How To Keep Your Health Insurance Costs Low in Slovenia
The Republic of Slovenia’s healthcare system ranked 21st in 2018’s European Health Consumer Index (EHCI), behind Switzerland, France and the UK, but ahead of the Republic of Ireland, Greece and Croatia. Although its position has slipped in recent years (in 2015, the country placed 15th), life expectancy has risen to higher than the EU average.
Health insurance in Slovenia
Slovenia operates a compulsory national health insurance scheme, called the Zavod za zdravstveno zavarovanje Slovenije (ZZZS) or Health Insurance Institute of Slovenia (HIIS). Employees contribute 6.36% of their wages, and employers contribute 7.09%, into this scheme. Retired Slovenians contribute 5.96% of their pensions, and self-employed residents should register to make contributions. Children, students, pregnant women, people who are unemployed and those who receive benefits are automatically covered.
If you are relocating to Slovenia when retired or self-employed, you will need to complete an S1 form to ensure health insurance coverage, as this will not be automatically taken care of by an employer.
The HIIS plan covers most standard healthcare needs, for instance GP visits, prescriptions, and state hospital visits, but you will need to pay between 5% and 90% of the fee as a co-payment if you only have a HIIS plan. Emergency care is free for everyone in Slovenia, so you will not incur any co-payment fees in the event of an emergency. The table below summarises the co-payments required for different types of care, and full information can be found on the HIIS/ZZZS website.
|Medical services to which additional payments apply||Additional payments|
Transplantations of organs, most demanding surgical operations irrespective of the reason for them, intensive therapy, dialysis, and other most demanding therapeutic and rehabilitation services
Medical services in the field of specialist outpatient and inpatient activities; services in the field of health resort treatment as the continuation of hospital treatment, with the exception of injuries that were not caused at work; services in the field of dental and oral cavity treatment; orthopaedic, orthotic, hearing and other medical appliances
Specialist outpatient, inpatient and health resort services as continuation of hospital treatment, and the non-medical part of nursing in a hospital or health resort as continuation of hospital treatment, as well as orthopaedic, orthotic and other appliances related to the treatment of injuries that were not caused at work
Medical services of health resort treatment and non-medical nursing within health resort treatment (the hotel part of the hospitalisation) that is not a continuation of hospital treatment
Dental prosthetic treatment of adults, ophthalmic appliances for adults
Medical products from positive list
Medical products from interim list
Medical products from negative list
Ambulance transport that is not urgent
You must register as a resident once you have lived in Slovenia for three months, and once you are registered you are entitled to HIIS cover. If you choose to wait to register as a resident until then, you will need to make sure you have the right travel insurance in place. If you have a European Health Insurance Card (EHIC), you will automatically be covered. However, if you are from the UK and moving to Slovenia from 1 January 2021 onwards, bear in mind that your EHIC will not necessarily cover you post-Brexit. Therefore, you will need to make sure that you have the correct coverage in place before you move.
Private health insurance in Slovenia takes the form of voluntary/supplementary health insurance (VHI). Voluntary health insurance is designed to cover the co-payments necessary with HIIS. This is offered by three providers: Vzajemna, Triglav and Generali. Their websites are in Slovene, so make sure that you have assistance from someone who can speak the language if you wish to apply for coverage online. Although prices vary slightly between the three providers, monthly premiums are between €30 and €40. By law, they are the same for all policyholders. Students, children, unemployed people, people receiving benefits and pregnant women are automatically covered by VHI, in the same way as they are covered by HIIS.
Having HIIS and supplementary health insurance will ensure that you aren’t paying out of pocket for a wide range of healthcare. However, there may still be areas where you need more cover. For instance, you may require cover for dental procedures, extra maternity services, or pre-existing conditions. For these, you may opt to take out a private plan with an international provider, such as Cigna Global or BUPA.
As well as VHI, Vzajemna, Triglav and Generali offer dental, specialist and accident insurance policies and family plans. The main benefit of specialist insurance is to reduce waiting times, as the shortage of specialists in Slovenia can mean a long wait even after you have received your referral.
Dental and accident insurance policies may work out as the most cost-effective options for you, especially if there is a family plan that suits you and your dependants’ needs. If you are single and do not expect a lot of out-of-pocket healthcare expenses, you may not find even VHI necessary and could choose to keep your costs low by sticking with only HIIS. However, a VHI plan is strongly recommended.
The cost of prescriptions can easily add up, especially if you have several conditions and/or several dependants requiring medication. The HIIS categorises medications into positive, intermediate/interim and negative. For positive medications, co-payments are 0-30%. For intermediate, they are 75-90%, and for negative, the patient is liable for the full cost of the medication.
HIIS also sets the Highest Recognised Value (HRV) of each medication, and any cost over this must be covered by the patient or patient’s VHI. However, those with long-term conditions or chronic illnesses are eligible for free prescriptions, as are pregnant women, children, students and people who are unemployed or on a low income.
