If you are an expat who is residing and working in Slovakia, you will be registered with one of the three main state-approved health insurance schemes: this is compulsory and both you and your employer must make contributions into the system. Basic healthcare is thus mainly free at the point of delivery.However, public healthcare in Slovakia currently lags behind other European nations and many expats choose to take out private health cover. We will look at some of your options below.
Personalising Your Health Insurance Cover
If you are employed, then your national insurance contributions will be split between your employer and yourself: with your employer paying 10% into the system and you paying 4%. Most expats will be signed up with the state health insurance system (Všeobecná Zdravotná Poisťovňa or VšZP), or possibly one of the two approved private schemes which operate under state governance.
If you are self employed, you will have to pay the full 14% yourself, but it is based on your overall income. If you are unemployed, the government will pay your share. Medical treatments are assigned ‘points’ which are then converted into monetary value.
Most basic healthcare, such as visits to your doctor and hospital treatment, is covered under the state plan. You are entitled to a free annual dental check-up, but not to any other form of dental treatment under national insurance. You will also be eligible for some basic optical care.
It is worth noting that Slovakia is a medical tourism destination for dental care, elective optical care, cosmetic and other elective surgeries. Out-of-pocket costs tend to be low in comparison with other European nations.
However, many expats choose to take out private policies for extra peace of mind and convenience, so we are going to suggest some options for you to consider in order for you to keep your premiums as low as possible.
Selectable Options
Check the small print of any private policy to see whether it covers treatments that you may want to access, such as specialist treatment or more advanced dental care, for example, crowns or dental implants.
Remember to check if your potential policy covers pre-existing conditions: the definition of this varies between insurers. Usually the term applies to any conditions which 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 for diagnosis.
You may also want to check out whether your policy has a ‘hospitalisation’ clause covering you for occasional hospital visits. You may need to discuss this directly with your insurer.
Take a good look at any potential policy for any cover relating to healthcare which does not apply to you: some policies have provision for maternity care, for instance, and if you are not intending to become pregnant (or prefer to rely on the cover provided by the Slovakian public maternity system, which has actually been rated more highly than public maternity provision in the UK), then you may wish to reduce your policy costs by having such options removed.
Cost Sharing
You may also be able to reduce the cost of your premium through ‘cost sharing’: this means that you and your insurer will 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. However, you would then have to pay the entire amount for 11 such visits (€1000/€85 = 11.8) before your insurance began to 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 Slovakia in any one policy period. For example, if you just want basic dental treatment such as an occasional filling, it might be worth working out whether one or two out-of-pocket costs might be cheaper than full dental cover.
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