Client billing and instructions

All bills sent by th Wellbeing County of Southwest Finland should be paid on due date the latest. Also, its is important to use the reference number on the bill.

If you need to postpone the due date or draw up a payment plan, please contact the client service for billing of the Wellbeing Services County of Southwest Finland.

tel. 02 313 1141

The client service for billing is available from Monday to Thursday at 9–11 (select 1).

Jos haet eräpäivän siirtoa tai maksusuunnitelmaa toisen täysi-ikäisen henkilön puolesta, sinulla tulee olla voimassa oleva valtakirja valtuutuksen antajalta. Toisen puolesta asiointiin oikeuttaa huoltajuus, valtakirja, edunvalvontapäätös tai vahvistettu edunvalvontavaltuutus. Vapaamuotoisen valtakirjan voi antaa vain täysi-ikäinen ja oikeustoimikelpoinen henkilö.

Suosittelemme lähettämään valtakirjan Suomi.fi-palvelun kautta tai postitse Varhan kirjaamoon.

Suomi.fi-palvelu
Varsinais-Suomen hyvinvointialueen kirjaamo

Vapaamuotoisessa valtakirjassa tulee olla

• riittävät tiedot valtuuttajan ja valtuutetun tai valtuutettujen yksilöimiseksi
• tieto siitä, mitä asioita valtuutus koskee
• tieto siitä, saako valtuutetulle antaa asioiden hoitamiseksi salassa pidettäviä tietoja valtuuttajasta (luvan voi antaa esim. etuustietojen ja muiden taloudellista asemaa koskevien tietojen tai terveydentilaa koskevien tietojen antamiseen)
• voimassaoloaika (toistaiseksi tai määräajan)
• valtuuttajan allekirjoitus, nimenselvennys ja päiväys.

When calculating the total amount that accumulates the payment ceiling, the payments made during the calendar year (1 January - 31 December) are taken into account. The accumulation depends on the care period or treatment period, not the due date or payment date of the bill.  

The user of services must monitor the fulfilment of the payment ceiling (Act on Client Fees in Social Welfare and Health care, Section 6 a). The original payment receipts must be kept and presented on request. 

The fees charged for services used by persons under 18 years of age are added to the fees charged from their custodian. 

Once the payment ceiling has been reached, the client will, as a rule, receive the services covered by the payment ceiling free of charge until the end of the calendar year in question. An exception is a treatment day fee of up to 25,10 euros, the so-called maintenance fee, charged for short-term institutional care for persons over 18 years of age. 

The wellbeing services county can collect the information necessary for monitoring the client’s compliance with the payment ceiling. In addition, the wellbeing services county has the right to obtain the necessary information from a public or private service provider to monitor compliance with the payment ceiling, notwithstanding confidentiality provisions. 

The following are covered by the payment ceiling

• outpatient health care services in basic health care
• examinations and treatment in an outpatient clinic in specialised health care
• day surgery procedure
• oral and dental examinations and treatment, excluding technical dental fees
• specialised oral and maxillofacial procedure
• physiotherapy, neuropsychological rehabilitation, nutritional therapy, foot care, speech therapy, occupational therapy and other similar treatment that improves and maintains functional capacity, provided by a health care professional
• fees for serial treatment
• temporary home nursing care and temporary home hospital care
• short-term institutional care (Health Care Act, Section 67)
• short-term day and night care
• short-term institutional services (Social Welfare Act, Section 22)

The following are not covered by the payment ceiling

• social welfare services
• income-related fees
• deductible portions of service voucher or transport services
• temporary home care
• meals, support and security services for the elderly
• day rehabilitation and short-term care, i.e. 24-hour sheltered housing and communal housing in units for the aged
• rehabilitative assessment period for home care in services for the aged
• weekday rehabilitation in services for the aged as a support service
• rehabilitative daytime activities as a support service
• fees collected from the person cared during the primary carer’s statutory leave
• health care certificate fees
• fees for unused and non-cancelled services
• ambulance transport
• institutional rehabilitation provided to a person receiving services in accordance with the Act on Special Care for Persons with Intellectual Disabilities or the Act on Services and Support Measures Organised on the Basis of Disability (Health Care Act, Section 29)

Once the payment ceiling has been reached, the client will, as a rule, receive the services covered by the payment ceiling free of charge until the end of the calendar year in question. An exception is a treatment day fee of up to 25,10 euros, the so-called maintenance fee, charged for short-term institutional care for persons over 18 years of age.

By virtue of the Act on Client Fees, you can apply for a fee exemption by the end of the calendar year following the year in which the payment ceiling is reached.

What you should do

Call number 02 313 1141 (select 1) from Monday to Thursday between 9.00 and 11.00. 

