3. Are MAP procedures covered by the social security system? Yes. Public health services include MAP procedures. Pursuant to the Health Insurance Act (sairausvakuutuslaki; 1224/2004), health insurance covers the cost of necessary medical care when infertility is caused by an illness. Infertility is in addition paralleled to illness in cases of permanent relationships where the pregnancy does not start within one year. Also men are covered.
4. Are there specific criteria for such coverage? Yes. Pursuant to the practice instructions of the Socio-medical Advisory Board of the Social Insurance Institution of Finland, MAP-procedures are available within the public health care to women until the age of 40. Also women over 40 years are treated if the prognosis is good. The costs are reimbursed by the health insurance scheme until the age of 43 years. In case of older women, the health insurance coverage is assessed on a case-by-case basis in the light of the medical data of the woman concerned.
5. Is the financial coverage limited to a number of MAP procedures? Yes.
The financial coverage has not been limited by law. The number of MAP procedures has however been limited to three attempts in the practice of the Social Insurance Institution of Finland, because according to statistics, the prospect of a successful procedure is known to decrease thereafter.
Infertility related to a decrease in the amount of gametes caused by aging is not considered an illness and is thus not covered as necessary medical care by the health insurance. MAP procedures are usually not covered after sterilization either. Possible costs borne by a cell donor are not covered, because they are unrelated to the treatment of the donor’s disease.
The insurance coverage of MAP procedures for an applicant over 43-years of age is decided upon on a case-by-case basis. An application for reimbursement is made with the Social Insurance Institution of Finland for both the medicines and the procedure itself. A statement by the doctor providing treatment must be attached to the application.