The quality of healthcare that you can expect as an expat in Slovakia will depend on whether you access the public system or take out private health insurance. Slovakia is a destination for healthcare tourism, including dental and cosmetic care, and the private sector is of a high standard.However, Slovakia’s public sector system is undergoing problems and many expats resident in the country opt to take out private health cover. We will look below at some of your options.
Public healthcare in Slovakia
Over 98% of the Slovakian population is covered by the national scheme, with 65% of people signed up to the state health insurance system (Všeobecná Zdravotná Poisťovňa or VšZP). The rest are registered with either Dôvera or Union zdravotná poisťovňa, private health insurers working on behalf of the government (Union is actually owned by the Dutch). Technically, therefore, Slovakia has universal coverage – but in practice, some Slovakians as well as expats take out private health cover if they can afford it in order to avoid the current challenges of the healthcare system.
Slovakia currently has significant inequalities in its healthcare provision. The WHO reports that patients are faced with prolonged waiting times, which they say are a consequence of public budget constraints, limited opening hours, a shortage of specialists (who often work in other facilities as well) and a comparatively high demand for services. In some regions access to cardiology, immunology, diabetology, rheumatology or endocrinology is limited.
In the early 2000s hospitals experienced rising liabilities towards health insurance funds and suppliers, and this, the WHO reports, rendered them vulnerable to corruption and resulted in a declining quality of health care provision. Fourteen health care facilities were transferred from state-owned organizations accepting national health insurance into (private) organizations which were not covered under the national scheme and this had an impact on services: only one public hospital had a dialysis unit, for example, following this restructuring.
The Health Consumer Powerhouse (HCP) ranks Slovakia in the ‘red’ band of countries evaluated, suggesting that its public sector healthcare is significantly lagging behind other European nations despite a relatively high rate of public spending. It cites, for example, Slovakia’s failure to reduce deaths caused by illnesses such as cardiovascular diseases, strokes and also high blood pressure, and the exposure of patients to hospital infections like staphylococcus. A recent analysis posted healthcare in Pakistan as being of a higher quality than that in Slovakia.
A recent EU report says that various studies suggest that life expectancy in Slovakia is low relative to the level of healthcare spending, and that this indicates potential room for improving the cost-effectiveness of the health system and reducing mortality rates. It goes on to say that the country’s public hospitals are saddled with a high level of debt, partly a consequence of misaligned financial incentives for hospital management.
There are attempts in train to try to improve matters, but given the above, expats resident in the country may prefer to opt for private sector healthcare. Note, however, that if you are working and resident in the country, it is likely that both you and your employer will be paying contributions from payroll into one of the state-approved insurers, and thus you will automatically be covered for some outpatient and inpatient care in the country.
You may therefore wish to evaluate whether any private insurance that you take out is comprehensive, or a top-up policy to cover any condition not already covered by state healthcare. You will need, in any case, to take out private insurance to cover you for the period when you are applying for residency.
If you are from an EU member state, you will be able to use your EHIC card to access public healthcare in Slovakia, if it is an emergency.
If you are covered under one of the national schemes, then most of your treatment will be free at the point of delivery, as follows:
• preventative medical check-ups
• urgent health care (in case of a sudden change of health conditions which directly endangers life or any vital functions)
• medical performance leading to the detection of a disease and determining the diagnosis, curing of the disease, mitigation of its effects, saving of life etc.
• compulsory vaccination
• urgent transport to a medical facility and between medical facilities
However, you will be expected to may co-payments for some additional healthcare services, which are set in law as follows:
• pharmaceuticals, medical devices, dietary food: co-payments for 60% of items
• prescription costs: €0.17 per prescription
• spas and other rehabilitation services: from €1.66
• 24/7 first aid medical service: €1.99
• transport health service: €0.07 per km
In order to access the public healthcare system, you must first register with a GP. They will be able to recommend you to a specialist at an outpatient department.
If you want to see a gynecological or psychiatric specialist, however, you do not need a referral from a general practitioner.
Remember to take your health insurance card provided by your insurer when you visit your GP.
Private healthcare in Slovakia
There are currently over 50 private hospitals in Slovakia. Most outpatient facilities are also private. All doctors in the country work in the private sector, although the bulk of their funding comes from the state.
Slovakia has some high-end facilities, mainly focused on ‘health tourism’ treatments such as lower price dental treatment, such as dental implants, or cosmetic surgery. However, you may wish to enquire about other treatment such as hip or knee replacements. Look at clinics in urban centres such as Bratislave, Kosice and Banska Bystrica, where you are more likely to find English-speaking medical personnel. You may also choose to seek treatment over the border in Austria or elsewhere.
Costs of procedures will vary between providers, but will be competitive in comparison to other European nations. If you have private cover, you should have an amount of choice in selecting a clinic or private hospital that suits your needs, at a good standard for both medical care and facilities.
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