If you are living and working in Romania, then you may need to access healthcare services there. The quality of the provision you receive will depend on whether you choose to access the public or the private sector. We will look at all aspects of the Romanian healthcare system below and consider some of your options.
Public healthcare in Romania
Unfortunately, according to the European Health Consumer Index, Romanian healthcare ranks as the weakest in Europe. Facilities are poor, and corruption is rife. Indeed, bribes (Șpagăs) are a commonplace phenomenon. Infant mortality is very high compared to in other European countries, while disease prevention is low. You will particularly find issues with hospitals outside of the major cities.
Romanian public maternity wards have been accused of having a high degree of ‘obstetric violence’ – this refers to the use of procedures that are not always medically necessary, such as C-sections and episiotomies. Patients also complain about verbal and emotional abuse. 86% of women interviewed by medical organisation MediHelp said that they would prefer to give birth abroad.
There has been an exodus of medical personnel, who mainly head for employment elsewhere in the EU, where they are offered better facilities and higher pay.
There are also significant disparities between the care received by those on high incomes compared to those on lower incomes. The EEA reports that life expectancy at birth in Romania is five years below the EU average. Maternal and infant mortality rates are among the highest in the EU, and mortality rates are more concentrated in low-income rural areas.
The high mortality rate is a result of diabetes, cardiovascular diseases, and cancer. However, the country also has the highest incidence of preventable infectious diseases, such as Tuberculosis (TB) and Multi Drug Resistant Tuberculosis (MDR-TB), in the EU. As well as this, the Hepatitis B incidence is twice the EU average.
In 2014, the government introduced the Romanian ‘Public Health Initiatives’, with an €8 million investment from Norway. The programme aims to:
- Increase immunisation and screening
- Eradicate Tuberculosis
- Address HIV/AIDS and Hepatitis B and C among injecting drug-users
- Counter the increase of non-communicable diseases (NCDs) relating to lifestyle
If you do choose care in the public sector, national health insurance covers the following:
- Emergency medical and surgical services
- Prevention services (including consultations and disease risk assessments)
- Medical services for acute conditions or flare-ups of chronic illnesses
- Medical services for chronic illnesses, including active monitoring for chronic illnesses with a major impact on illnesses with a high cardiovascular risk, type two diabetes, bronchial asthma, chronic obstructive pulmonary disease, and chronic kidney disease
- Specialist paraclinical medical services for outpatients
- Day and continuous (24 hour +) hospitalisation services (you should receive full reimbursement for hospitalisation if it is an emergency or a referral)
- In-home medical care
- Medicines, with or without a personal contribution for outpatient treatment
- Medical devices
Medication should be refunded from the CNAS (from around 50% to the full cost). Pharmacies are found throughout Romania, but if you need a particular medication, check with your doctor to see whether it is prescription only.
Despite attempts by the government to improve the provision of public healthcare, most expats prefer to avoid the difficulties presented by the state sector. They instead choose to enrol in private healthcare.
Private healthcare in Romania
It is worth noting, however, that private hospitals have also come under fire. This has been for their focus on cheap services that are nevertheless charged at a premium for private patients. They are seen primarily as money-making enterprises. The Mayor of Bucharest, Gabriele Firea, has said that they demand a lot of money for treatments but cannot necessarily carry through with them in complex medical cases. Patients end up being sent to state hospitals.
However, despite some poor outcomes, the private sector in the country is generally of a much higher standard than its public equivalent, in terms of medical care, equipment and infrastructure. Also, corruption is banned in private hospitals. Although you may still encounter it, it is not as institutionalised as it is in the public sector.
You will find most private provision in urban areas, such as Bucharest. The private sector is growing, however, with Poland and Romania being seen as attractive opportunities for private medical investors. For instance, Medicover is developing its Bucharest network, by providing recent services, such as:
- Ergospirometry at its Plevnei clinic
- Colorectal cancer screening through colonoscopy
- Laparoscopic surgery of colorectal cancer
- Molecular biology tests
The organisation is also implementing a new strategic direction at its maternity unit in Bucharest, with a focus on promoting natural birth. Private provider Ares is also expanding into the Romanian market.