The application must be accompanied by the original receipts of all fees included in the payment ceiling that have accumulated in a calendar year in an area other than the Wellbeing Services County of Southwest Finland.  

We will later publish a form on our website for applying for exemption. 

Overpayments

If the user of the service has paid more than 692 euros for the services included in the payment ceiling during the calendar year, the user is entitled to reimbursement of any excess payments, with the exception of the maintenance charge for short-term institutional care.

Certificate of exceeding the payment ceiling

The free card giving entitlement to the fee exemption is mailed to the client. The certificate indicates the client’s name and personal identity number and the names and personal identity numbers of the client’s children under 18 years of age as well as the period of exemption from payment. The certificate applies to all children under 18 years of age of the holder of the certificate. The exemption certificate must be presented when seeking treatment outside the services of the Wellbeing Services County of Southwest Finland (public services).

Right to rectification

A person dissatisfied with the client fee decision or a bill for the client fee may lodge a written request for rectification. Authority to whom the request for rectification is made: Wellbeing Services County of Southwest Finland 

A request for the rectification of a bill cannot be made if the bill is based on a separate decision made previously based on the client’s ability to pay. 

A request for rectification can be submitted by the person to whom the decision or bill is addressed, or whose right, obligation or benefit is directly affected by the decision or bill (party concerned).

Deadline for the request for rectification

A request for rectification must be submitted within 30 days of the receipt of the decision or bill.

The request for rectification must be submitted to the registry of the Wellbeing Services County of Southwest Finland on the last day of the set period of time before the end of the office hours of the registry.

• Through this link, you can find the contact information on the registry

A party shall be considered to have been informed of the decision or bill, unless otherwise indicated, in seven days after the decision or bill was sent. A decision or bill submitted electronically shall be deemed to have been served on the third day after the message was sent, unless otherwise indicated.

The day of notification is not included in the period for a request for rectification. If the last day of the period for a request for rectification is a public holiday, Independence Day, the First of May, Christmas or Midsummer Eve or a weekday Saturday, the request for rectification may be submitted on the first workday after it.

If the request for rectification has not been filed within the prescribed period of time, the request for rectification shall be dismissed as inadmissible.

Form and content of request for rectification

The request for rectification shall be submitted in writing. An electronic document also meets the requirement of written form.

The request for rectification shall state:

• decision or bill for which rectification is requested
• what kind of rectification is requested and
• the basis on which rectification is requested.

The request for rectification must also include the name, municipality of residence, postal address and telephone number of the person making the request for rectification. If the decision on the request for rectification can be served in electronic format, please also provide an email address.

The request for rectification does not eliminate the obligation to pay default interest incurred after the due date of the bill, if the request for rectification is rejected and the bill has not been paid due to the request for rectification.

Provisions on client fees charged for social welfare and health care services are laid down in the Act (734/1992) and Decree (912/1992) on Client Charges in Healthcare and Social Welfare.

Provisions on the reduction and non-collection of client fees are laid down in section 11 of the Act, according to which a fee imposed for social welfare services and a fee imposed for health care services according to a person’s ability to pay shall not be collected or it shall be reduced to the extent that the collection of the fee jeopardises the ability of the person or the person’s family to subsist or the performance of the person’s statutory maintenance obligation.

The reduction and non-collection of the fee shall take precedence over the social assistance referred to in the Act on Social Assistance (1412/1997).

The wellbeing services county that provides the services may decide that:

• fees other than those referred to in subsection 1 may not be collected or may be reduced on the grounds referred to in subsection 1; or
• fees may be reduced or may not be collected if there are grounds for doing so in the light of considerations related to dependents.

The reduction and non-collection of fees apply to social welfare fees and income-related health care fees. The reduction and non-collection of fees do not apply to flat fees in health care. The Wellbeing Services County of Southwest Finland (hereinafter referred to as Varha) has not decided that the flat fees in health care would be reduced or not collected on the grounds that the charging of the fee jeopardises the ability of a person or the person’s family to subsist or the performance of a person’s statutory maintenance obligation, and not for reasons related to dependents. 

The deductible portion of a service voucher cannot be reduced or waived, because the regulation on the reasonableness of client fees does not apply to a service voucher. If necessary, the value of a service voucher can be increased in accordance with Section 8 of the Service Voucher Act.

You can apply for a reduction or non-collection of client fees for social welfare fees and income-related health care fees in accordance with the examples in the table below.

Varha must provide the client with information on the reduction or non-collection of the client fee. The information must be provided before or in connection with the first service event. If it is not possible to provide the information before or in connection with the service event, it can be provided later, but at the latest when the client fee is charged. The information must be provided in such a way that the client sufficiently understands its contents. When providing the information, the client must be provided with the name and contact information on the party from which the client may request additional information, if necessary. 

