maksukatto

Maksukatto, literally meaning "payment ceiling," is a policy mechanism in Finland's health care and social security system that limits the amount of money an individual must pay out of pocket for eligible health services and medicines within a calendar year. The purpose is to protect households from excessive health costs and to provide predictable budgeting for medicines and care.

The maksukatto is part of the Finnish national health insurance system and applies to costs incurred for medicines that are reimbursed under the pharmaceutical benefits scheme, as well as certain charges for public health care visits and hospital services. The specific cap amount and the eligible costs are defined by law and revised annually by authorities; different beneficiary groups may face different thresholds or rebate rates.

Once a person’s cumulative out-of-pocket costs reach the cap, further eligible costs in that year are covered by the system, reducing or eliminating personal payments for the remainder of the year. The cap resets at the start of the next calendar year.

Administration of the maksukatto is overseen by Kela (the Social Insurance Institution of Finland) in cooperation with pharmacies, healthcare providers, and municipalities. The policy is intended to improve affordability and access to essential medicines and care while helping to contain public health spending. In policy discussions, maksukatto is often compared to out-of-pocket maximums in other welfare states and is a focal point in debates about health equity and cost containment.