Transplants are a growing market sector. There is one lung transplant centre in the country, two kidney centres, a liver clinic, and an advanced research and development centre in experimental medicine. Most medical tourists visit the country for dental treatment, however. An extraction costs around US$12, and implants cost up to about US$2K. A specialist consultation costs in the region of $50. Costs in Romania are among the lowest in Europe. Prices are highest in the capital, Bucharest, but are likely to be lower in Cluj, Brasov and Timisoara.
Most patients visit from Germany and the UK. For more information, you can contact the Romanian Medical Tourism Association.
Check with your chosen clinic that they accept your health insurance, and ask your insurer whether you need pre-approval. Check, too, to see what form of payment your chosen clinic would prefer. Some may offer a reduction for cash payments. You can also pay out of pocket – healthcare costs in the private sector are cheap compared to in other EU countries. However, bear in mind that costs can add up.
If you are an expat in Romania and suffer from a chronic illness, your treatment options and healthcare expenses will depend on your level of health insurance. You will be able to sign up for the national system, as long as you are paying contributions into it. These will be deducted from your salary if you are working in the country.
However, authorities, such as the World Health Organisation (WHO) and the European Health Consumer Index, consider the public healthcare system in Romania to be one of the weakest in Europe. It faces significant challenges, and we advise that you do not rely on it if you suffer from a chronic illness.
Most expats opt for private health insurance to cover any chronic conditions.
How does the Romanian healthcare system work?
Once you are resident, and as long as you are paying contributions into the system, you will be entitled to state health insurance under the national health insurance house (NHIS), known as Casa Naţională de Asigurări de Sănătate (CNAS). You may also be entitled to free healthcare if you are a widow or a war veteran, or if you are disabled and on a low income.
Your employer will register you with the NHIS once you have been given your tax ID number. However, you should check that your deductions are actually being made, as expats have reported difficulties in this regard.
The Romanian healthcare system and chronic illnesses
The WHO estimates that non-communicable diseases (NCDs) account for 92% of all deaths in Romania. Cardiovascular diseases are the most common, followed by cancer, respiratory diseases and diabetes.
According to the European Commission report on the state of health in Romania, the country had the highest death rate from preventable and treatable causes in the EU up to 2019. Romania has among the lowest life expectancy in the EU, although it has risen by four years since 2000. It is estimated that around half of all deaths in the country can be attributed to behavioural risk factors. Obesity rates are increasing, but tobacco use – a contributory factor to a number of NCDs – is on the decline.
Mortality rates from preventable and treatable causes are among the highest in the EU. Health authorities suggest that improved public health and prevention policies, increasing the role for primary care and improved access to services, could see a reduction in premature mortality.
Health spending in Romania is currently the lowest in the EU, on a per capita basis and as a proportion of the country’s GDP (5% in Romania, compared with 9.8 % in the EU). Publicly financed health spending (79.5 %) is commensurate with the EU average at 79.3 %. There is a low rate of out-of-pocket payments, but informal payments, i.e. bribes, are common.
The national healthcare scheme does cover chronic illnesses to some degree. If you are registered and choose to access this scheme, you will find that it covers the following:
- Medical services for acute conditions or flare-ups of chronic illnesses
- Medical services for chronic illnesses, including active monitoring for chronic illnesses with a major impact on illnesses with a high cardiovascular risk, type two diabetes, bronchial asthma, chronic obstructive pulmonary disease and chronic kidney disease
There are chronic illness advocacy groups at work in Romania, such as COPAC (the coalition of organisations of patients with chronic diseases in Romania) in Bucharest. Their role is to represent the patients’ perspective in dialogues with national decision-making and legislative authorities at a national and local level.