The Central Medicines Database contains information on all medications covered by HIIS, as well as what the co-payments/surcharges are for others. Groups of ‘mutually interchangeable’ drugs are defined by the Office of the Republic of Slovenia for Medical Products as: medicines containing the same active ingredients that can be interchanged to keep costs low. The groups include medication for diabetes, cardiovascular disease, skin diseases and allergies, and contraception.
Slovenia generally has a great level of healthcare coverage under the compulsory HIIS scheme, and it may be tempting not to get voluntary health insurance, in order to save money. However, when you consider that you could be liable for 90% of the fee of your treatment, it is strongly recommended that you invest in a VHI plan. It will help give you peace of mind.
What Quality Of Healthcare Can You Expect In Slovenia?
If you are living and working in Slovenia, then you may need to access healthcare services while you’re 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 Slovenian healthcare system below and consider some of your options.
Public healthcare in Slovenia
Slovenia has a compulsory national scheme of health insurance (Zavod za zdravstveno zavarovanje Slovenije/ZZZS), which is organised by the Health Insurance Institute of Slovenia (HIIS) and the Ministry of Health. It is paid for out of social security contributions and the state. This compulsory health insurance system is characterised by low public funding. A significant role is played by complementary health insurance.
The national health insurance system in Slovenia covers:
- GP visits
- Emergency and outpatient hospitalisation
- Prescription medication
- Childhood healthcare
- Prenatal and maternity care
- Specialist services
However, the state system does not fully cover all aspects of healthcare. For example, it will only contribute 70% to 80% of the following:
- The non-medical part of hospital treatment (bed and food)
- Fertility treatment and abortion
- Some surgeries (such as organ transplants)
The World Health Organisation (WHO) reports that Slovenia’s average life expectancy is above that of the EU. Life expectancy at birth was 80.9 years in 2015, almost five years longer than in 2000. However, the WHO says that these extra years of life are not always spent in good health, and healthy ‘life years’ are below the EU average.
The gains are primarily the result of a consistent reduction in premature deaths from cardiovascular diseases and cancer. However, these continue to be the leading causes of death. Over 3/4 of female deaths and 2/3 of male deaths can be attributed to either cardiovascular diseases or cancer. The mortality rates from both these diseases have fallen since 2000, but they remain above the EU average. They are among the worst in Europe for men.
Slovenian public healthcare is in need of reform. In 2016, the government adopted the National Health Plan 2016–25. They launched a number of initiatives, such as seeking to strengthen primary care and provide greater access to comprehensive and quality treatment. The WHO reports that it aims to do this via improved integration of care and a more adequate professional skill-mix across care levels. This is in part to allow the healthcare sector to respond to the changing needs of an increasingly ageing population.
Thus, Slovenian public healthcare has experienced reform proposals over the last decade, but these have often been subject to delay or outright failure.
Health financing is described by the WHO as a difficult policy area. It is hoped that the adoption of the new National Health Plan (NHP) 2016–25 will help to resolve these issues with healthcare reform.
In 2015, Slovenia had the second highest per capita health spending among the newer member states, at €2039 per head on healthcare, compared to the EU average of €2797. This equals 8.5% of GDP, which is also below the EU average of 9.9%. Nonetheless, despite this, the share of public expenditure on health (71.1%) was 7% below the EU average (78.7%) in 2015.
Public spending on health has steadily decreased due to the ongoing economic crisis. It has been affected by cost containment measures, such as salary freezes, the reduction of tariffs, and increased co-payment costs. The economic crisis highlighted issues with the fiscal sustainability of the health system. The WHO suggests improvement efficiency with regard to hospital care, provider payment, and procurement systems.
Access to health services is considered by health authorities to be good, with
few reports for unmet needs for medical care and very little variation between income groups (this is probably due to supplementary VHI insurance). However, waiting lists for specialised care remain a challenge.
This is partly because Slovenia has one of the lowest physician densities in the EU. A lack of primary care doctors leads to problems with access and over-referrals to specialists, thus placing additional stress on the system. Nurse density was slightly above the EU average in 2015. Part of the aim of the NHP is to improve workforce planning and to distribute health professionals more effectively.
Private healthcare in Slovenia
Although you cannot opt out of the health insurance scheme once you are registered with it, many expats choose to take out private health insurance in addition to their public healthcare cover. This helps them to avoid the problems outlined above, such as bottlenecks with specialist appointments.
The WHO reports that overall private spending as a share of total health spending increased from 26% in 2008 to 28% in 2015. It notes that the share of private expenditure is high compared to the EU average.
The quality of private clinics is generally regarded as good, and equipment can be state of the art. You are likely to find a higher percentage of English-speaking personnel in private sector clinics.
The Ministry is taking steps to address both the transparency and accountability of private provision. You may wish to contact the Slovenian Association of Medical Tourism in relation to private clinics. Many hospitals are accredited with international organisations, such as the Joint Commission International. Corrective eye surgery and dental treatment are popular reasons for foreign patients to visit the country.
