Romania – Health Service

What is the standard of healthcare in Romania?

Romania’s health system has undergone genuine improvement over the past two decades, with rising life expectancy and meaningful reductions in both infant and maternal mortality rates. That said, performance continues to lag behind OECD peers across a range of measures, including access to care, service quality, healthcare capacity, financing levels, and health risk factors.

In structural terms, Romania follows a Bismarck-style social insurance framework — comparable in principle to those of Germany or France, where entitlement is tied to contributions rather than funded through general taxation as in the UK’s NHS. Unlike those more established systems, however, Romania grapples with chronic shortfalls in funding and ageing infrastructure.

Romania has raised its healthcare budget considerably in recent years, yet it remains at the bottom of the European Union in per-capita spending, allocating EUR 971 per inhabitant to health. The consequences of this long-term underfunding are visible: most medical buildings are at least 35 years old, and of the 554 hospitals recorded in Romania in 2023, only four were constructed after 1989.

In 2023, more than half of Romania’s population (54%) lived in rural areas, where access to healthcare poses significant difficulties. Urban centres account for over 90% of all hospitals and independent specialist clinics, and 60% of family physician practices (as of 2024). This stark geographic divide is among the most important realities for anyone planning to settle outside a major city.

Urban hospitals tend to have more staff relative to their rural counterparts, where vacancies are persistently difficult to fill — in 2024, more than 90% of doctors were working in urban settings. Major cities such as Bucharest, Cluj-Napoca, Timișoara, and Iași host well-equipped hospitals alongside an expanding private sector with physicians trained to international standards. Elsewhere, conditions can differ markedly.

Efforts to reform the system are ongoing, encompassing improvements to health budgeting, better remuneration for medical professionals, and the introduction of performance-linked payment arrangements. Nevertheless, longstanding challenges persist — among them inefficient public spending, workforce gaps, corruption, weaknesses in primary and community care, and fragmented data systems.

For authoritative and up-to-date assessments, readers should consult the WHO Romania country profile and the Romanian Ministry of Health.

How is healthcare funded in Romania, and is private health insurance necessary?

Romania’s healthcare system operates on a universal insurance basis, with funding drawn primarily from compulsory contributions rather than general government revenue. The National Health Insurance House (CNAS) oversees the distribution of these funds and enters into contracts with both public and private providers. Contributions are deducted from wages, granting insured individuals access to a wide range of medical services.

For those employed by a Romanian company, contributions are handled through payroll: 5.5% of salary is deducted from the employee, and the employer contributes an additional approximately 5.2% on their behalf (as of 2024 — confirm the current rates with CNAS or the Ministry of Finance prior to relocating).

The Social Health Insurance (SHI) scheme provides a broad basic benefits package to around 89% of the population — one of the lowest coverage rates in the OECD. The basket of covered services is extensive, encompassing preventive care, outpatient and hospital treatment, emergency services, dental care, rehabilitation, perinatal services, home nursing, medicines, and medical devices. However, services may not always be fully funded, and patients can face co-payments for certain types of treatment.

Medicines purchased at pharmacies are only partially reimbursed through public insurance, with patients responsible for covering the remainder — a consequence of limited reimbursement lists and high spending on non-prescription products. Dental care is similarly constrained: public cover extends only to children, veterans, and individuals with chronic conditions, and relatively few dental practices hold contracts with CNAS.

In Romania, financial barriers are the principal reason people forgo necessary medical attention — a pattern that differs from most OECD countries, where waiting times are the more common grievance. In 2023, more than half of those reporting unmet healthcare needs cited cost as the deciding factor.

Private health insurance is not a legal requirement for EU citizens covered by CNAS, but it is broadly regarded as sensible. Even with public insurance in place, many expats take out a private plan to access better-resourced facilities and shorter waiting times. For non-EU nationals seeking resident status, demonstrating proof of medical cover is a formal requirement. Current requirements should always be verified with the General Inspectorate for Immigration and CNAS.

How do I register with a doctor or access primary care in Romania?

Romania’s healthcare structure is divided into three tiers: primary care (family doctors and GPs), secondary care (specialist consultations and diagnostic services), and tertiary care (hospital-based treatments and complex procedures). The family doctor — referred to locally as a medic de familie — serves as the entry point to the rest of the system, fulfilling a role similar to that of a GP in other European countries.

Before accessing insured health services, you should contact your local Health Insurance House (CAS) branch and register with a family physician. Foreigners who have obtained the right to reside in Romania are entitled to healthcare on the same terms as Romanian nationals, provided they pay into the health insurance fund.