They aim to work towards improving access to information for patients with chronic diseases, and monitoring the implementation and performance of national programmes.
The country has a National Diabetes Programme. Anyone who has diabetes, regardless of age, is eligible for free insulin and medication. Children up to 18 years old can receive 100 test strips per month. Once you are 18, if you are on insulin treatment, regardless of the type of diabetes, you will receive 100 test strips every three months. If you need more, you will need to pay (it costs approximately €15 for 50 strips). Insulin pumps are covered by the programme, but there is usually a waiting time, and most people do not use them. However, if you do get one, all materials (including infusion set and syringes) will be free.
Applying for disability/sickness benefits
Romanian employees are entitled to pay for up to five days of sick leave with a compensation of 75% of salary. Benefit for incapacity to work (concediu medical şi indemnizaţie pentru incapacitate temporară de muncă) is paid to employees who are legally resident in Romania if they suffer from ordinary illnesses or have accidents outside working hours. The benefit is paid to replace an income that you can no longer receive due to illness.
The maximum duration of sick leave is 183 days or up to 18 months for serious illnesses. Compensation is provided by the state for sick leave exceeding five days.
You will need to have contributed to the social health insurance system for at least six months over the last 12 calendar months.
You can also claim benefits if you have to stop working to care for your child (concediu medical şi indemnizaţie pentru îngrijirea copilului bolnav).
Private cover for chronic illnesses
If you have private health insurance, check with your provider to see whether you are covered for treatment for your chronic illness within the private sector. Some policies do not cover pre-existing conditions.
The private healthcare sector in Romania is substantially better than the public scheme, with more modern facilities and no shortage of personnel.
Arad has a breathing method practice, which uses the Buteyko method for treating asthma and other respiratory illnesses, and there are others in Bucharest.
You will also find private provision for treating diabetes, although specialists tend to be confined to the larger cities. Similarly, you will find specialists in arthritis, but again, these will mainly work in the more urban areas.
Romania has a relatively large number of pharmacies, but expats have reported some difficulties in accessing their medication. Some say that pharmacies do not stock their brand medicine, meaning that they must purchase generic medication instead. Romania’s healthcare system is under considerable strain, and, as a result, you may experience problems.
What is available?
We advise that you take your medication into the country in its original packaging. Ensure that you take a sufficient quantity to last for the length of your trip, if necessary – usually you can obtain up to a three-month supply. Health commentators suggest that you may not be able to obtain prescription or over-the-counter drugs in stores or pharmacies in Romania, as the equivalent drugs may not be available and can be of dubious quality.
There are some pharmacy chains across the country, including Catena, owned by Anca Vlad, which has over 500 outlets. Sensiblu (A&D Pharma group) has more than 400 outlets; Dona (owned by Eugen Banciu) has 275 outlets; Help Net (part of Farmexim) has 175 stores; and Ropharma has 125.
Around 17% of drug stores in Romania belong to five of the largest pharmacy chains, and there are also smaller networks, such as Ecofarmacia in Transylvania and Vlad Pharmacy in Timisoara. Romanian pharmacy chain Belladonna recently sold approximately 50 of its pharmacies to the Slovak-Czech investment group Penta Investments. The Hungarian Richter Group owns other outlets.
In 2015, the Generic Drug Manufacturers Association in Romania (APMGR) warned that over 1,300 accessibly-priced generics had disappeared from the local market between 2012 and 2015. This was due to a clawback tax and a mandatory reduction in prices. They say that availability and access to medicines has been lost, as either these are withdrawn from the market or tenders are not performed in a sufficiently timely manner to ensure budget optimisation.
How much do prescriptions cost?
Medication is cheaper in Romania than in many other European nations. There is a reliance on generics, but, as mentioned above, these may be of a doubtful quality, and many may be unavailable.