Some medical centres are combined with spas and include various forms of treatment, from medical/surgical procedures to complementary therapies, including but not confined to:
- Vascular surgery
- Aesthetic plastic surgery
- Gynaecological procedures, such as diagnostic hysteroscopy, biopsy and histological examination
- Laryngology to correct problems with breathing and sleep
- Orthopaedic services
- Massage therapy
- Apitherapy (bee and honey related)
Some options are:
- Morela Okulisti Center for Eye Surgery
- Institute of Oncology Ljubljana
- Univerzitetni Klinicni Center Maribor
- General Hospital Celje
- Pediatric Kliniko V Ljubljana
- Bolnisnica Topolsica
- Psihiatricna Bolnisnica Ormoz
- Jz Psihiatricna Bolnisnica Vojnik
- University Clinic Golnik
Check with your chosen clinic to see whether they accept your health insurance, and check with your insurer to see whether you need pre-approval. Ask, too, what form of payment your chosen clinic would prefer. Some may give a reduction for cash payments. Do not be afraid to ask for testimonials and references, and contact the expat community for recommendations.
Dental And Ophthalmic Care In Slovenia: How To Find The Right Options For You
Healthcare in Slovenia is generally of a good standard, and dental and ophthalmic care are no exception to this rule. However, while you should not have problems accessing the care you need, you may encounter issues around what is covered by state healthcare and what needs to be covered by out-of-pocket payments.
Slovenian residents are automatically enrolled into the state Health Insurance Institute of Slovenia system (HIIS) – Zavod za zdravstveno zavarovanje Slovenije or ZZZS. It is funded by national contributions, through wages by the employer and employee, as a set amount based on income by self-employed people or deducted from retired residents’ pensions. Children, students, pregnant women, unemployed people and those receiving certain benefits are automatically covered by HIIS.
Which dental treatments are covered by state healthcare in Slovenia?
Some dental care is covered under HIIS, but as with all other non-emergency medical care, a co-payment is required. The co-payment amount ranges from 10% to 90% of the total cost of treatment. For instance, standard dental work requires a 20% co-payment, but only 10% of dental prosthetic treatment is paid by the state under HIIS.
Voluntary (also known as ‘supplementary’) health insurance (VHI) is available in Slovenia from three providers: Vzajemna, Triglav and Generali. As mandated by law, every policyholder pays the same monthly premiums, which vary slightly between the three providers, but which are between €30 and €40. VHI covers co-payments on all medical care under HIIS, so policyholders need only pay for medical treatment that falls outside of this HIIS umbrella.
Certain dental treatments, such as implants, cosmetic treatments, and porcelain crowns and bridges, are not covered at all under HIIS, so these must be paid for in full. However, Triglav and Vzajemna offer dental plans. Monthly premiums start at less than €6 and, depending on the plan, can include annual cleaning and check-ups, white fillings in the sides of the mouth (white fillings in the front teeth are covered by HIIS/VHI), oral cancer treatment, and prosthetics in the event of an accident.
Criticisms of Slovenian dental care
Dentists in Slovenia are required to be highly trained and must register with the Medical Chamber of Slovenia in order to practice in the territory. Dentists must also see a minimum number of patients and meet continuous professional development requirements to continue to practice each year. Dental care quality is therefore high, and Slovenia is becoming an increasingly popular destination for affordable dentistry, attracting patients from across Europe.
Dentistry is the only medical field in Slovenia where private practitioners make up more than 50% of those practicing, and around 15% do not take state or voluntary health insurance. The relative lack of public dentists means that waiting lists can be long for HIIS or VHI patients. Some Slovenians choose to go to Croatia for dental treatment, as they find that the innovation and knowledge can be better there and that the treatment is often more affordable.
What ophthalmic care is available in Slovenia and what is covered by state healthcare?
You should be able to find the ophthalmic care you need in Slovenia, but some services and treatments cost more than others. Clinics offer services, including prescription glasses and contact lenses, treatments for eye diseases, diagnostic exams, and exams required for driving licences. Elective treatment, such as laser eye surgery, is also available privately.
The HIIS insurance plan covers 10% of the cost of ophthalmic appliances for adults, which may include glasses, contact lenses and prosthetics. 90% is therefore payable as a co-payment if you do not have VHI or international health insurance.
All three VHI providers also offer specialist health insurance to cut waiting times, so depending on the situation, ophthalmological care may be covered under this type of plan, but ophthalmology appointments do not need a GP referral. The VHI websites are in Slovene, so if you are looking to have something specific covered by a plan, make sure that you have the help of someone who can translate for you, before you commit to anything online.
The state operates a vision screening system for children at several stages up to seven years old, to support early detection of vision problems and eye diseases. Children with visual impairments can attend Slovenia’s dedicated Centre IRIS (Centre for Education, Rehabilitation, Inclusion and Counselling for the Blind and Partially Sighted) in Ljubljana, which supports children from pre-school to the end of secondary education.
Criticisms of Slovenian ophthalmic care
Ophthalmologists can obtain certification in Slovenia, but this is on a voluntary basis. The Association of Ophthalmologists of Slovenia manages this as an independent body, as well as preserving the role of ophthalmologists and maintaining ethics in the profession. As certification is voluntary, make sure, where possible, that you choose a certified ophthalmologist, and research the specialist you are going to see to make sure you get the right care.