Additional information

If necessary, the client may request additional information from Varha’s client fee unit at: 02 313 1141 (Monday to Thursday 9.00 - 11.00, line 2 or 3).

The preparations for a reduction or non-collection of fees are based on an application submitted by the client or the client’s custodian, representative or trustee. The application may be in free form or the client may use the application template of the Wellbeing Services County, which can be printed out below. You can also get the application form from your own employee or client fee unit.

The application must state for what period or from which date the reduction or non-collection is applied for, on what grounds (income/expenses) and which service the application concerns. The application must also state grounds as to how the client fee jeopardises the client’s or family’s ability to subsistence or the performance of the statutory maintenance obligation.

The application must be accompanied by the following documents for the applicant and the applicant’s spouse (including common-law partner):

• tax decision last confirmed (if not already submitted for the income statement for the service fee)
• the pre-completed tax return for the current year with its itemisation sections (if not already submitted for the income statement for the service fee)
• receipts of income and expenses referred to in the application
• bank statements of all of the client’s and potential spouse’s bank accounts, including bank transaction data, for a period of three months prior to the date of application
• potential decision on social assistance
• a copy of the payment programme of a person in debt adjustment
• other clarifications and documents referred to in the application. 

Please fill in the application as accurately as possible and include all necessary annexes, and sign the application. An incomplete application slows down the processing of the case and, if necessary, the application will be returned or it may lead to a negative decision.

The client and the client’s legal representative must provide the authority with all information necessary to assess the need for a reduction or withdrawal of the fee (Act on the Status and Rights of Social Welfare Clients 812/2000, Section 20).

The decision on reducing or not collecting the client fee will be made by the personnel of the client fee unit in accordance with Varha’s delegation decision. The assessment of the reduction or non-collection of client fees is made individually on the basis of an assessment of the client’s and the family’s overall financial situation.

As a rule, the fee may be adjusted from the beginning of the month of application or, on a case-by-case basis, retrospectively for a period not exceeding six (6) months, if it is determined that a change in the fee is necessary. A decision to reduce the fee may be made on a one-off basis, for a fixed term or until further notice (but not exceeding 12 months), taking into account the client’s overall situation.

If the client’s or the family’s need for services changes or if there are changes in the overall financial situation during the validity of the decision, Varha’s client fee unit must be notified of this. Varha has the right to recover the client fees retrospectively, if the decision to impose the fee was based on incorrect information provided by the client or the client’s representative. The fee is rectified retrospectively for a maximum period of one year (Act on Client Charges in Healthcare and Social Welfare, Section 10 j).

The client is given a written decision on the application for a reduction or non-collection of the fee (also on a negative decision). Instructions for request for rectification are always included with the decision.

A reduction calculation of the client fee, showing the client’s ability to pay, is always used as the basis for a decision to reduce or not collect the client fee. 

Net income to be taken into account

• salary, entrepreneur income and pension income
• benefits paid by Kela or insurance companies (e.g. sickness allowance, parental benefits, unemployment benefits, housing allowance, care allowance)
• capital income
• interest and dividend income
• child allowances and pensions for all children
• child maintenance allowance / child maintenance support for all children
• support for primary care 

Expenses to be taken into account

The application for a reduction or non-collection of client fees must be accompanied by receipts of expenses.

• rent / maintenance charge
• heating costs (e.g. electricity or oil heating)
• real estate tax
• water charge
• any other obligatory property costs (e.g. chimney sweeping, waste collection, road fee)
• interest on housing loan
• interest on student loan
• interest related to the purchase of a car, if the purchase of a car has received support under the Disability Services Act
• home care support services fees and day activities fees related to client’s home care client relationship (transport costs for meal and shopping services, sauna service and security phone)
• private security phone fee (monthly rent, etc.) not related to the client's home care client relationship
• child maintenance support
• enforcement: The application must be accompanied by the enforcement decision of the enforcement authority, a summary of the debtor’s enforcement matters. The appendix must show the amount in enforcement, from which the income it is enforced, and the date when the enforcement starts and ends. If the ending date of the enforcement is not known, the client or the person taking care of the client’s affairs must notify Varha’s client fee unit of this as soon as the client or the person taking care of the client’s affairs has become aware of the ending date of the enforcement. 
• debt adjustment of a private person: Please attach a copy of the decision of the District Court and/or a payment plan if the decision of the District Court does not indicate the amount of the payment.
• home insurance (so-called basic home insurance) for one’s own residential dwelling
• any other obligatory insurance of residential property used for one’s own residential use
• long-term prescription medication (prescribed for 3 months or more), if the medication costs have not been taken into account when imposing the client fee: The client must attach prescriptions and receipts of long-term medication. Medication costs are taken into account up to the amount of the annual medication ceiling. 