The process for registering to access public healthcare as an expat typically involves the following steps:

1. Obtain legal residence in Romania (a requirement for stays exceeding 90 days — contact the General Inspectorate for Immigration).
2. Visit the local branch of the National Health Insurance House (CNAS), bringing your residence permit, passport or national identity card, and proof of address.
3. Complete your health insurance registration at the CNAS office. Documents required may include a national ID, evidence of residence, your employment contract, and a tax identification number. Depending on your immigration status, a residence permit or visa may also be needed.
4. Upon successful registration, you will be issued a health insurance card, which must be presented whenever you access healthcare. You will also need to choose a GP as your primary care provider, since this doctor acts as the gateway to specialist and hospital services.
5. If you are employed, your employer is responsible for paying your contributions into the health insurance system. Self-employed individuals and retirees must enrol independently and make voluntary contributions.

In 2024, 6% of adults in Romania reported unmet primary care needs — twice the EU average — pointing to significant access difficulties at this fundamental level of the system. In practice, this means that finding a GP accepting new patients can require patience, particularly in rural areas. Urban settings generally offer shorter waits and greater choice of practitioners.

Consultations with a registered family doctor are free of charge for insured patients. Co-payments may arise for some specialist referrals and outpatient medications. For the most current registration guidance, visit the CNAS website.

What services do hospitals in Romania provide, and what should patients expect?

The basic benefits basket covered under Social Health Insurance encompasses preventive care, outpatient services, inpatient hospital treatment, emergency medical services, dental care, rehabilitation, perinatal care, home nursing, prescription medicines, and medical devices. Public hospitals provide this full range, from routine surgical procedures to complex specialist interventions.

The experience of receiving care in public versus private settings, however, can differ substantially. While public insurance is capable of meeting most day-to-day healthcare needs in principle, public hospitals frequently contend with staff shortages, limited medical supplies, and infrastructure requiring significant repair.

One cultural and practical point that tends to surprise expats unfamiliar with the Romanian system: families routinely take on an active role in the personal care of hospitalised patients. Unlike systems such as the NHS or healthcare networks in northern and western Europe — where nursing staff manage virtually all personal care — families in Romanian public hospitals are often expected, and sometimes needed, to assist with feeding, washing, and other daily routines during an inpatient stay. Newcomers should factor this into their expectations and planning.

Corruption within the healthcare sector has been a recognised concern. Informal payments to medical staff in exchange for preferential treatment have long been a feature of the system, even if large-scale corruption cases attract the most media attention. Understanding this aspect of the cultural environment, while neither participating in nor encouraging such practices, will help expats navigate public healthcare with greater confidence.

Private hospitals typically provide a more patient-oriented environment with more modern facilities. That said, in the event of a serious emergency — such as major trauma or severe internal bleeding — patients may be transferred to a public hospital, which generally has a broader pool of specialists equipped for complex cases.

Prominent private hospital groups including Regina Maria, MedLife, and Sanador have established strong reputations for quality care and are well regarded among the expat community in Bucharest and other major cities. These institutions typically offer reduced waiting times, more comfortable surroundings, multilingual staff, and up-to-date diagnostic technology.

How does follow-up and aftercare work in Romania?

Specialised outpatient rehabilitation services are delivered by physiotherapists working alongside other clinical staff, and physical medicine and rehabilitation are included within the standard benefits package. In theory, post-hospital aftercare is accessible through the public system, though in practice availability can be restricted.

Follow-up care in Romania is generally arranged through outpatient referrals from your GP or the hospital department that treated you. After discharge, patients are typically expected to attend outpatient appointments at the relevant hospital clinic, or return to their registered family doctor for ongoing monitoring and prescription management. Rehabilitation services are included in the public benefits package but are subject to capacity constraints and waiting times.

Continuity of care can be difficult to guarantee within the public system, due to persistent weaknesses in primary and community-level healthcare, uneven access to services, and fragmented health information systems. Patients managing complex or chronic conditions — or recovering from surgery — may find that follow-up appointments are slower to materialise in overstretched public hospitals than in systems with more robust community nursing infrastructure.

Mental health conditions, which represent the second leading cause of years lived with disability in Romania, continue to be underdiagnosed, owing to social stigma and limited service availability. The mental health system leans heavily on institutional care and medication-based treatment, while unmet need for community mental health support remains comparatively high. Expats who depend on regular psychological or psychiatric care should arrange private provision before relocating, as access to community-based mental health services through the public system is limited.

For post-operative physiotherapy, rehabilitation, and specialist follow-up, many expats find private providers more practical. A combined approach is common: CNAS for foundational coverage, and a private plan for convenience and quality. Private insurance costs approximately €300–€1,000 per year depending on coverage level (as of 2024 — confirm current premiums with providers before purchasing).