There are relatively few ophthalmologists in Slovenia, and therefore waiting times for routine appointments can be between three and six months. Ophthalmic care can also be quite expensive in Slovenia. In 2003, the territory introduced Diagnoses Related Groups (DRG), whereby acute care was prioritised and ophthalmology as a specialty was devalued. However, this also meant an increase in outpatient procedures, and cataract surgery has been particularly successful, with the highest percentage of outpatient cases in the EU, as reported by the World Health Organisation.
Getting the right dental and ophthalmic care in Slovenia may require a lot of research, and trial and error might be involved with private and state practitioners. You may find, depending on where you choose to live, that having care outside the territory is best. Wherever you go, make sure that you have the right insurance, so that you can avoid high co-payments and out-of-pocket expenses.
How Much Do Health Procedures Cost In Slovenia?
Slovenia has become an increasingly popular destination for medical tourism, due to the country’s national healthcare coverage and the relative affordability of certain types of care. However, waiting times can be long, and out-of-pocket payments can add up. It is therefore important to make sure that you have the right insurance in place for you and your family’s needs.
Compulsory health insurance in Slovenia
Health insurance is compulsory in Slovenia. The Zavod za zdravstveno zavarovanje Slovenije (ZZZS) or Health Insurance Institute of Slovenia (HIIS), Slovenia’s state healthcare system, is funded by income and pension contributions. Employees contribute 6.36% of their salary, which employers match and top up to 7.09%, to cover work-related medical concerns. Self-employed Slovenian residents register for HIIS and pay a rate based on their income, and 5.96% is deducted from pensions. You have to register as a Slovenian resident when you have lived in the country for three months, at which time you will be signed up for HIIS contributions and covered under the scheme.
Pregnant women, students, children, people receiving benefits, and unemployed people are automatically covered by HIIS, with no need for contributions. Emergency treatment is free for everyone in Slovenia, and a lot of basic non-emergency medical care is completely covered by HIIS. However, there are many categories of care that require a co-payment, as well as some that are not covered at all and must be undertaken privately.
Examples of care requiring no co-payment under HIIS include compulsory vaccinations, prevention, detection and treatment of HIV and other contagious diseases, treatment and rehabilitation of blindness and myopia, and treatment and rehabilitation of diseases and injuries at work.
Other treatments and procedures are free for certain qualifying groups, but they require a 10% to 90% co-payment for other patients. These are as follows:
- Transplantations of organs, most demanding surgical operations irrespective of the reason for them, intensive therapy, dialysis and other most demanding therapeutic and rehabilitation services – 10% additional payment
- Medical services in the field of specialist-outpatient and inpatient activities; services in the field of health resort treatment as the continuation of hospital treatment, with the exception of injuries that were not caused at work; services in the field of dental and oral cavity treatment; orthopaedic, orthotic, hearing and other medical appliances – 20% additional payment
- Specialist-outpatient, inpatient and health resort services as continuation of hospital treatment, and the non-medical part of nursing in a hospital or health resort as continuation of hospital treatment, as well as orthopaedic, orthotic and other appliances related to the treatment of injuries that were not caused at work – 30% additional payment
- Medical services of health resort treatment and non-medical nursing within health resort treatment (the hotel part of the hospitalisation) which is not a continuation of hospital treatment – 90% additional payment
- Dental prosthetic treatment of adults, ophthalmic appliances for adults – 90% additional payment
- Medical products from positive list – 0% to 30% additional payment
- Medical products from interim list – 90% additional payment
- Medical products from negative list – 100% additional payment
- Ambulance transport which is not urgent – 90% additional payment
A full list of what is covered can be found on the HIIS/ZZZS website.
Voluntary/supplementary health insurance
There are three Slovenian providers for voluntary or supplemental health insurance (VHI). Vzajemna, Triglav and Generali offer plans that cover the co-payments required by HIIS insurance. By law, policy premiums are the same for everyone. The monthly cost for VHI with Vzajemna is currently €35.67, with Triglav is €35.55, and with Generali is €34.50.
If you do not opt for VHI, the below details how much you can expect as a co-payment for different types of treatment (costs correct as of December 2019):
- Femoral fracture – € 1,768.62 co-payment required
- Appendix removal – € 854.83 co-payment required
- Hip replacement – € 1,630.63 co-payment required
- Cardiovascular ultrasound – € 11.37 co-payment required
- Two-week therapy at the spa – € 1,550.00 co-payment required
Each VHI supplier also offers additional health insurance packages, such as for specialist care, dentistry and accidents. The main benefit of specialist cover is to reduce waiting times, as these can be long under HIIS. A lot of dental care is not covered by HIIS or VHI, so you may want to consider getting dental insurance.
Medications for certain conditions in Slovenia are free, but otherwise the HIIS maintains positive, intermediate/interim and negative lists of medications. Positive medications are covered 70% to 100% by HIIS, intermediate ones are covered 10% to 25%, and negative medications are not covered at all. The remainder must be co-paid by the patient, if they do not have VHI, and the cost will depend on what the medication is and whether the doctor prescribes brand name or generic drugs.