How to get the care you need
Although there are various pharmacies and dispensing pharmacies attached to hospitals in the country, provision of medication is unreliable. You may be able to find medication online, but this usually depends on the nature of the medication concerned. You may also find that some drugs are unavailable via this route (such as opioids).
If you are intending to give birth in Romania, you will need to make a decision early on regarding whether you would like to use the public or the private sector. It should be noted that the public healthcare system is well below the standard of those in neighbouring European nations, and many expats opt for private cover. Most expats recommend that the public health system should be avoided if at all possible.
How to decide on a birth plan
A birth plan is a list of what you would like to have happen during labour and afterwards. It is written so that your doctor knows what your wishes and expectations are.
- Where do you want to give birth?
- Who do you want to have with you (e.g. your partner)?
- What kind of birth do you want (e.g. vaginal birth or a Caesarian)?
- Do you need any birthing aids?
- Do you want pain relief, and if so, what kind?
- What kind of birthing environment would you prefer?
You can find a downloadable birth plan in Romanian here. You will obviously need to get this translated if you are not bilingual.
Home births are not common in Romania and account for a very small number of births. It is illegal for doctors to attend home births, and they are usually attended by a doula or an independent midwife.
C-section deliveries, episiotomies, and maternal mortality rates are very high. The number of C-sections is increasing; they are performed on nearly half of all births and not always for sound medical reasons. If you do not want a Caesarean, ensure that you make your wishes very clear; likewise with induced births.
Romanian public maternity wards are known for having a high degree of ‘obstetric violence’ – the use of procedures that are not always medically necessary, such as C-sections and episiotomies. Patients have also complained about verbal abuse.
Care in the private sector is substantially better, with state of the art equipment, a ban on corruption, and attention paid to birthing plans. There is also the option for alternative birthing methods, such as water and Lamaze birth.
Maternity care in Romania
In 2016, medical organisation MediHelp conducted a survey of mothers, in order to assess care in the public healthcare system. 35% said they would choose a public hospital for financial reasons, if they did not have health insurance. 65% of respondents said that they either intended to, or would be more comfortable to, give birth within a private hospital. Meanwhile, only 36% of the women who had already had a baby in the public sector reported that they were satisfied with their care, in comparison with 91% of women who had given birth in private hospitals. 86% of the women said they felt at risk of developing viral and bacterial infections in Romanian hospitals and would prefer to give birth overseas.
There is a shortage of paediatrics, practitioners, and midwives in the public maternity sector. Conditions such as child anaemia and neonatal deaths are higher in Romania than in the rest of the EU. Corruption is rife throughout the country’s public health sector. Although giving birth in the public sector is supposed to be free, patients usually find that they end up handing over bribes (Șpagăs) to the medical staff. For all of these reasons, most expats choose to take out private healthcare. However, it should be noted that, ironically, the reputation of medical personnel in the public sector is better than that of those in private clinics and hospitals, in terms of actual medical skill.
Once you have registered your pregnancy with your GP, you will be given a referral to visit an obstetrician-gynaecologist. You should be set up with a sequence of tests, for instance blood tests and ultrasounds, on a regular basis. You can choose your OB/GYN, as long as they work with the hospital that you intend to have your baby in.
Some hospitals may be certified under the international Baby Friendly Hospital Initiative (BFHI), supported by UNICEF.
Mothers stay for, on average, four days in hospital after giving birth, depending on their circumstances.
Average costs range from €3K to €6K, although you will find that a C-section is more expensive.
Maternity leave and allowance (concediu medical şi indemnizaţie pentru maternitate) are granted to pregnant women, or women who have given birth during the last six to eight weeks (postpartum women), for a total of 126 calendar days.
Maternal risk leave (concediu medical şi indemnizaţie de risc maternal) is granted to pregnant or postpartum women who are not on maternity leave and whose employers cannot guarantee working conditions that are free of risks to their health or that of their child. Maternal risk allowance may be granted for up to 120 days before and after maternity leave, but you will need a doctor’s note.