What are the rules on medical treatment for foreign visitors and new arrivals in Romania?

Emergency treatment is available to everyone in Romania regardless of insurance status. This means that even before you have registered with CNAS, you are entitled to receive emergency medical care. Non-emergency services, however, require valid insurance coverage.

Short-term visitors from EU and EEA countries may use the European Health Insurance Card (EHIC), though its scope is restricted to emergency and necessary care and does not extend to private providers. Non-EU visitors should make sure their travel insurance policy includes adequate medical coverage for Romania.

EHIC holders are not required to pay for covered treatment upfront, as the local health insurance house reimburses the healthcare provider directly. Contracted providers can be located through the CNAS provider directory.

Anyone remaining in Romania for more than three months is required to obtain resident status. Once residency has been granted, foreigners are entitled to healthcare on the same basis as Romanian citizens, subject to paying into the health insurance fund.

As an EU member state, Romania participates in the EU’s social security coordination framework, which allows for mutual recognition of insurance entitlements across member states. For nationals of non-EU countries, Romania has bilateral social security agreements with certain states, though the scope and practical effect of these arrangements vary considerably and change over time. You should verify your specific entitlements directly with the Romanian Ministry of Health, CNAS, or the relevant social security authority in your home country before making any move.

What are the most important health insurance options for expats in Romania?

Expats in Romania generally have three principal insurance pathways to consider, and it is common to draw on more than one simultaneously.

• CNAS public health insurance: The National Health Insurance House makes public health insurance available to all legal residents of Romania. Expats who relocate and pay the required contributions can enrol in the public scheme and access subsidised or free treatment from contracted public and private providers. This represents the broadest foundation of coverage and is open to all legal residents meeting the contribution requirements.
• Local private health insurance: Private insurance provides access to private clinics and hospitals, reduced waiting times, and generally superior comfort and service standards. Premiums vary by provider and plan, but are typically more affordable than equivalent cover in western Europe or North America. Leading private networks — including Regina Maria, MedLife, and Medicover — offer personal subscription plans as well as employer group schemes.
• International health insurance: Digital nomads, retirees, and extended-stay visitors frequently rely on international health insurance rather than, or in addition to, local cover. International plans are particularly suited to those who travel regularly, as they offer cross-border protection that domestic Romanian policies generally do not provide.

Private insurance is widely used to fill the gaps left by public provision, particularly for specialist consultations, private hospital admissions, and elective procedures. Given that dental care, outpatient medicines, and mental health services all carry substantial out-of-pocket costs under the public system, a well-designed private policy should specifically address these areas.

When comparing policies, key features to look for include: inpatient and outpatient coverage, reimbursement of prescription costs, dental care (given the narrow public dental provision), mental health support, and direct billing arrangements with major private hospital networks. Private insurance costs approximately €300–€1,000 per year depending on the level of cover (as of 2024). Always verify current premiums and policy terms directly with your insurer, and check that policies meet the requirements of Romanian insurance regulation as overseen by the Financial Supervisory Authority (ASF).

For non-EU expats applying for resident status, demonstrating proof of medical coverage is a formal condition of the application process, making insurance not only a health safeguard but also a practical necessity.

Are there any particular health risks or considerations for people moving to Romania?

Romania is generally a safe environment in terms of public health, but there are specific risks and circumstances that anyone planning to relocate should be aware of before arriving.

Vaccinations: The CDC and WHO recommend the following vaccinations for Romania: typhoid, hepatitis A, polio, tick-borne encephalitis, rabies, hepatitis B, influenza, COVID-19, pneumonia, meningitis, chickenpox, shingles, Tdap (tetanus, diphtheria and pertussis), and MMR (measles, mumps, and rubella). Ensure all routine vaccinations are current before departure and seek personalised advice from a travel health clinic.

Measles: Romania has experienced a recurring measles outbreak since 2022. Between January and May 2024, 15,763 cases were recorded, resulting in 16 deaths — a stark illustration of the importance of verifying that MMR vaccination is up to date before moving to the country.

Tick-borne encephalitis (TBE): TBE is a viral illness transmitted through the bites of infected ticks. Transmission can also occur through consumption of unpasteurised milk or dairy products from infected animals such as cows, goats, and sheep. TBE is endemic in Romania, with natural foci actively expanding their geographic range. Risk is concentrated in Tulcea district, Transylvania, the foothills of the Carpathian mountains, and the Transylvanian Alps. Vaccination is advisable for those residing in TBE-risk zones, people working in forestry, woodcutting, or agriculture, and individuals engaging in outdoor pursuits such as camping, hiking, or fieldwork in forested areas.