Groups of ‘mutually interchangeable’ drugs are defined by the Office of the Republic of Slovenia for Medical Products. They are medicines containing the same active ingredients that can be interchanged to keep costs low. Included in the groups are medication for diabetes, cardiovascular disease, skin diseases and allergies, and contraception.
Under the Medicinal Products Act, there is a maximum allowed price (MAP) and agreed price for each medication, and the HIIS also sets the highest recognised value (HRV) for drugs covered by the HIIS plan. If a prescription exceeds the HRV, the difference is payable by the patient. You can search the Central Medicines Database to see which medications are covered by HIIS and what the co-payments/surcharges are for others.
Healthcare is generally of a high quality in Slovenia, and the HIIS scheme provides a good level of protection. However, if you are considering relocating to Slovenia, it is important to consider all your current and future needs. This way, you can make sure that you have the right coverage to avoid surprise out-of-pocket costs as much as possible.
Prescriptions In Slovenia: What Is Available And How To Ensure You Get The Right Level Of Care
There are a number of pharmacies throughout Slovenia, so you should easily be able to access your prescription medication. However, there are some restrictions on some drugs, as mentioned below.
What is available?
If you take medication into the country, make sure that you label it properly. Also, pack enough to last for the duration of your trip, if possible. You should not expect to obtain prescription or over-the-counter drugs in local stores or pharmacies. Equivalent drugs may not be available, or they could be of an unreliable quality. You may need to ask the Slovenian Embassy/Consulate in your country whether there are any restrictions on medicines, such as sleeping pills, medication for ADHD and strong painkillers.
You will only be able to obtain some medicines (such antibiotics and drugs to manage high blood pressure) if you have a prescription from your GP. However, you will be able to buy some basic medication over the counter.
If you need medication urgently, outside the working hours of your nearest pharmacy, you should visit your nearest emergency pharmacy – this may be in a neighbouring town. Local pharmacies often have rotas of emergency provision, as do local hospitals, so contact one of these if you need more information.
How much do prescriptions cost?
Slovenia has a compulsory national scheme of health insurance, called zavod za zdravstveno zavarovanje Slovenije (ZZZS). This will cover some of your prescription costs, as long as you are registered with it. Your employer should sign you up with the ZZZS.
You will usually need to pay either 30% or 90% of the full cost of your prescription, depending on the medication. The ZZZS also sets a maximum amount payable for each medicine. Your doctor will be able to tell you how much you will need to pay.
If you have a chronic illness or a long-term condition, you can get free prescriptions.
You may be able to buy generic medication that is an equivalent of your branded drugs. For more details, talk to the pharmacist or your doctor.
How to get the care you need
Make sure you register with a GP as soon as possible. If you are entitled to access public healthcare, register in order to receive a health card. Make sure, too, that you take your health card with you to all medical appointments, as well as to the pharmacy, as it can entitle you to discounts.
Pharmacy provision is widespread, with several hundred outlets across the country, and you can find your local pharmacy online or using the phone directory. Alternatively, you could simply seek signs with a green cross on a white background, the usual symbol of pharmacies in Europe.
Some pharmacies, such as Lekarna Ljubljana, have online provision as well. Only state pharmacies are allowed multiple branches. There is a 24-hour pharmacy adjacent to the University Medical Center in Ljubljana.
Maternity Care In Slovenia: What The Options Are And How To Decide On A Birth Plan
If you are intending to give birth in Slovenia, you will need to decide whether to use the public or the private sector. Note that most expats choose the private sector, even though pregnancy and birth in Slovenia are fully covered by compulsory state medical insurance. We will look at some of your options below.
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. Write one 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 Cesarean)?
- 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 will find 14 maternity hospitals in Slovenia, which offer different types of deliveries. Natural (vaginal) delivery is still the most prevalent in Slovenian hospitals.
Home births are increasingly popular in the country, however. Home births can be conducted by professional birth attendants (licensed midwives) or by birth assistants (doulas, etc).
Mothers’ rights group Mamazofa has drawn up a list of requirements, which they say need to be addressed in Slovenia. This list may give you an insight into some of the prevalent issues:
- Established birth practices have not been satisfactorily updated in line with the most recent scientific findings. Some frequently used practices are not of benefit during a low-risk labour and birth, and some even harm women and/or babies. There are also practices with scientifically proven benefits that have not become established in Slovenia.
- Women and their partners are not always properly informed about the advantages and disadvantages of individual interventions and/or treatments, care and procedures during pregnancy, labour, birth and the postpartum period, or about the possible choices and their advantages and disadvantages
- The attitude of medical experts towards a woman during pregnancy, childbirth and afterwards, as well as towards her child and family, does not always meet quality standards
- Many women and parents are not sufficiently informed about patient rights; the realisation of patient rights is not always ensured or consistent
Contact local groups if you are concerned about anything, such as potential language barriers, or if you feel you may need assistance or advocacy in making your wishes known.