You will also need to have contributed for at least six months of the last 12 months, prior to your maternity leave, to the social insurance system.
Maternity allowance is paid for 126 calendar days while you are on leave. This period is made up of 63 days of leave before the birth (antenatal leave) and 63 days after the child is born (postnatal leave). The first 42 days of leave after the child is born are compulsory. The remaining 84 days need not be taken if you do not need them, or they can be taken earlier, before the birth, or later, after the birth.
Maternity allowance is equal to 85% of your average monthly income during the last six months prior to maternity leave. The allowance is not subject to income tax, but you will need to pay a contribution of 10% of it to the health insurance system.
Any child that is born inside the country must be officially registered.
After the birth, you will be issued with a “live birth” certificate (certificatul constatator al nasterii) by the hospital. You then have 15 days to visit the city hall (Primăria) of the county in which your child was born to register the birth.
Will my baby be a Romanian citizen?
Your child will only be a Romanian citizen if one of their parents is Romanian.
Romania has a universal healthcare system, which operates on a two-tier model, with both public medical insurance and optional private healthcare. Everyone who makes contributions into the social security system, including expats, are eligible for state care. You must be registered with a doctor in order to qualify.However, the Romanian public health system is experiencing a number of challenges and is ranked as the weakest in Europe, according to the European Health Consumer Index. Thus, most expats who are resident in the country opt for private cover.
How does the Romanian state health insurance system work?
If you are planning to move to Romania, you will need proof of cover before you are granted residency, so you will need to take out some form of private health insurance before you arrive in the country.
Once you are resident, if you are paying contributions into the system (which will be deducted from your salary), you will be entitled to state health insurance under the national health – Casa Naţională de Asigurări de Sănătate (CNAS) or National Health Insurance House (NHIS). You may also be entitled to free healthcare if you are a widow or a war veteran, or if you are disabled and on a low income.
Your employer will register you with the NHIS once you have been given your tax ID number, but double check to make sure that your deductions are actually being made – some expats have reported difficulties in this regard. Your workplace may also have a contract with a local health clinic. Contact the NHIS if you are self-employed, as it may be possible for you to make voluntary contributions.
The following contributions will be taken out of your salary: 5.2% by the employer and 5.5% by you. The overall social security rate is likely to be higher.
Otherwise, you will need to register with your local GP. To find one, you can search online, look in the phone book, or seek word of mouth recommendations from the local expat community. Note that the number of English-speaking medical personnel may be limited, particularly in the public sector.
Similarly, you will need to find a dentist – basic dental services are covered by the NHIS, but more sophisticated dental treatment generally is not covered, so for this you will need to register with a private dental practice.
You should also be able to use your European health insurance card (EHIC) in Romania, if you are a member of an EU state. However, this is for emergency care only and should not be used as a replacement for comprehensive health insurance.
How much does private health insurance in Romania cost?
The cost of your actual policy will depend on your own state of health and your insurance provider.
Medical treatment in the private sector is relatively cheap. It may cost you as little as 50 RON (about €10) for a consultation with a specialist, but it is usually more expensive. A private health plan will usually cover your expenses, plus visits to your GP and hospital treatment, but check what your insurance actually covers – you may still find that you have to pay.
Private hospitals have come under fire in Romania for focusing on cheap services that are charged at a premium for private patients, and they are seen primarily as money-making enterprises. Despite this, the country has a growing medical tourism industry.
Everyone who makes contributions into the Romanian social security system, including expats, are eligible for state health insurance and can access the public healthcare system. However, the Romanian public health system is experiencing a number of serious challenges and has been ranked as the weakest in Europe, according to the European Health Consumer Index.As a result, most expats who are resident in Romania choose to take out private cover. In fact, you will need to show proof of private cover before you can apply for residency.
