Benefits & support · medicine reimbursement
Medicine reimbursement calculator 2026
Medicine reimbursement (lääkekorvaus) means that Kela pays part of the price of your prescription medicines directly at the pharmacy. How much you pay yourself depends on the initial deductible, the medicine’s reimbursement category and the annual cap (lääkekatto). This calculator estimates your yearly out-of-pocket on that basis.
For example, with 1,200 euros of basic-reimbursable medicine costs a year you pay about 636 euros yourself, because the cap (636.12 € in 2026) is reached – Kela covers the rest. With smaller costs your out-of-pocket stays below the cap. The result is indicative.
Medicine costs
The total pharmacy price of prescription medicines per year (Kela-reimbursable).
Basic reimbursement is for everyone; special rates need a doctor’s statement and a Kela decision.
You pay per year
€636/ v
An estimate of your yearly out-of-pocket after the lääkekatto cap.
| Initial deductible | €70 |
| Your share after reimbursement | €678 |
| You pay in total | €636 |
| Kela covers | €564 |
The calculator is indicative. It assumes a single reimbursement category and prices at or below the reference price. The actual out-of-pocket depends on reference prices, the timing of purchases and any multiple categories. Kela calculates reimbursement per medicine. Once the cap is reached you also pay 2.50 euros per medicine per purchase; the calculator does not add these. Check your own situation in OmaKela.
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How do medicine reimbursement and the cap work?
Reimbursement lowers the price of prescription medicines directly at the pharmacy. You first pay the initial deductible, which is 70.33 euros in 2026; for children and young people it applies only from the start of the year in which they turn 19. Once the deductible is met, Kela reimburses part of the cost by category: basic 40%, lower special 65% and higher special 100%. In the higher special category you still pay a 4.50 euro copay per medicine per purchase. Special rates require a doctor’s statement and a Kela decision. The yearly out-of-pocket is capped at the lääkekatto of 636.12 euros in 2026. The initial deductible also counts toward the cap. Once the cap is reached, you pay only a 2.50 euro copay per medicine for the rest of the year. Reimbursement is calculated on the price or the reference price; the part above the reference price is not reimbursed.
The initial deductible, reimbursement categories and the cap
Every calendar year starts with the initial deductible, which is 70.33 euros in 2026. You pay prescription medicines in full until this amount is met, after which you get reimbursement on the remaining purchases. For children and young people the deductible applies only from the start of the year in which they turn 19, so until then reimbursement starts straight away. The deductible also counts toward the lääkekatto cap.
The amount of reimbursement depends on the category. Basic reimbursement is 40 % of the medicine price and applies to all reimbursable medicines. The lower special rate is 65 % and the higher special rate 100 %. In the higher special category you still pay a 4.50 euro copay for each medicine per purchase. Special rates are meant for certain long-term illnesses and require a doctor’s statement and a Kela decision.
Your yearly out-of-pocket is capped at the lääkekatto, which is 636.12 euros in 2026. Once the cap is reached, you pay only a 2.50 euro copay per reimbursable medicine for the rest of the year; this is called the additional reimbursement. Both the initial deductible and the copays after it count toward the cap. The part above the reference price is not reimbursed and does not count toward the cap.
The reimbursement is deducted directly at the pharmacy with your Kela card, so you do not need to apply for it separately. Information that the cap is reached also reaches the pharmacy immediately at the time of purchase. People on a small income can apply for Kela’s medicine credit (lääkeluotto), which covers the cap and is repaid in 12 monthly instalments without interest. You can follow how your cap is building up in OmaKela.