However, the good news is that The European Perinatal Health Report for 2015 places Slovenia among the safest countries in the world in which to give birth. It has one of the lowest Cesarean section rates in Europe, although around 20% of all Slovenian births are done via this method.
Maternity care in Slovenia
Your first port of call, if you think you might be pregnant, will be your GP. S/he will arrange a schedule of necessary tests, such as ultrasounds, blood tests and other checks. Your GP is responsible for organising the birth. After preliminary diagnostics, a doctor will be assigned to you. A midwife will attend the delivery, or else the chief doctor and paediatrician will be present.
You will be allowed to have your partner, and perhaps other relatives, with you. You will also be entitled to three meals a day, a private bathroom, TV and internet in some private hospitals. It is advisable to visit the hospital beforehand to discuss services and your specific needs.
After the birth, your child will undergo tests for any genetic diseases and developmental irregularities. After your discharge, you will receive visits from a community nurse. Generally, they will contact you and set up a home visit. However, if you give birth outside the region of your permanent residence, you will need to contact the community nursing service yourself via your community healthcare centre.
Babies and preschool children can have a preventive examination with their selected paediatrician at the ages of one, three, six, nine, twelve and eighteen months, as well as at the ages of three and five years.
There are parents’ schools (Šola za starše) and courses for new mothers, which maternity hospitals organise.
Maternity leave (materinski dopust) lasts for 105 days. You will begin maternity leave 28 days before you give birth. During this period, you will receive a maternity allowance.
Paternity leave (očetovski dopust) lasts for 90 days. You should use the first 15 days by the time your child reaches the end of their sixth month. You can use the remainder, in the form of full leave, until the child reaches the age of three. The paternity allowance amount, within 15 days of the child’s birth, is 100% of the average salary of the father. The father does not receive benefits for the remaining 75 days, but his social security contributions, at the amount of the minimum wage, will be paid for the period of paternity leave.
One of the parents has the right to go on leave and take care of the child or to extend the pregnancy decree for 260 days immediately after the term expires. The amount of parental compensation will depend on your average salary over the previous 12 months. Your allowance cannot be higher than 2.5 times the average gross wage.
Child allowance for 360 days provides an additional benefit for the maintenance, upbringing and education of the child. The payment amount will depend on income. To receive benefits, you must submit an application to the local Social Welfare Office.
Will my baby be a Slovenian citizen?
Children born to foreign parents in Slovenia do not acquire Slovenian citizenship on the basis of their birthplace.
How to Look After Your Mental Health in Slovenia
Mental health problems are prevalent the world over and can pose a real challenge to individuals who suffer from them. For expats, these issues may feel compounded, due to immigrant-related socio-economic factors, such as difficulties in securing employment. Expats may also be more vulnerable to mental health problems, because of the emotional upheaval involved in leaving friends and family behind in their home countries.
Depression is one of the most common mental health concerns. According to the World Health Organisation (WHO), as many as 40 million people (or 4.3% of the population) are affected by this in Europe alone. In Slovenia, the figure for chronic depression, as of 2017, was one in every 11 individuals. Other prevalent conditions include anxiety disorders, drug and alcohol misuse, bipolar disorders, and schizophrenia.
If you are resident in Slovenia, or are looking to make the move, and you suffer from a new or existing mental health condition, then what level of care can you expect?
Mental health care in Slovenia
Slovenia has a well-funded healthcare system, with clean, modern facilities, highly trained staff, and well-equipped clinics. The healthcare system is funded by compulsory health insurance, which is contributed to by employers and employees, alongside the voluntary contributions required of most adults.
Usually, mental health conditions will be diagnosed and treated by a doctor. In the first instance, you should contact your local GP and describe your symptoms. You may be prescribed medication to help control your symptoms, or you may be referred for more specialist diagnostic care.
In saying this, you do not need a GP referral in order to access psychiatric care. In an emergency, you should dial 112 for an ambulance, or contact one of the following organisations:
- Emergency psychiatric clinic, Njegoševa 4, Ljubljana
- Walk-in psychiatric service, mental health centre, Grablovičeva 44b, Ljubljana
- Centre for clinical psychiatry, Studenec 48, Ljubljana
- Begunje Psychiatric Hospital, Begunje 55, Begunje na Gorenjskem
- Ormož Psychiatric Hospital, Ptujska cesta 33, Ormož
- Vojnik Psychiatric Hospital, Celjska cesta 37, Vojnik
- Idrija Psychiatric Hospital, Pot sv. Antona 49, Idrija
As well as the above major psychiatric hospitals, Slovenia has 15 certified health resorts that combine modern medical procedures with alternative therapies. These alternative practices often centre around the healing benefits of water and minerals, including seawater, peat and mud.
Compulsory health insurance
Compulsory health insurance is provided for all residents, including foreign nationals who are working in the country and paying taxes, by the Health Insurance Institute of Slovenia (Zavod Za Zdravstveno Zavarovanje Slovenije). Anyone working in Slovenia, including individuals who are self-employed or are retired and in receipt of a qualifying pension, are insured under this scheme.