Personalising your health insurance cover
Your employer will be able to register you with the national insurance system, but most expats prefer to avoid the difficulties presented by the state sector. They therefore tend to enrol in private healthcare. It is advisable to take out medical evacuation insurance as part of your policy.
Your other option is to pay out-of-pocket expenses in the private sector. Remember, however, that costs can escalate rapidly if you have a chronic condition or need to see a specialist.
Check the small print of any private health insurance policy to see whether it covers treatments that you may want to access, such as specialist surgical treatment or more advanced dental care, like crowns or dental implants.
Remember to check whether your potential policy covers pre-existing conditions; the definition of a pre-existing condition will vary between insurers. Usually, the term applies to any conditions that present symptoms or for which you’ve been treated in the last five years. This normally includes any conditions you were diagnosed with over five years ago, but some insurers have different time limits on when the diagnosis must have been given.
You may also want to check whether your policy has a ‘hospitalisation’ clause covering you for occasional hospital visits. You may need to discuss this directly with your insurer. You may also wish to check whether there is a medical evacuation clause.
Take a good look at your potential policy for any cover relating to healthcare that does not apply to you. Some policies have provision for maternity care, for instance, and if you are not intending to become pregnant (or would prefer to rely on the cover provided by the Romanian maternity system), then you may wish to reduce your policy costs by having such options removed.
You may also be able to reduce the cost of your premium through cost sharing. This is where you and your insurer share the costs of any treatment. You will pay up to an agreed limit, and your provider will cover the rest. Different insurers will have different ways of arranging cost sharing.
Co-pay: where you pay a fixed sum for your treatment and your insurer covers the rest. For instance, if the total cost of your treatment is €85, and your co-pay amount is set at €40, then you will pay €40 and your insurer will pay €45.
Co-insurance: where you pay a fixed percentage of the total cost and your insurer covers the rest. For instance, if your co-insurance is set at 20%, you will pay 20% of €85 and your insurer will cover the remaining 80%.
Deductibles: where you pay the entire amount allowed for all services provided until the deductible is met. For instance, if your policy has a €1,000 annual deductible, you would pay €85 for each visit to your GP for 11 visits (€1000/€85 = 11.8), after which your insurance would pay out to the doctor directly.
You may also need to take a look at whether there is an out-of-pocket maximum that you would be expected to pay after your deductible has been met.
Let’s say that your plan above, with a €1000 deductible, also has a co-insurance option of 20% and an out-of-pocket maximum of €1500. You will thus pay €85 for 11 visits to the doctor under your deductible until it is met. You will then pay €17 for each visit as your 20% coinsurance, until you reach the co-insurance ceiling of €500 (€1,500 minus the deductible of €1,000), or about 29 more visits (€500/€17 = 29.4). At that point (40 total visits in a year), you would pay nothing more for the remainder of the plan year.
It’s worth doing the maths, especially if you don’t think that you’ll need to make more than a couple of visits to your GP in any one policy period. For example, if you just want dental check-ups with an occasional filling, it might be worth working out whether one or two out-of-pocket costs might be cheaper than full dental cover.
As so many variables have an effect on the cost of international private medical insurance 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.
Romania is a beautiful country, and you will find a number of opportunities to maintain your fitness and health there.Romanians are interested in sports. Association football is the most popular sport, and Steaua Bucharest were the first Eastern European side to win both the European Cup and the European Supercup in 1986. The sport has long roots in the country; Romania is one of only four national teams from Europe to have taken part in the first World Cup in 1930.
Other popular sports include handball, volleyball, basketball, rugby union, tennis, and gymnastics. Romania has had success with both the men’s and the women’s national volleyball teams in international volleyball competitions. If you are based in Romania and are interested in any of these sports, then it is worth looking around for a local team to join.