Rabies: Vaccination against hepatitis A, hepatitis B, and rabies is also recommended. Stray dogs continue to be present in parts of Romania, particularly in rural communities, making rabies awareness relevant for long-term residents.

Road safety: Major roads in Romania are generally in reasonable condition, but secondary and rural roads can be poorly maintained. In rural settings, road users share routes with horse-drawn carts, livestock, and stray animals. Caution is particularly advisable when driving after dark or during winter months.

Heat: Nearly half (48%) of Romania’s population is exposed to summer days where temperatures exceed 35°C, compared with an OECD average of 29%. Those with cardiovascular or respiratory conditions should plan carefully for the summer months, especially in cities such as Bucharest.

Mental health: Mental health conditions are the second leading cause of years lived with disability in Romania and remain underdiagnosed due to stigma and inadequate service access. The system relies predominantly on institutional and pharmacological approaches to treatment. Expats requiring regular mental health support should research private options before relocating, as community-based services through the public system are limited.

Before making your move, consult the WHO Romania country profile and your national travel health advisory service for the most current guidance.

Frequently asked questions: Healthcare in Romania for expats

Can I use Romania’s public health system as an expat?

Foreigners who have obtained the right to reside in Romania are entitled to healthcare on the same terms as Romanian citizens, provided they pay their contributions to the health insurance fund. Expats in employment are enrolled automatically through their payroll; self-employed individuals and retirees must register independently with CNAS. Check current eligibility conditions at cnas.ro.

How do I find a doctor who speaks a language other than Romanian?

In Romania’s main cities — particularly Bucharest, Cluj-Napoca, Timișoara, and Iași — many doctors, especially those working in the private sector, speak English, French, or German. Private facilities such as Regina Maria Băneasa, Sanador Hospital, Medicover Hospital, and Monza Hospital are well known for their multilingual staff and English-speaking physicians. Outside urban areas, finding a doctor able to consult in a language other than Romanian is considerably more difficult. Private hospital networks generally list the languages their specialists speak on their websites.

What happens in a medical emergency in Romania?

Dial 112, Romania’s unified emergency number covering ambulance, police, and fire services. Emergency treatment is available to everyone regardless of insurance status. Ambulance services (SMURD) operate nationally, though response times in rural areas may be longer than in cities. If you carry a European Health Insurance Card, present it at the emergency department.

How do prescriptions work in Romania?

Pharmacies (farmacii) are plentiful, and many operate around the clock. Prescription medicines require a valid doctor’s prescription, while a broad range of products is also available over the counter. Public insurance reimburses approximately half the retail cost of prescription medicines, leaving patients to pay the balance out of pocket. Insured patients holding a prescription from a contracted family doctor or specialist are entitled to a subsidy when collecting medicines from a pharmacy. Verify current reimbursement rates at cnas.ro.

Are pre-existing conditions covered by Romanian health insurance?

Under the CNAS public system, insured individuals can access care for pre-existing and chronic conditions within the standard benefits package — there is no blanket exclusion for pre-existing conditions as might be found in some private plans. Certain services may still attract co-payments, however. Private insurance policies in Romania may impose waiting periods or exclusions for pre-existing conditions, so it is important to review policy terms carefully before signing. Verify current rules with the Financial Supervisory Authority (ASF).

Is the European Health Insurance Card (EHIC) accepted in Romania?

Yes. The EHIC entitles EU residents to the same benefits as those covered by Romanian public health insurance for certain necessary care during a temporary stay in Romania. It is important to note that the EHIC covers necessary care only — it does not extend to private providers or non-urgent treatment. Cardholders do not pay for covered treatment at the point of access, as the local health insurance house reimburses the provider on the basis of the EHIC. The EHIC is not a substitute for comprehensive private health insurance for long-term residents.

What is the quality of private hospitals in Romania compared to public ones?

Private hospitals are generally more patient-oriented than their public counterparts, offering modern facilities, shorter waits, more comfortable environments, better administrative efficiency, and more consistent access to multilingual staff. That said, if a serious medical emergency arises, patients may be transferred to a public hospital, which typically has a larger pool of specialists for complex interventions. For routine and planned procedures, private providers in Romania’s major cities offer a high standard of care at a cost that is relatively modest by western European standards.

Do I need private health insurance to get a Romanian residence permit?

Proof of medical coverage is a formal requirement for non-EU expats applying for resident status. EU citizens who can demonstrate active CNAS membership through employment contributions generally satisfy this condition. Non-EU nationals who are not yet employed — such as retirees or those living on passive income — typically need to present a private health insurance policy as part of their residency application. Requirements may change, so always confirm the current documentation needed with the General Inspectorate for Immigration.