Frequently asked questions about the payment cap
See frequently asked questions about the health and social services’ payment cap here.
About the payment cap
After you have paid the amount of the payment cap for health and social services, services in the scope of the payment cap will generally be free of charge for you until the end of the year (with the exception of the so-called upkeep fee in short-term inpatient care). You have to apply for a certificate of having passed the payment cap. The party/municipality/joint municipal authority in which the payment cap is passed will grant the certificate.
In 2025, the payment cap is EUR 762 per year. The amount follows the National Pensions Index and is reviewed every other year. The payment cap is monitored by the calendar year. The payment cap is regulated by the Act on Client Charges in Healthcare and Social Welfare.
The invoice you receive will say if it is part of the payment cap. The following fees are part of the payment cap:
Healthcare fees
- Health station fees (not charged in Helsinki)
- Outpatient clinic fees
- Ambulatory surgery procedure fees
- Serial treatment fees
- If the serial treatments are conducted in two different years, the treatments and fees included in the payment cap are registered for the year in which the treatment occurred
- Individual physiotherapy fees
- Night and day care fees (upkeep fee charged after the payment cap has been passed)
- Rehabilitation
- Daily hospital fees for short-term inpatient care (upkeep fee charged after the payment cap has been passed)
- Psychiatry day hospital fees (the fee will not change after the payment cap has been passed)
- Oral and dental check-up and treatment, excluding
- Dental technician fees, such as dentures, mouth guards, orthodontic appliances or sleep apnoea mouth guards
- Specialised dental technician care implemented as an outsourced service
- Primary care’s oral and maxillofacial care procedures in specialised health care
- Physiotherapy, neuropsychological rehabilitation,nutritional therapy, speech therapy, occupational therapy and podiatry provided by a healthcare professional
- Temporary home health care and temporary at-home hospital care
- Rehabilitative assessment periods
Social welfare fees
- Daily hospital fees for short-term inpatient care (upkeep fee charged after the payment cap has been passed)
- Night and day care fees (the fee will not change after the payment cap has been passed)
- Rehabilitation treatment for a person with a disability or rehabilitation conducted as special care for people with developmental/intellectual disabilities
- Permanent guide for Social Services and Health Care Division: Payment cap for client fees charged for health care and social welfare services (PYSY094, valid: 1 March 2024–28 February 2033)
- Please note that passing the payment cap does not impact client fees not in the scope of the payment cap.
- Healthcare fees
The following fees are not part of the payment cap:
Healthcare fees
- Long-term institutional care fees
- Fees for a medical certificate
- Ambulance service fees
- Occupational health care fees
- Fees for an appointment that was unused or not cancelled
- Oral health care’s dental technician fees, for example, for dentures, mouth guards, orthodontic appliances or sleep apnoea mouth guards
- Specialised dental technician care implemented as an oral health care outsourced service
- Fees for psychiatric housing rehabilitation when charged for supported housing
- Family care fees
- Special payment category fees
- Penal interest and collection fees
- Copayment for service vouchers
Social welfare fees
- Fees for home care and home care support services
- Fees for long-term institutional care and family care
- Fees for day activities for the elderly
- Fees for short-term service housing in accordance with the Social Welfare Act
- Fees for children’s daycare, family care, housing services, transport services for individuals with a severe disability and invoices other than those mentioned in the payment cap list
- Penal interest and collection fees
Other payments not in the scope of the payment cap
- Fees for services arranged during the statutory leave of an informal caregiver
- Fees for care reimbursed on the basis of Employment Accidents Insurance Act, Act on Farmers Employment Accident Insurance, Military Injuries Act, Motor Liability Insurance Act, Patient Injuries Act or some other similar act
- If you use private health and social services, their fees do not accumulate the payment cap.
- The payment cap for medicine and travel costs is taken care of by Kela (link to an external service)(Link leads to external service) .
More fees have been included in the scope of the payment cap. For example, the following fees accumulate the payment cap:
- Oral and dental check-up and treatment (excluding dental technician fees)
- Oral and maxillofacial care procedures in specialised health care
- Temporary home health care
- Client fees paid from income support
Yes. Also the health and social services client fees paid with income support accumulate the payment cap.