If hiking is your thing, then you will find over 400 parks and trails in Romania. The wooded Carpathian slopes are a popular destination, as the mountains cover more than 30% of the country. You can sign up for hiking tours, either short ones or ones of a longer duration, and there is provision for all levels of fitness and experience. Make sure, if you’re heading up into the mountains, that you take plenty of water with you, plus sunscreen, a hat, and some light rain gear – mountain weather can change very quickly. Make sure that you let someone know where you are going, too.
You will also find 211 kilometres of slopes, which is great if you’re into skiing. Romania’s ski resorts are served by 150 ski lifts. Sinaia and Straja are two of the top resorts, along with Poiana Brasov. The country has low prices, compared to more famous European destinations, and there are a number of ski schools, including R&J Scoala Ski Polana Brasov and Valtour Ski School. The season in Romania generally runs between November and March.
If you want to get out and about on the water, you will find plenty of opportunities to do so. You can take part in a wide range of activities, from wild water and river rafting in the Carpathians to swimming and surfing along the Black Sea coast. You can even go kitesurfing on Kazeboo beach, or you could try jet skiing.
Cycling is possible for all levels of fitness and experience. You could go for a gentle bike ride through the country’s vineyards, or you could attempt the Transalpina, which is the highest altitude road in the country. You can arrange customised or self-guided tours, whether you are interested in mountain biking or more gentle routes.
Bucureşti Rugby represents Romania in the European Challenge Cup. Cricket was played in the country in the late 19th and early 20th centuries, but levels of participation then declined; the sport has recently been revived. The Transylvania Cricket Club (TCC) was formed in Bucharest in 2006.
Going to the gym is a common pastime in Romania, and subscriptions to sports clubs and fitness centres have been increasing in recent years. Membership is likely to cost around €40 per month, but you can check with your employer to see whether a gym membership is included in your employment package. Some companies have 7card affiliation, which offers access to any of the associated gyms across Bucharest. You will find a wide range on offer, depending on which gym/fitness centre you choose:
• Tae Bo
• Martial arts
• Multifunctional training
You will find that some gyms have pools and possibly even wet areas (e.g. steam rooms, jacuzzis, saunas) attached.
Wellness centres and spas have become popular across Romania, and you will find a wide range of choice in this sector, including a variety of treatments. The country has over a third of Europe’s natural thermal springs and mineral spas, and it has been a spa centre since Roman times. Some centres also offer alternative therapies, such as acupuncture and Reiki.
Some spa facilities are attached to hotels, such as the Epoque hotel in Bucharest, with an indoor heated swimming pool with hydromassage and water jets and both a dry and wet sauna. You will also find Therme, described as ‘a theme park of spas,’ the biggest wellness, relaxation and entertainment centre in Europe. This is 10 minutes away from Bucharest, and a whole spa day costs less than €100. It has numerous pools and different mineral and sauna treatments.
The Premier Palace Spa Hotel Bucharest is a five star medical spa hotel in the middle of Bucharest, spread over three floors, with 20 separate treatment rooms, plus amenities, such as a Finnish sauna, a bio-sauna, a steam bath, Thalasso, showers with visual and sound effects, a swimming pool, a hydro-jet pool, and a bar.
The spa offers numerous treatments and therapies, including treatments for osteoarticular, vascular, peripheral nervous system, and respiratory diseases, as well as detox programmes, stress management, and anti-aging programmes with Gerovital H3.
The Orhieeda Spa offers a hammam experience, in addition to a Finnish sauna.
Yoga is popular in Romania, and you can visit a number of yoga retreat centres across the country. For example, the Akasha Wellness Retreat in Transylvania (not far from Dracula’s castle!) offers a range of yoga classes. It also serves gluten- and sugar-free vegan meals, made mostly of organic, seasonal local produce.
It is possible to find vegan meals in Romania. A large percentage of Romanian Christian Orthodox devotees fast for some of each year, abstaining from meat and other animal products. You might be met with a blank stare if you mention the word ‘vegan’ in a restaurant, but you will have more success if you ask for ‘fasting’ foods.
