Healthcare in Croatia
Croatia has a universal healthcare system providing a form of mandatory insurance of all people. The population is covered by a basic health insurance plan as required by law and optional insurance administered by the Croatian Health Insurance Fund. Croatia’s social health insurance system is based on the principles of solidarity and reciprocity, by which citizens are expected to contribute according to their ability to pay and receive basic health care services according to their needs.
Croatian citizens are required to participate in health care expenditures, except for certain groups of insured people such as:
- Children under age of 18
- Children of dependents that are incapable of living and working independently
- People with residency in Croatia that are incapable of independent life
- Family members of dead or missing Croatian armed forces members and disabled members of Croatian armed forces
- The cost of some elective health care services such as plastic surgery are not covered by mandatory health insurance.
How the Croatian healthcare system works
Every one must have a general practitioner, if they intend to use the state health insurance policy. While it is not required to have a general doctor by law, your general doctor should always be your first stop when seeking treatment. At the initial visit, the general doctor will do an analysis and recommend further treatment, testing and referrals, as needed.
To gain free access to hospital, diagnostic and polyclinic services, a referral from a public general practitioner with a contract with HZZO, the national healthcare service, is required. This referral is called an uputnica, phonetically pronounced oo-poot-nit-sa. An uputnica is an order of sorts, used for diagnostics such as blood and urine tests, prescriptions and procedures.
Having an uputnica is critical when using the Croatian healthcare system. They are used at every level of healthcare, from simple blood tests to the anesthesia required for surgery. Croatia is paper-heavy and orders such as these are not always transmitted digitally, so do not lose your uputnica!
Once more with feeling…DO NOT LOSE YOUR UPUTNICA!
Health care contributions in Croatia are mandatory for all employed citizens and are paid for by their employers. Dependents of employees obtain their health care coverage through contributions paid for by working members of their families. Self-employed workers in Croatia are also obliged to pay health care contributions.
Croatian citizens who are exempt from paying health care contributions include retired people and people with low income. The low income threshold is calculated based on their total income in the previous calendar year, per family member, which must be no more than 45.59% of the national budget base per month. This is subject to change and you should check with your local HZZO office to see what the current rate is.
Croatian citizens have the option to obtain health services with private health care providers which are not HZZO contracted partners, either through direct payment or through supplemental insurance which is covering the payment. All residents of Croatia are required to have insurance through HZZO even if they choose not to use it or if they choose to use private insurance. Health insurance premiums do not vary based on residency status, but may change at the prerogative of HZZO. A list of local HZZO office where you can get more information can be found here.
Supplementary health insurance
In addition to the compulsory health insurance, HZZO also offers supplementary health insurance. It covers all types of additional payments regarding the basic health insurance in all healthcare institutions including, without limitation: primary health care, specialist examinations, diagnostics, laboratory tests, physical therapy, dental medicine services, hospital treatment and getting prescription medication. It essentially serves as a means of payment for the co-payment.
You can sign up for your orange supplementary health insurance card by going to the HZZO offices, or you can do it online. The cost for this supplement is about 70 kuna per month unless you are a student, person with low income, 100% disabled or a blood donor. Blood donors qualify for free supplementary insurance once they reach the minimum threshold of 25 donations for females or 35 donations for males. Once you have donated the minimum number of times, take your blood donation booklet to the HZZO offices and request your free supplementary health insurance.
The steward of the health system is the Ministry of Health, which is responsible for health policy, planning and evaluation, public health programs, and the regulation of capital investments. The Ministry of Finance also plays a key role and is responsible for the planning and management of the government budget.