It is up to you to keep track of when you exceed the payment cap. When you pass your payment cap, you can apply for a certificate. Apply for the certificate from the party/municipality/joint municipal authority in which you passed the payment cap.
- If you pass the payment cap with an invoice sent by the City of Helsinki financial management service, please contact the financial management service or apply for the certificate with the below form.
Apply for the certificate of having passed the payment cap with this form
- If you pass the payment cap with an invoice sent by HUS, please contact the HUS client invoicing service (link to an external service)(Link leads to external service)
Yes. We recommend keeping all original invoices and receipts, preferably in chronological order.
They may be requested when you apply for the certificate of having passed the payment cap.
Yes, it is. Guardians may request for the invoices of a child under the age of 18 to be combined with the guardian’s invoices, which means that the payment cap is passed for the guardian as well as for all children under the age of 18.
The payment cap is calculated during one calendar year (1 January to 31 December) and starts from the first treatment visit or day that is subject to a fee.
If the treatment you are receiving occurs in two different years, the fees accumulating the payment cap are registered for the year during which the treatment occurred. The validity of the payment cap always ends on 31 December.
Reimbursements for medicine and travel costs do not accumulate the health and social services’ payment cap.
The payment cap for medicine and travel costs is applied for from kela. Read more about the annual maximum limit on out-of-pocket medicine costs (link to an external service)(Link leads to external service) and travel costs (link to an external service)(Link leads to external service) .
When you pass the payment cap
When you pass your payment cap, you can apply for a certificate. Apply for the certificate from the party/municipality/joint municipal authority in which you passed the payment cap.
- If you pass the payment cap with an invoice sent by the City of Helsinki financial management service, please contact the financial management service or apply for the certificate with the form.
Apply for the certificate of having passed the payment cap with this form
- If you pass the payment cap with an invoice sent by HUS, please contact the HUS client invoicing service (link to an external service)(Link leads to external service) .
- Keep your invoices and receipts in the order of visits/treatments. They may be requested when you apply for the certificate of having passed the payment cap.
The processing time for payment caps is 2–3 months from your contact request.
If you passed your payment cap with an invoice sent by the City of Helsinki financial management service and you have contacted us, we will send you a certificate of having passed the payment cap.
In addition, we will send you information related to the justifications of the calculation and, if necessary, additional information, such as
- Have you paid too many client fees
- Have invoices been refunded or is there a replacement invoice for treatment days at short-term inpatient care with a lowered upkeep fee
Among others, the following fees will not be charged:
- Health station fees (not charged in Helsinki)
- Outpatient clinic fees
- Ambulatory surgery procedure fees
- Individual physiotherapy fees
A more detailed list is available on page 2 of the Social Services and Health Care Division’s permanent guide on the payment cap (link to an external service)(Link leads to external service) .
The payment cap is valid from the day you pass it until the end of that calendar year. When your payment cap applies, the services covered by the payment cap will generally be free of charge for you until the end of the year.
Invoices after the payment cap has been passed
Even though you have passed your payment cap, an upkeep fee of EUR 25.10 will be charged for short-term inpatient care (EUR 18.10 if the care is between 1 January and 29 February 2024). The upkeep fee is approximately one half of the daily hospital fee for inpatient care.
The upkeep fee will also be charged for short-term psychiatric inpatient care as well as night and day care. People under the age of 18 will not be charged this fee.
If you have received an invoice from some other service included in the payment cap, please contact the party that sent you the invoice.
If you have passed your payment cap with HUS and received an invoice from the City of Helsinki financial management service that does not acknowledge the payment cap, please contact the financial management service (link to an external service)(Link leads to external service) .
If you have paid too many client fees, the amount exceeding the payment cap will be refunded. The extra client fees are always refunded in the order of the used services (not in the order of invoicing or payment).
I paid too much to the financial management service
Extra client fees are primarily deducted from open invoices. If you do not have any open invoices, the financial management service will send you a form by post requesting for your bank account number for the refund.
I paid too much to HUS
HUS is responsible for extra fees paid to them in accordance with their guidelines.
The Helsinki City Hospital operates in Laakso, Malmi and Suursuo. The City of Helsinki is also responsible for the psychiatric hospital (Aurora hospital).