Employee dependants are also insured, provided they are resident in Slovenia and under the age of 18.
Voluntary health insurance
While compulsory health insurance covers access to many key services, others are only available under voluntary health insurance (VHI), which must be paid for separately. To benefit from voluntary health insurance, you must apply via a Slovenian insurance company.
The vast majority of Slovenian residents have additional coverage to access services such as: private hospitals and health spas, some more complicated medical aids and diagnostic tests, high-standard dental care, and cosmetic surgery. Children are not required to have VHI, as they are covered under compulsory health insurance.
Visiting a doctor
In order to see a doctor in Slovenia, you must have a health insurance card. The Health Insurance Institute of Slovenia issues a card free of charge to all residents when they obtain compulsory health insurance for the first time. You will need to show your health insurance card at every appointment with a doctor or dentist, as well as every time you visit a pharmacy to collect prescription medications.
In order to help safeguard your mental health, you may want to consider some preventative measures that could help make your move to your new country easier. These could include:
- Learning the language – one huge factor for expats is the struggle to make new friends in a country where language is a barrier. To avoid this, you could enrol in language classes when you arrive.
- Consider counselling – moving to a new country is never easy, particularly if you have had to move for work and feel out of your depth. Speaking to a professional may help you order your thoughts and process your emotions.
- Keep in touch with loved ones back home – do not underestimate the power of feeling connected to those you love and miss in your home country. Make time for regular video calls to check in with each other, or keep the conversations going with texts and emails.
- Seek help – if you can feel yourself struggling, reach out to an expat support group.
How To Register With The Health System In Slovenia
Slovenia has a two-tier system of health insurance, based on both private and public cover. As an expat (depending on your circumstances), you should be able to take advantage of the national health insurance scheme, with which you must register if you are employed.
How does the Slovenian state health insurance system work?
State primary healthcare in Slovenia is provided by a combination of state and private providers. State providers include primary healthcare centres and health stations, which are institutions established and owned by local communities. In smaller communities, for example, healthcare service is organised into such stations, connected to the nearest community healthcare centre.
You can choose your own primary care provider. You will need to register with your local GP, who you can find online, via the phone book, or through word of mouth from the local expat community. You can select a doctor who practices medicine in various kinds of frameworks: community healthcare centres, healthcare stations, or a private physician with a concession. Appointments must be made in advance.
Similarly, you will need to find a dentist. Again, you can do this through online resources, your local community, or the phone book. State health insurance covers dental care for everyone up to the age of 19. Otherwise, the national scheme does not cover a wide range of dental care, and you will need to take out a private policy or pay out of pocket for any dental treatment you receive.
Make sure that any provider you choose is contracted to the Health Insurance Institute of Slovenia (HIIS), if you are paying national health contributions into the system and are therefore entitled to access it. You have the right to change providers after a year. You will be issued with a health insurance card and will need to take this to all of your appointments.
You will need a referral from your GP to proceed to specialist and hospital care. However, this is not required in the cases of chronic diseases or long-term treatment.
You will find a variety of provision, such as:
- Outpatient clinics for preschool and school children
- Gynaecologist outpatient clinics
- Emergency services
- Dental clinics
Community healthcare centres have community nursing services, which perform home visits when necessary. Some of them also include clinics for occupational and sports medicine, clinical laboratories, roentgen services, and some specialist clinics.
All adults aged 30+ who have compulsory health insurance are entitled to a preventive examination every five years, while patients with certain chronic diseases or increased risk of developing such diseases are entitled to examinations every year.
You will be able to access hospital treatment, but if you are not insured, you will need to pay out of pocket.
The country has a number of pharmacies, and you should not have too much difficulty in accessing your prescription medication or over-the-counter remedies.
You may be able to contact your country’s embassy for a list of English-speaking medical personnel. Many Slovenian medics do speak English, but it would be unwise to count on this.
If you are an EU citizen, you will be entitled to access public healthcare in Slovenia. If you receive a UK state retirement pension or long-term incapacity benefit, you may be entitled to Slovenian state-funded healthcare, paid for by the UK. You will need to apply for form S1 from the International Pension Centre. If you are living in Slovenia before the end of 2020, your rights to access healthcare in Slovenia will stay the same for the length of your legal residency, so you will continue to get state healthcare in Slovenia from 1 January 2021 on the same basis as a Slovenian resident.
Private health insurance in Slovenia
Although you cannot opt out of the health insurance scheme once you are registered with it, many expats choose to take out private health insurance in addition to their public healthcare cover.
Private providers in Slovenia are often healthcare professionals working individually or in group practices, who offer combinations of services and specialties. You can select a private physician of your choice, but you must cover all costs out-of-pocket or through your private cover.
Remember to check with your insurance provider whether you require any pre-approval for surgery or major treatments. Check with the clinic regarding outcomes, and do not be afraid to ask for testimonials and references.
