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Health insurance in the Republic of Croatia

Healthcare in the Republic of Croatia – Introduction

 

Health insurance is compulsory
Health insurance in the Republic of Croatia is compulsory, meaning that every citizen of the Republic of Croatia should have regulated compulsory health insurance status.

Compulsory Health insurance is implemented by the Croatian Health Insurance Fund (CHIF) and regulated by the Compulsory health insurance Act (Official Gazette, no. 80/13, and 137/13. Internal consolidated text).

Health insurance and healthcare for aliens is governed by a special act - Compulsory Health Insurance and Health Care of Aliens in the Republic of Croatia Act (Official Gazette No. 80/13., and 15/18. Internal consolidated text).

Compulsory health insurance provides all the persons insured by the CHIF with the rights and obligations on the principles of reciprocity, solidarity and equality, in the manner and under the conditions laid down by EU Regulation (EC) No 883/04 of the European Parliament and of the Council of 29 April 2004 on the coordination of social security systems, the Directive 2011/24/EU of the European Parliament and of the Council of 9 March 2011 on the application of patients’ rights in cross-border healthcare and Croatian regulations on compulsory health insurance.

Persons who are required to be insured
Persons required to obtain health insurance are as follows:

  • persons with permanent residence in Croatia
  • aliens with an approved permanent stay in Croatia
  • nationals of other EU Member States (EU), the European Economic Area countries (EEA) and Switzerland, as well as the citizens of other states with approved temporary stay in Croatia, and on the basis of the employment with the employer headquartered in Croatia, i.e. on the basis of performing economic or professional activity, providing that the conditions of special regulations governing the issue of residence and work of aliens in Croatia have been met
  • nationals of the other Member States in the EU/EEA/Switzerland with the approved temporary stay in Croatia provided they do not exercise compulsory health insurance in another Member States of the EU/EEA/Switzerland, and
  • nationals of a State that are not Member States in the EU/EEA/Switzerland with a temporary stay in the Republic of Croatia, unless otherwise stated by the European law, international treaties on social security, or special laws.
    Application, changes, cancellation of the compulsory health insurance can be executed at any CHIF regional or branch office, within 8 days from the day of the occurrence of the changes or termination of the circumstances on the basis of which one obtains the status of the insured person under compulsory health insurance.

    The insured persons from another Member State in the EU/EEA/Switzerland and the contracted states

    Persons who, during their stay in Croatia, are insured under compulsory health insurance in another Member state in the EU/EEA/Switzerland or one of the countries with which Croatia has entered into an international treaty on social insurance regulating the issue of utilizing healthcare (Bosnia and Herzegovina, Serbia, Montenegro, Turkey and North Macedonia), shall utilize healthcare services as specified by the European regulations, or international treaties, but in the same way as the persons insured by the CHIF.

Rights under the compulsory health insurance
Rights under the compulsory health insurance in Croatia include the right to financial compensation and the right to health care services.
The right to health care includes the right to:
• primary health care,
• specialist-consultative health care,
• hospital health care,
• medications determined by the basic and supplementary medicine list of the CHIF,
• dental prostheses determined by the basic and supplementary prostheses list of the CHIF,
• orthopaedic and other medical prostheses determined by the basic and supplementary orthopaedic and other medical prostheses list of the CHIF, and
• the right to cross-border health care.

Compulsory health insurance also provides for the rights on the basis of accidents suffered at work and occupational diseases.

Healthcare activity
Healthcare activity is carried out on the primary, secondary and tertiary level, as well as on the level of the healthcare institutes.
Healthcare services at the primary level shall be bestowed upon the insured person by the CHIF based on their free choice of GP doctor and dentist, in general, according to their place of residence. Foreign policy holders requiring healthcare during their stay in Croatia shall do so at the expense of the foreign health insurance provider. They shall not choose a physician, but for the purpose of utilizing primary health care services shall visit any primary health care contracted physician.
Healthcare at the primary level is provided through:
• general/family medicine
• health care of preschool children
• health care of women
• field nursing care
• the in-house health care treatment
• dental health care
• sanitary-epidemiological health care service
• laboratory diagnostics
• pharmacy and
• emergency medical assistance.
Healthcare at the secondary and tertiary level is provided based on the obtained patient referral form from the selected primary health care physician.
Healthcare activity at the secondary level consists of specialist-consultative and hospital health care, while at the tertiary level it consists of performing the most complex forms of specialist-consultative and hospital healthcare activities.

Single EU emergency number is 112.

Healthcare costs participation
The insured persons are obliged to participate in the costs of health care for services that are not entirely covered by CHIF. Minimum participation amount is 10.00 HRK, and maximum cannot exceed 2,000.00 HRK per one invoice.

Supplementary health insurance
To cover the participation costs, a person with compulsory health insurance regulated by the CHIF is entitled to enter into an agreement with the CHIF on supplementary health insurance.

Organization of the Croatian Health Insurance Fund
Croatian Health Insurance Fund is divided into the Directorate of the CHIF, four regional offices and 16 branch offices.
Contact details are available on www.hzzo.hr/kontaktirajte-nas/
The Ministry of Health of the Republic of Croatia performs supervision over the lawfulness of the CHIF.

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