How does the state health insurance system work?
Healthcare and health insurance are run by municipalities and the Norwegian government: budgets are organized locally but levels of some spending are nationally set. Norway’s public hospitals are run by the four Regional Health Authorities (RHA).
EAA citizens are automatically covered by the national health insurance scheme, but may need to seek hospital care beyond their local areas if there is high demand.
You will find that, unless you are in a vulnerable group, you will have to co-pay for GP visits and outpatient hospital care. In addition, you will need to pay some of the cost of prescriptions. The average doctor’s visit costs between 150 and 350 kr (€15 – €35). If you are visiting Norway, you might also have to pay a non-refundable fee in addition to this, but check with the medical provider, particularly if you have an EHIC card.
Costs are capped by the state: once your expenditure reaches the 2000kr mark (about €200) you will be eligible for an exemption card (frikort) which will give you free treatment for the rest of the year.
The Norwegian government revises the exemption limit every year. This is quite complex: there are two exemption cards, for different parts of the Norwegian healthcare system, and you will not be able to use your Group 1 card for Group 2 treatment.
Your treatment provider will report your user fees automatically to the Norwegian Health Economics Administration (Helfo), but you must keep your receipts.
If you are elderly or disabled, you will receive some care, but it is means-tested. Some groups (for instance, those who have HIV) are eligible for free treatment in any case, so check to see if this applies to you.
Your first port of call for information is Helfo, who can supply you with an EHIC if you are from an EU member state. If you have an EHIC, you will still have to pay the standard (non-refundable) patient fees.
There are some exemptions due to bilateral healthcare agreements, for example with Australia, so you will need to take a look at the terms of the agreement if you are coming from this part of the world.
You will need to register with a GP, but you can choose which surgery you sign up with and you can change your GP up to twice a year. You can do this online via helsenorge.no. The GP is likely to be self-employed but will be funded by the municipality, Helfo, and out of pocket co-payments from patients. The latter have to pay upfront unless they require further care: this will be paid directly by Helfo, but after that you will need to apply for reimbursement.
Finally, note that this does not apply to the overseas territory of Svalbard: you will need to take out private insurance if you are going there.
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Who is eligible for state healthcare?
The system is founded on a universal access model, allowing healthcare to be extended to as many people as possible in the country, including expats.
How do you apply to join the state health insurance system?
If you are an expat from an EAA state, you will be automatically covered once you enter the country.
Otherwise, your first port of call should either be your employer, who can help you navigate your way through the system, or Helfo, who will be able to give you all the necessary advice. You will need a social security card, but once you have got one, you will be treated like anyone else in the system.
What is covered by the state health insurance system?
Norwegian health insurance is comprehensive.
In Group 1, your exemption card will apply to:
- doctors’ visits
- psychologists’ visits
- appointments at the outpatient clinic at your local hospital
- appointments in the radiology department
- patient travel
- medication from the ‘blue list.’
In Group 2, your exemption card will apply to:
- examination and treatment by physiotherapists certain types of dental treatment stays at approved rehabilitation centres travel for treatment abroad arranged by Oslo University Hospital (Rikshospitalet HF)
The state scheme also covers nursing home care and mental health treatment, and fully covers anyone under the age of 18.
The system will not cover optical treatment so you will need to pay for your glasses. It does not cover elective, non-essential plastic surgery.
Note that there is a difference between the emergency room (akuttmottak) and the urgent care centre, sometimes known as the "doctors on duty" (legevakt): the emergency room will need a letter of referral from your GP, whereas the urgent care centre is for life-threatening emergencies.
If you have a chronic condition, you may be issued with a "blue prescription" (blå resept) which will give you a deduction for some of your medication. A prescription for short-term medication is known as a "white prescription" (hvit resept) and you will have to pay the full amount for this.
Are retirees covered by state medical insurance?
If you are a retired expat in Norway, you will be eligible for the national insurance scheme if you are making contributions. If you are an EAA citizen you will be automatically covered.
Are students covered by state medical insurance?
If you are a student from a Nordic country, you will be covered by the Norwegian National Insurance Scheme if you are registered in the National Population Register in Norway. If you are not a member you will still be entitled to health services under the National Insurance Act and you do not have to verify this with a European Health Insurance Card.
If you are from an EU member state you will be able to use your EHIC card.
If you are from outside the EU, you must arrange private insurance, although you will become eligible for the national scheme if you remain in Norway for longer than a year.
Will your family be covered by your insurance?
If they are registered with the state insurance scheme, your family will be covered.
Is dental treatment covered by state health insurance?
The following people are entitled to free dental treatment:
- children and young people up to the age of 18
- people with mental health disabilities
- elderly people who are receiving care services from the municipality
Young people aged between 19 and 20 are entitled to public dental treatment, but they must pay a reduced co-payment.
Otherwise you must visit a private dentist and pay the treatment costs upfront. The National Insurance Scheme covers the cost of treatment by dentists or dental hygienists if patients are suffering from certain illnesses.
What are the contribution rates for state health insurance?
Contribution rates for national insurance are around 8 – 9% of your gross salary. You can also make voluntary contributions — this is about 9.1% of your gross salary.
Why buy private health insurance?
People typically take out private cover to speed up the time that it takes to be seen and treated (which can take up to 57 days at the last analysis, especially in the summer when many medical personnel go on holiday), and to access improved facilities. Norwegian healthcare is of a very high standard, but like many other countries in Europe the nation is suffering from an overstretched system caused by an ageing population.
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What is covered by private health insurance?
Private health insurance in Norway does not cover acute cases or emergency hospitalization: there is simply no care in the private sector for this. The uptake of private cover by Norwegian residents is correspondingly minimal and only around 9% of the population have private medical insurance: most of this cover (around 91%) is paid for by employers.
How much does private health insurance cost?
Local insurers include Storebrand, who have plans for around €50 per month, but there may be a minimum residency period before expats can buy insurance cover.
For those seeking international private medical insurance (iPMI) cover for multiple countries including Norway, numerous variables can have an impact on the cost.
The most important variables are:
- age (the higher the more expensive)
- area of cover (i.e. in addition to Norway, which other areas is coverage required in? If those other areas include any of the US, the Caribbean, Singapore, China, Hong Kong or Dubai this can significantly increase the overall price)
- product choice (higher end insurance products are more expensive)
Other variables include:
- payment frequency
- country of residence
As so many variables have an effect on the cost of international private medical insurance in Norway it becomes very difficult to give accurate estimates without knowing the full details of the coverage required. However, as a very rough guide, using a standard profile of a 40 year old British male with no deductibles, no co-insurance, a middle tier plan/product, all modules included and worldwide coverage excluding the US, a ballpark price of around £4,000/$5,000 might be expected. Were coverage to be expanded to include the US then the premium could increase to almost double that amount.
Which companies offer private health insurance?
The big international providers operate in Norway, including:
- Bupa Global
- Cigna Global
- Pacific Prime
Glossary of health insurance terms
blå resept - "blue prescription"
hvit resept - "white prescription"
Jeg har et EHIC-kort - I have an EHIC card
Jeg har privat helseforsikring - I have private health insurance