3.6. Eye glasses and optometry. 5
4. Contracts with service providers. 6
Cable Sickness Fund
1.Introduction and Contact details
Cable Sickness Fund provides reimbursements to its members. The costs are covered with membership fees collected from the members of the fund. In this brochure we give you detailed information on what kinds of costs are reimbursable and how you apply for your reimbursements.
The manager of the fund is Raija Mustalahti. Do not hesitate to contact fund’s office in all matters concerning your reimbursements. Especially if you are unsure about anything related to your reimbursements.
The fund has its own board the members of which are elected annually by the general meeting of the fund. Board members must represent fund members in all participating companies. Meeting is held annually, in April every year the latest. Every member of the fund has one vote in the meeting.
2.Payments and membership
Every member pays 1,3 % of their salary as a payment of membership. This is looked after by one’s employer and you see the fee deducted on your payment roll monthly. Companies taking part in this sickness fund in particular are listed at our website also.
All employees whose work contract is for three months or longer and whose salary is based on hourly working time have mandatory membership in the fund. Membership will begin simultaneously with your work contract.
After having had a membership continuously for twenty years one can shift as a pensioner member. Their monthly membership fee is 2,2 % of pension. Remember to contact the office within one month from the arrival of your pension decision, should you wish to remain as a member.
3.Reimbursements and directions for applying
In this chapter we give you information on our reimbursements.
3.1.Health Care Centre
Costs caused by a visit in your local Health Care Centre are reuimbursed to full. This includes doctor’s appointment (EUR 23,00), clinic appointment (EUR 46,00) and emergency visit (EUR 31,60) fees.
Costs of doctor’s Medical Certificates are reimbursable in case they are meant for one’s employer as a verification of absence from work due to sickness. Certificates for special medicine reimbursement (Medical Certificate B) for Kela are reimbursable as well.
Medical certificates for other purposes, e.g. for driver’s licence are not reimbursable.
All invoices for medical certificates must include detailed information for which purpose the certificate is written. An invoice with detailed information about the exact date of visit and the type of appointment must be provided when applying reimbursement. Invoice must also contain personal information.
3.2.Clinics, GP´s appointments and hospital costs
Costs for clinical appointments in specialised public hospitals (university or central hospital) EUR 46,00, surgical operations (EUR 150,80) and hospital costs (EUR 54,60 per day) in public hospitals are fully reimbursable.
The fund also reimburses the fees for temporary home health care and home hospitals, and
serial treatment fees.
Physiotherapy given in public health care centre and public hospital clinics (EUR 12,80 per appointment) is reimbursable without any limitations.
Non reimbursable costs include fees for retirement housing, long-term care in hospital or rehabilitation in institutional care.
There is an annual out-of-pocket limit for public health care costs. In 2024 this limit is EUR 762. Should this limit be met the clinic appointments and surgical operations are free of charge for the rest of the calendar year. The reduced fee for hospital care is EUR 25,10 per day, which is not reimbursed by the fund.
Remember to ask for a client charge card with your first visit from your local health care centre. Represent the card always when visiting public health care and make sure all your costs are documented to the card, this way it’ll be easier to keep track with your out-of-pocket limit.
3.3.Private clinics & doctors, laboratory and radiological examinations
Costs for necessary treatment of illness and examinations are fully reimbursed; however office work fees are not reimbursed. Appointments to both general and specialist doctors are reimbursable as well as laboratory exams, x-rays, ultrasounds and magnetic resonance images. All examinations require a prescription from a doctor.
In the case of private health care magnetic resonance imaging examinations, computed tomography examinations and cone beam examinations, the condition for reimbursement is that the examination performed is based on a specialist's referral.
Regarding private healthcare examinations and treatment, compensation is not paid for laboratory examinations that are vitamin or trace element examinations or package examinations.
Radiation therapy, cytostatic therapy and artificial kidney therapy given in a private treatment facility are also not reimbursed.
Apply by sending invoice (pay it first!) and the original documents you received. Include your application form with your signature on both the signature line and the mandate below (SV 127en). This way you ensure your both you Kela reimbursement and sickness fund reimbursement can be paid with no hindrance.
Should your visit be to a private clinic that has an agreement with Kela and they can reduce your Kela reimbursement on the spot, send your paid bill with details of price and reimbursement to the fund’s office for the fund’s reimbursement.
Private surgical operations can be reimbursable in some cases. One must have strong argumentation demonstrating the reasons for which the reimbursement should be granted. Reasons for granting could be such as long queue times to operations in public health care or significant disadvantage that affects one’s daily life and routines. Whether the reimbursement will be granted or not will be decided by the board of the fund. All applications must be posted to the fund manager.