How To Keep Fit And Healthy In Slovenia
If you love keeping fit in the great outdoors, the Republic of Slovenia is the perfect choice for your new home. Slovenia is a small but beautiful country, with Alpine mountains in the northwest, Mediterranean coastline in the southwest, and forest covering more than half of the territory. It therefore comes as no surprise that Slovenians love getting out and exploring. There is something for everyone, whatever your fitness level and preferred exercise style.
Slovenia is generally regarded as a healthy country, with one of the highest life expectancies in Europe. At 81.39 years in 2017, Slovenian life expectancy overtook the EU average of 80.9 years. As is common in many similar countries, the leading cause of mortality is heart disease. Rates of type two diabetes and obesity have increased nationally in recent years, and childhood obesity is a key problem. To combat this, the Slovenian government operates several healthy lifestyle initiatives.
In line with World Health Organisation (WHO) guidelines, the government recommends that adults aged 18 to 64 undertake at least 150 minutes’ moderate intensity or 75 minutes’ vigorous intensity aerobic exercise (or an appropriate combination of both) per week, with at least two sessions of muscle strengthening for the main muscle groups. In primary schools, 45-minute physical education (PE) lessons are mandatory two to three times a week, and the healthy lifestyle scheme provides five extra hours of after school exercise. In secondary schools, one to three 45-minute PE lessons are required weekly.
Under the Occupational Safety and Health Act (ZVZD-1), employers are required to plan and implement ‘workplace health promotion’ activities that should encourage improved physical and mental health.
Sports in Slovenia
Slovenia is a very sporty country, with a national team presence in many international tournaments, despite the country’s relative smallness. Slovenians’ favourite team sports are football, basketball, boxing, handball and ice hockey, with cycling, swimming, tennis, skiing, ski jumping and athletics popular individual pursuits. Football is by far the most popular sport, with 287 clubs, 1,400 coaches and 38,000 players registered nationally in 2019.
Given the country’s 58% coverage of forest, its network of caves, and its 10,000km of mountain trails, hiking, climbing and caving are popular pastimes. There is even a national saying that you are not a true Slovenian until you have summited the country’s highest mountain, Triglav. If you plan to do a lot of hiking, you may find a membership with the Alpine Association of Slovenia beneficial to keep your costs low.
If you are looking to lift weights, work with a personal trainer, or simply to work out indoors, there are several gyms throughout Slovenia. Popular choices include Fitinn, 4P Fitness, Alfa Gym and Maxx Gym. Gyms charge by the month, but some also have the option to pay for each visit or to buy packages of visits that are valid for a set period of time. Monthly fees start as low as €20 for basic access, and a one-off visit should cost you around €8.
Diet and cuisine in Slovenia
Slovenia’s local diet is something of a melting pot of the different cuisines in the nearby countries of Hungary, Austria, Germany, Italy and Croatia. The main components include cereals (particularly buckwheat), pork, fish, bread, pastry, potatoes, pasta, fruit, vegetables and beans.
Traditional and popular Slovenian dishes include kranjska klobasa (Carniolan sausage), pršut (air-dried ham similar to prosciutto), Žlikrofi (stuffed ravioli-type pasta), and soška postrv (river trout). Blejska Kremšnita (Bled cream cake), the round, nutty Slovenska Potica holiday cake, and various kinds of a doughy, layered dumpling called štruklji are popular sweet treats.
A traditional Slovenian breakfast comprises fresh bread, butter, honey, apples, and a glass of milk. However, these days, it is much more common to have a continental-style breakfast, including meat, eggs, cheese, cereal, bread, juice, tea and coffee.
Lunch is the main meal in Slovenia, and Sunday lunch is an important tradition. This will typically consist of a hearty beef, vegetable or mushroom soup with noodles or semolina dumplings to start, a main of meat with roasted potatoes and salad, and fruit strudel, most commonly apple, for dessert. Dinner is usually a simple and light plate of meat and cheese with salad.
Similar to other countries in the region, Slovenia is renowned for its beer, wine and schnapps, but it is also known for having some of the best quality water in the world. Although quality varies between cities and the more remote countryside, you can expect great tap water in the territory, especially in the capital, Ljubljana.
Given the high rates of diabetes, obesity and cardiovascular disease, in recent years, the Slovenian government has focused on promoting a low-fat diet, rich in fruit and vegetables. School meals are subsidised to minimise the disadvantage to children from lower socioeconomic backgrounds, and workplaces are encouraged to make healthy food available and promote a healthy diet and lifestyle to employees.
Thanks partly to the Italian influence on Slovenia’s cuisine, it is relatively easy to follow a vegetarian or vegan diet in Slovenia when dining out. You can also enjoy fresh produce from supermarkets. Salads and pasta dishes are popular, and Slovenians are keen gardeners who usually grow their own vegetables and herbs. There are many tourist farms, where you can pick your own locally grown produce. Seasonal favourite fruits and vegetables include dandelions, lamb’s lettuce, asparagus, cherries, berries, mushrooms, nuts, pears, root vegetables and apples.
Keeping fit and healthy is important, and the diversity of the cuisine and landscape in Slovenia should make it enjoyable. There’s a lot to explore in the territory, so make sure you take the time to get out in the Slovenian countryside as much as possible.