Medicine reimbursement 2026 at a glance
| Item | 2026 | What it means |
|---|---|---|
| Initial deductible (alkuomavastuu) | €70.33 / year | You pay reimbursable medicines yourself until this is met. Applies from the start of the year in which you turn 19. |
| Basic reimbursement | 40% | Of the price or reference price, for all reimbursable medicines. |
| Lower special reimbursement | 65% | Certain long-term illnesses; needs a doctor’s statement (B-lausunto) and a Kela decision. |
| Higher special reimbursement | 100% | Copay of €4.50 for each medicine per purchase. |
| Annual cap (lääkekatto) | €636.12 / year | The deductible and the copays you pay count toward it. |
| After the cap | €2.50 / medicine | Copay for each reimbursable medicine per purchase for the rest of the year. |
Example: yearly out-of-pocket by medicine costs
| Reimbursable costs per year | Basic 40% | Lower special 65% | Higher special 100% |
|---|---|---|---|
| €250 | €178.13 | €133.21 | €124.33 |
| €500 | €328.13 | €220.71 | €124.33 |
| €1,000 | €628.13 | €395.71 | €124.33 |
| €1,500 | €636.12 (cap) | €570.71 | €124.33 |
| €2,000 | €636.12 (cap) | €636.12 (cap) | €124.33 |
| €5,000 | €636.12 (cap) | €636.12 (cap) | €124.33 |
The higher special column assumes 12 purchases a year, one medicine each time: €70.33 + 12 × €4.50. Once the cap is reached you also pay €2.50 per medicine per purchase; the table does not include these.
Frequently asked questions
How does medicine reimbursement work?
You first pay the initial deductible (70.33 € in 2026), after which Kela reimburses part of the cost: basic 40%, lower special 65% or higher special 100%. The reimbursement is deducted directly at the pharmacy with your Kela card. Your yearly out-of-pocket is at most the cap, that is 636.12 euros.
What is the initial deductible in 2026?
The initial deductible (alkuomavastuu) is 70.33 euros per calendar year. You pay medicines in full until this amount is met, after which you get reimbursement. The deductible does not apply to children and young people: it applies only from the start of the year in which you turn 19.
What is the lääkekatto cap in 2026?
The lääkekatto (annual out-of-pocket cap) is 636.12 euros in 2026. It is the maximum you pay for reimbursable medicines in a calendar year. Once the cap is reached, you pay only a 2.50 euro copay per medicine for the rest of the year. The initial deductible also counts toward the cap.
What do the reimbursement categories mean?
Basic reimbursement is 40% of the medicine price and applies to all reimbursable medicines. Lower special is 65% and higher special 100%; in the higher special category you pay a 4.50 euro copay per medicine per purchase. Special rates cover certain long-term illnesses and require a doctor’s statement and a Kela decision.
Does the deductible count toward the cap?
Yes. Both the initial deductible and the copays you pay after it count toward the lääkekatto. The part above the reference price does not count, though. Information that the cap is reached reaches the pharmacy in real time, so you get the additional reimbursement immediately without a separate application.
Does the deductible apply to children?
Children and young people have no deductible: it applies only from the start of the year in which you turn 19. Until then, reimbursement starts from the first purchase, without the 70.33 euro deductible. The lääkekatto applies to everyone regardless of age.
How much do I pay myself if my medicines cost 1,000 euros a year?
An adult with basic reimbursement (40%) pays about 628 euros: first the 70.33 euro deductible, then 60% of the rest. With the lower special rate (65%) the out-of-pocket is about 396 euros. Both stay below the 636.12 € cap. The figures assume medicine prices at or below the reference price.
What do I pay once the cap is reached?
For the rest of the year you pay 2.50 euros for each reimbursable medicine per purchase, and Kela pays the rest as additional reimbursement. The pharmacy gets the information from Kela immediately at the time of purchase, so you do not need to apply for anything.
Does the part above the reference price count toward the cap?
No. If you refuse substitution with a cheaper product, you pay the part above the reference price in full yourself and it does not count toward the cap. A reimbursable medicine bought without reimbursement does not count either.
Can I pay the cap in instalments?
People on a small income can apply to Kela for a medicine credit (lääkeluotto) before buying their medicines. It covers at most the annual cap, 636.12 euros, and is repaid in 12 equal monthly instalments without interest. Earned income and benefits together may not exceed 1,800 euros a month, with higher limits for families with children. The credit is a three-year pilot that began on 27 October 2025.