If you are planning on living and working in Croatia, you will require health insurance of some form. The country currently has a two-tier system, consisting of both private and public cover. The latter is compulsory but you can also take out private health insurance for extra peace of mind or as a top-up for the national system. There is also a form of supplementary insurance available.

Croatia is well supplied with medical institutions, both in the state and private sectors. Healthcare is governed by the Ministry of Health and the Ministry of Finance, and institutions are run both regionally and by the central government.

Having national health insurance is mandatory for everyone in Croatia. It is state run and governed by the HZZO (the Croatian Institute for Health Insurance). Once you have registered you will be issued with a card, which you must bring with you to all your medical appointments.

Note that if you are an EU citizen and have an EHIC card, you will be able to use this in Croatia as the country is a member of the EU. However, the EHIC is intended primarily for emergencies.

Once you are registered, you will be entitled to sign up with a GP, who can issue you with a referral (uputnica) to a specialist if necessary. You will not be able to see a specialist directly and referrals are used at all levels of the medical system, including for some quite minor procedures such as blood tests. If you do not use your referral, you must return it to your doctor.

HZZO healthcare is mandatory for all residents of Croatia, so if you are an EU citizen, or are applying for residency but are from outside the EU, and are working in Croatia, you will have to pay contributions into the system. You will also need to pay contributions into the HZZO if you are self employed.

If you are from another EU state, then you will need documentation from your own health insurance provider to inform the Croatian authorities that you will need to be signed up with the HZZO.

If you are from outside the EU, in order to be registered, you will need to have initiated the process for residency in Croatia. This is done via the police (MUP) and they will need to provide you with documentation for the HZZO, who will in turn provide you with a document that you can then take back to the police and add to your visa application. It will take 1-3 months to get your registration processed by the HZZO, but they can give you a letter in the meantime in order to access any health provision that you may need.

The HZZO covers a range of healthcare such as:

• emergency treatment
• primary care
• hospitalization
• specialist treatment
• medical tests
• maternity care
• prescriptions (there may be a small co-pay for your prescription charges)

However, unless you have additional insurance, you may need to make a co-payment for the above. In general the HZZO will cover 80% of your treatment but 20% will need to be paid by you: this co-payment can be offset by taking out supplementary insurance with the HZZO.

GP visits will cost in the region of 10 kuna (just over US$1): make sure the practice is signed up with the HZZO or you could end up paying more, although in comparison to the USA, for instance, charges are very low. Seeing a specialist could cost you around 300 – 500 kuna (US$40 – 70) per visit.

You will be charged a daily fee of 100 kuna (US$15) for a hospital stay. Fees for patients are capped at 2000 kuna (US$295).

You will be charged a standard co-payment of 10 kuna (US$1) per prescription.

In addition, you may need to make a co-payment for the following:

• 50 kuna (US$7) for specialist diagnoses not classed as primary healthcare
• 50 kuna (US$7) for orthopaedic and other aids
• 25 kuna (US$4) per day for physical rehabilitation
• 1000 kuna (US$147) for dental aids
• 500 kuna (US$73) for dental aids for people over 65

You cannot seek reimbursement from the HZZO itself: if you are covered elsewhere by an EU national health insurance scheme or by a private insurer, you will need to contact them directly in relation to any co-payments.

If you want treatment that is actually free at the point of delivery, then you can sign up for dopunsko insurance, which is an additional form of cover on top of your HZZO policy. This will enable you to have free at point of delivery treatment for:

• GP visits
• prescriptions
• hospital treatment including, but not limited to:
• non-basic blood and diagnostic tests
• specialist appointments
• emergency care
• physical therapy

If you are a retiree, you will still be signed up to the HZZO and if you are a citizen of Croatia, you will be exempt from making contributions. If you are not a citizen, however, you will need to check with the HZZO to see if deductions need to be taken from your pension.

If you are an international student studying in Croatia, you will need to take out health insurance in your home nation or sign up with the HZZO on arrival. If you are a member of an EU state, you will need to show that you are covered by health insurance in your own country and should thus be eligible to access public healthcare in Croatia.

The Croatian authorities state that compulsory health insurance registration is not required for foreign students with temporary residence in Croatia for the purpose of higher education if your stay is related to youth mobility programs, general student exchange agreements, inter-university agreements and other programs and initiatives carried out by relevant education and science institutions, as long as these programs include health care provisions.

Your family will be covered by the HZZO, but it is recommended that you take out dopunsko insurance (see below) if you are reliant on the public insurance sector to streamline any healthcare for your family.

Dopunsko policies will cover dental medicine services and the HZZO itself should cover basic dental care. You may have to make a small co-payment (10 kuna/US$1) for each visit to the dentist.

Premiums are currently around 530 kuna (approximately US$78) per month. These will be deducted from your salary.

However, if you are from outside the EU and are enrolling with the HZZO for the first time, you will need to make a one-off payment of 6356 kuna (around US$937), which is treated as a back payment for the previous year. So be prepared to pay quite a steep bill for your health insurance in your first year of residence in Croatia.

HZZO and a number of other local providers offer dopunsko insurance from a range of premiums, from 43 – 70 kuna (US$6 – 10) per month. You can also pay an annual lump sum.

If you are a regular blood donor, the HZZO incentivizes this by giving you a free supplemental policy dependent on the number of donations (it is usually around 25 – 30 donations depending on your sex).

If you are living and working in Croatia, you will need to sign up with the HZZO as this is compulsory, but you may additionally choose to take out private health cover to avoid any lengthy waiting times or to ensure a higher quality of treatment. You will be able to sign up with either local providers, who do not have to be contracted partners of the HZZO, or with international providers.

Private health insurance will cover the full range of primary and secondary care and will in addition allow you to access a higher standard of facilities and avoid lengthy waiting times. Cosmetic surgery and more advanced dental treatment will also be available in the private sector.

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.

You can also take out dopunsko policies (see above for details), which remove the need for co-payments in the public system.

The main international providers operate in Croatia including:

• AETNA
• Allianz (who also offer dopunsko insurance)
• BUPA
• Cigna
• Foyer Global Health

Local providers who offer dopunsko insurance include:

• HZZO
• Croatia Osiguranje
• PBZ via Generali
• Uniqa
• Wiener Osiguranje

dopunsko insurance – supplementary insurance on top of the HZZO mandatory health insurance policy

Hrvatski zavod za zdravstveno osiguranje / HZZO - Croatian Health Insurance Fund