Expenses not taken into account

• over-the-counter medication
• health care expenses (payment ceiling)
• massage and other similar services
• clothing costs or medical supplies due to the client’s special needs, which are reimbursed under another act or which are not necessary for the patient’s health or treatment
• hobby fees
• insurance premiums (with the exception of obligatory residential property insurance and home insurance for the client’s own residential dwelling)
• consumer credits or unsecured loans
• financial consideration of housing
• housing and study loans, interest on housing and study loans
• inheritance tax
• litigation costs
• deductible portions of transport services
• other household management expenses
• renovation and other potential costs related to the maintenance of property in owner-occupied dwellings
• voluntary service packages in private sheltered housing and compulsory service packages related to housing.

The client must notify and the person preparing the matter must take into account any other reductions already granted to social and health care fees, payment ceilings for the period corresponding to the application and any social assistance granted. The client must monitor and be aware of the payment ceilings for health care services and medication costs and, if necessary, become a client of the self-care supplies distribution service.

The client must make an application to Kela for the necessary benefits (does not mean social assistance) before applying for a reduction or non-collection of the client fee (or apply for the benefits as soon as possible afterwards).

When assessing the client’s ability to pay or whether collecting the fee jeopardises the subsistence of the person or family or the performance of the person’s statutory maintenance obligation, the spouse’s income and expenses in the case of marriage or couples living in similar circumstances are also taken into account.

If the persons are married but live at different addresses (one at home and one, for example, in long-term institutional care), they are considered to have separate households. In this case, the spouse’s income and expenses are not taken into account in the calculation of the reduction or non-collection of the client fee.

The basis for calculating the applicant’s ability to pay is based on the principle that expenses are deducted from the income in order to assess whether the subsistence of the person or family or the person’s statutory maintenance obligation are jeopardised due to the client fee.

An available margin is defined for the applicant in the reduction calculation in accordance with the table below (the figures are updated annually according to index adjustments). The applicant must have the basic amount of social assistance (555.11 euros for a person living alone in 2023) or the minimum available margin in long-term intensified sheltered housing (167 euros in 2023) or the minimum available margin in long-term institutional care (112 euros in 2023) depending on the client’s permanent place of residence and service. The Act on Client Fees defines how client fees are determined in these services.

If the result of the reduction calculation is negative, the fee will be reduced by the deficit indicated by the calculation. If the result of the reduction calculation is positive, there is no justification for reducing the fee.

The calculation of a client living at home takes into account the basic amount of social assistance, by which the client covers food costs, personal hygiene and household cleanliness costs, medicines and medical supplies available from pharmacies without a prescription, minor health care costs, hobby and recreational pursuits, telephone costs, purchase and maintenance of clothing, costs related to the use of local transport, parking space rent, newspaper subscription fees and other everyday subsistence expenses, such as fuel costs. (Social Assistance Act, Section 7 a). If the client has a spouse or minor children, the basic amount of social assistance is taken into consideration for each individual in accordance with the basic amount of social assistance determined annually by Kela, depending on the family size.

The purpose of the available margin in long-term 24-hour sheltered housing or long-term family care is to cover, for example, the residents’ personal hygiene costs, haircut and hairdressing fees, foot care services, minor health care costs (such as services provided by a doctor, home nursing and physiotherapist, hospital and home hospital fees, spectacles and dental care), shopping service, medicines (in so far as they would not be taken into account as a deduction when calculating the client fee), local transport fees, subscriptions to personal newspapers, costs for use of telephone, clothing costs and fees for hobbies.

If the client’s service varies during the month, for example between hospital and home, the available margin is calculated according to the place of permanent residence/type of housing. In situations where the client has sufficient personal assets and/or shared assets with his/her spouse, the assets are considered to cover the available margin in accordance with the basic amount of social assistance or type of housing for the client and possibly also for his/her spouse and minor children (see section 2.2).

If the client has been granted supplementary or preventive social assistance, the amount of the reduction in the client fee is determined as the monthly average of the social assistance granted. The condition is that there will be expenses eligible for supplementary or preventive social assistance within the next 6 months.

The subsistence requirement of a person or family or the statutory maintenance obligation are not considered to be jeopardised if the client has, on the basis of the above calculation, the statutory or other available margins separately determined by the municipality.

If the client encounters temporary payment difficulties, the client may contact the client fee service number, tel. 02 313 1141 (Monday to Thursday 9.00 to 11.00, line 2 or 3) to agree on a payment plan (such as postponing a due date or paying an overdue bill in more than one instalment).