Members who are in working life must present a recommendation from a specialist in occupational health care. Retired members must fill an application form in which detailed information about the situation is given. Maximum reimbursement is EUR 500 from the surgery. Equipment and products, medicines etc. are reimbursable to maximum amount of EUR 150,80, hospital fee in private hospital is reimbursed to maximum of EUR 54,60 per day.
3.4.Physiotherapy, Naprapath, Osteopathy and Chiropractic
Physiotherapy given in public health care centre and public hospital clinics (EUR 12,80 per appointment) is reimbursable without any limitations.
Private physiotherapist is reimbursable 75 % of the cost per session, maximum amount of appointments is 20 times annually.
Legalised chiropractor appointment costs are reimbursed 75 % of the cost.
Legalised naprapath appointment costs are reimbursed 75 % of the cost, maximum amount of appointments is 5 times annually.
Legalised osteopathy appointment costs are reimbursed 75 % of the cost, maximum amount of appointments is 5 times annually.
Apply by sending the invoice and/or receipt and doctor’s prescription for physiotherapy/chiropractor/naprapath/osteopathy treatments.
3.5.Medicines and medicinal products
Medicines are fully reimbursable if the purchase is based on doctor’s prescription and it is reimbursable in Kela as well. The reimbursement includes Kela-reimbursement. Reimbursable amount is up to the reference price. Should one purchase medicine more expensive than the reference priced variant, the remainder is not reimbursable.
From the beginning of 2016 there has been an initial deductible of EUR 50, this amount is reimbursable to the members of the fund.
The fund reimburses copayment costs EUR 2,50 and EUR 4,50 after your annual out-of-pocket limit of EUR 626,94 has been exceeded by your medicine costs. Kela keeps record and the pharmacy receives information from Kela about the fulfillment of the annual deductible as soon as the medicine is purchased.
3.6.Eye glasses and optometry
Eye glasses need to be prescribed by either an ophthalmologist or an optician. One can apply reimbursement from either eye glasses or contact lenses. Should your purchase consist only on eye glass frames, it is not reimbursable. Reimbursement can be paid for the first time after membership of one year. After this you can apply reimbursement every two years.
Maximum amount of reimbursement is EUR 350 and it is paid after two years has passed from previous reimbursement of eye glasses. This is based on the purchase date printed on your purchase receipt.
Should you find yourself unsure of the exact date of your previous purchase, always contact the fund office to clarify this! Glasses bought before the time limit has filled are not reimbursable!
Make sure your receipt has your name printed on it.
The fund also reimburses the fee of eye sight examination executed by an optometrist or if necessary, the appointment fee of an ophthalmologist (see doctor’s appointment fee reimbursements).
Lasik-surgery is reimbursable under same conditions as eye glasses above, the amount being up to EUR 500.
3.7.Dental health care
Maximum reimbursement is EUR 400 annually, with the prerequisite of a membership of one full year in the fund. With private dental care one must make sure to apply Kela-reimbursement before sending the receipts to the fund.
Public dental care and costs excluded from Kela-reimbursement can be sent directly to the fund.
3.8.Appliances
Appliances prescribed by a doctor can have a limited reimbursement if they cannot be obtained for free from public health care (crutches etc.), leg braces, support hoses, support corsets and bodices can be reimbursed up to EUR 50 annually. Other personal aids can be reimbursed to maximum amount of EUR 840, with the percentage of reimbursement being 50 %. Gadgets such as blood pressure meters or blood sugar meters are not reimbursable.
3.9.Travel costs
The fund reimburses the copayment of travel costs when reimbursement has been granted based on the Health Insurance Act. The copayment for one-way trip is EUR 25.00. Travel costs under EUR 25.00 are not reimbursable.
Should you have used Kela-taxi or an ambulance apply those costs by sending the invoice or the receipt of the costs.
3.10.Home nursing
Being nursed in one’s own home is not reimbursable under any circumstances.
4.Contracts with service providers
The fund has several contracts with different service providers.
Each member of the fund can receive direct compensation from the fund's contracted service providers.
Contracts do not include physiotherapy, surgery or costs of utensils.
5.How to Apply?
- Apply within six months from the payment date in your receipt.
- Send all necessary documents. If you are unsure which documents to send, always contact the fund office.
- Send your documents to
Kaapelin Sairauskassa
Lapintie 3
33100 TAMPERE
- Make sure to include your email address and the number of your bank account.
- Contact: Raija Mustalahti (040-592 7322), info@kaapelinsairauskassa.fi