High-cost protection within outpatient care means that you do not need to pay more than a certain amount in patient charges over the course of one year. You add up the cost of visits to clinics in the region and in other county council areas as well as private healthcare providers (which have an agreement with VGR). When you have reached the threshold of SEK 1 100 you will be issued with an exemption card.
What does high-cost protection cover?
High-cost protection applies when you visit a medical practice and when you receive medical care that can be provided by, for example, a district nurse, physiotherapist or psychologist. If you are entitled to what is termed essential dental care – dental care that is part of treatment for a disease or dental care that is a result of a long-term disease or disability – the patient charges you pay can also be included.
High-cost protection does not cover everything. For example, it does not cover:
- preventive care, such as breast screening and gynaecological health checks
- the cost of appointments you have failed to keep
- the cost of certificates
- the cost of copies of your case notes
- travel by ambulance
If you have visited a clinic as an outpatient and paid a total of SEK 1 100 for medical care and treatment within one year, you are eligible for an exemption card. The card entitles you to free healthcare for the remaining 12 months, calculated from the first visit that formed the basis for the exemption card, in other words the oldest payment made under the high- cost protection scheme. The exemption card is valid throughout the country.
This is what you do
For each visit, attach the receipt to your high-cost card or ask the staff to write on the card the charges you have paid. Cards are available from the clinic. It is important that you bring your high-cost card with you.
If you pay by invoice, you contact patient invoicing 4-5 days after you have paid. They will send a receipt showing that the invoice has been paid. Bring the receipt along with you next time you visit as an outpatient. You can also go to your nearest health centre, where the reception staff will arrange for the amount to be added to your high-cost card.
As a patient, it is important that you keep a check on how much you have paid in patient charges so that you can be issued with an exemption card.
Children and young people
Children and young people under the age of 18 who are members of the same family have joint high-cost protection. Charges for children are combined on the same card.
If you lose your exemption card
Save your high-cost card, together with a note of the patient charges, or the receipts, even after you received your exemption card. This will make it easier to obtain a replacement (with the same period of validity as the original card) if you happen to lose or misplace your card. You can receive help with this at any clinic.
You can obtain a new exemption card even if you do not have the necessary documentation for an exemption card. In this case, you must contact the clinic that issued your exemption card or any other clinic you have visited using your exemption card and which has recorded the period of validity of the card.
High-cost protection for patient transport, SEK 1 500
For patient transport, you must pay SEK 1 500 per year before high-cost protection comes into effect.