Romanian healthcare is ranked as the weakest in Europe according to the European Health Consumer Index. Facilities are poor, infant mortality is very high for Europe, and disease prevention is low. You will find particular issues with hospitals outside the major cities.

Private hospitals have also come under fire for focusing on cheap services which are nevertheless charged at a premium for private patients, and are seen primarily as money-making enterprises.

As an expat in Romania, if you are making contributions, you are entitled to state health insurance under the national health (CNAS or Casa Nationala de Asigurari de Sanatate – National Health Insurance House or NHIS). Your contributions will be deducted out of your salary. 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.

You should be able to use your EHIC card in Romania if you are a member of an EU state, but this is for emergency care only and should not be used as a replacement for comprehensive health insurance.

Everyone who makes contributions into the social security system, or who is a member of a vulnerable group, will be eligible for state care. This includes expats. You must be registered with a doctor in order to qualify.

Your employer will sort this out if you are working in the country once you have been given your tax ID number, but double check to make sure that your deductions are actually being made (expats have reported difficulties in this regard). Your workplace may also have a contract with a local health clinic.

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 with a high cardiovascular risk, type 2 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 hospitalization 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 across the country, but if you need a particular medication, check with your doctor whether it is prescription-only.

You will be covered if you are making contributions to the state insurance fund. You may also be able to make voluntary contributions; however, it is highly recommended that you take out private cover. If you are planning to move to Romania, you will need proof of cover before you are granted residency.

Students will be covered if they are under 26, but if you are above that age you will need to take out private cover.

If you are from outside the EU, you will become eligible for state health insurance after 12 months in Romania. If you are in the country for a shorter period (3–12 months), you can apply for national health insurance via the County Health Insurance Office and you will need:

• a certified copy of your passport and residence permit stamp
• a certified copy of the admission letter from your educational institution

If you are studying in the country for under three months, you will need alternative cover.

You will need to make sure that your family are co-insured under your current policy, but your employer should register you with a policy which covers your dependents.

One free check-up per year, as well as some other free services, are covered, but more sophisticated dental treatment generally will not be covered.

Despite the disadvantages of the Romanian system, the relative cheapness of treatment does make the country something of a destination for dental tourism.

The system is funded by contributions: 5.2% by the employer and 5.5% by the employee. The overall social security rate is likely to be higher.

It is recommended that you take out some form of private cover before you arrive in Romania: you will need to show evidence of private health insurance before you are issued with a visa.

Medical treatment in the private sector is relatively cheap. It can cost you around 50 RON (about €10) for a specialist’s consultation. A private health plan will cover this, plus visits to your GP and hospital treatment, but check what your insurance actually does cover – you may still find that you have to pay.

This will depend on factors such as your age and any pre-existing conditions, and the kind of package you opt for. It can be as little as €40 per month — but read the small print and check what this actually entitles you to.

Most of the big companies offer cover for Romania, including:

• AXA
• Bupa Global
• Cigna Global
• Pacific Prime

There are also local Romanian providers.

Am card EHIC - I have an EHIC card

Aveți o asigurare de sănătate private - I have private health insurance

CNAS or Casa Naţională de Asigurări de Sănătate - National Health Insurance House