You will find ciorba (sour vegetable soup), mamaliga (polenta), vegetable stews, eggplant salad, iahnie de post (baked beans), zacusca (a vegetable spread), and mushroom stews. The country has a long tradition of herbalism, and you will find a number of home remedies across Romania, too, from the use of garlic for ear infections to placing flour on cuts to staunch them.
Overall, you will find many opportunities to keep fit and well during your time in Romania, with provision for exercise, relaxation, and diet.
If you are registered with the national health insurance system in Romania, then your treatment will theoretically be free or low cost. We say ‘theoretically’, because, unfortunately, corruption remains rife in Romanian public healthcare, with many people offering bribes. This is also not unknown in the private sector, although it is less common.Given that the standards of the public system fall well below those of Romania’s EU neighbours, most expats opt to use the private healthcare system. With more modern, up-to-date clinics and no shortage of medical personnel in the private sector, the country has a growing market share in medical tourism, primarily for dental treatment, but also for other procedures.
Statistics suggest that around 100,000 foreign patients travel to the country every year to receive medical treatment. They travel mainly from European nations, such as Germany, Italy, France and the UK, but there are also some from Israel. There are even Romanian expats, who travel back home for low cost private care.
If you are an EU citizen and have an EHIC card, you will be able to use this in Romania under certain circumstances, but note that the EHIC is really only intended for emergency treatment.
Costs for medical procedures are amongst the lowest in Europe, but be very careful that you do not base your choice purely on cost, as quality may suffer as a result. The private sector is usually good, but choose your clinic with care. Prices are highest in the capital, Bucharest, and are likely to be lower in Cluj, Brasov and Timisoara.
For more information, you can contact the Romanian Medical Tourism Association.
It is estimated that around 70% of the medical tourists visit Romania for spa tourism, while the remainder visit for dental treatments, anti-ageing treatments and aesthetic surgeries. Transplants are a growing market sector. There is one lung transplant centre in the country, two kidney centres, a liver clinic, and an advanced research and development centre in experimental medicine. However, one of the country’s best-known transplant surgeons was placed under supervision in 2017, after being accused of embezzling public funds for 17 years.
Romania has been known for its thermal springs since Roman times, and the spa industry in the country is well established.
Procedures in the private sector include:
• Hernia surgery
• Gallbladder surgery
• General surgery
• Thoracic surgery
• Reconstructive surgery
• In-patient and out-patient care
• Full health check ups
• Surgical unit
• Medical laboratory
• MRI, CT, full diagnostic and radiology department
• Complete physiotherapy and rehabilitation services
A hip replacement costs in the region of €2K to €6K. Knee replacements also cost from €2K. Breast implants cost from around €3K, and breast reductions cost a similar amount. Facelifts cost from around €4K. Liposuction costs from around €1400.
For optical corrective surgery, some quoted costs for LASIK are around €2K to €6K. Cataract surgery costs from around €280 to €500. Consultations cost up to €25. A vitrectomy (the removal of floaters in the eye) costs between €100 and €150.
You will need to contact clinics directly to get more specific quotes. Do not be afraid to shop around, and note that the cheapest option is not necessarily the best one.
Here are some sample quotes for dental treatments:
• Scaling: €30
• Filling: €30
• Extraction: €35
• Wisdom tooth extraction: €110
• Implant: €450 to €750
• Crown: €190 to €320
• Veneers: €350
• Whitening: €230
Some medical tourist operators offer hotel packages, and some may also be able to offer advice on flights.
Check for references, qualifications and testimonials. If your private policy covers dental or elective cosmetic treatment, check with your provider to see exactly what they will cover. Also, check with the clinic to make sure that they will accept your insurance. Make sure that you are aware of any hidden costs and that you discuss the details of your treatment with your chosen clinic. If you are visiting the country specifically for treatment, ask how long will you need accommodation for, in the event of follow-up appointments etc.