What is “dopunsko” and why you should have this health insurance

If visiting a doctor within the HZZO network, filling prescriptions, or getting non-basic health services like specialty blood tests at the hospital, you’ll be asked “Imate li dopunsko?”, which means “Do you have dopunsko?”. If you reply that you do not have it (“Nemam”), you’ll likely get this response…

via GIPHY

I’ve grown quite tired of getting this response, so I broke down and signed up for it. Truthfully, we should all have dopunsko. Let’s start from the beginning.

In Croatia, there are three types of health insurance:

Obvezno is the mandatory basic public health insurance that you probably already have if you live here. You must have it to get dopunsko. Dopunsko and dodatno are optional supplemental health insurance policies. If you want to read about dodatno, the highest level of health insurance, hop over here.

In this article, we cover:

The facts are these…

What is dopunsko health insurance

Dopunsko is a supplemental health insurance policy above and beyond your regular health insurance. It is defined by the Zakon o dobrovoljnom zdravstvenom osiguranju (Law on voluntary health insurance).

If you have only the state health insurance through HZZO, you’ll still be required to make a co-payment in the following situations WITHOUT DOPUNSKO:

  • Visiting a doctor
  • Filling prescriptions
  • Anything that requires you to go to the hospital including, but not limited to:
    • Non-basic blood and diagnostic tests
    • Specialist appointments
    • Emergency care

Where to get dopunsko and what does it cost

Dopunsko is offered by HZZO as well as by private insurers. The price varies depending on the insurer, the additional benefits you choose, and your age. Private insurers tend to offer multiple options.

Here are some insurers that allow you to sign up online for dopunsko:

PBZ also offers this supplement through Generali, which is a good option if you already have a bank account with them. You’ll need to sign up at a bank branch. Their policy starts from 60 kuna.

Most insurers will give you the option to pay monthly or to pay annually in one lump sum.

The following groups qualify for free dopunsko through HZZO:

  • People with disabilities with 100% damage to the body, or physical damage according to special regulations, people with multiple types of damage, and people with physical or mental impairment or mental illness who can not independently perform age-appropriate activities in accordance with social regulations care
  • Donors of human body parts for the purpose of treatment
  • Voluntary blood donors with more than 35 donations (men) or with more than 25 donations (women)
  • Full-time pupils and students older than 18
  • People whose total income per family member in the previous calendar year does not exceed 2.065,60 kuna per month or 2.582,00 kuna for singles.

What does dopunsko cover

It reduces or eliminates the co-payment for health services and medications. It is important to check the exact benefits with each insurer.

The standard inclusions for dopunsko are:

  • Health care for services of doktor opće medicine (family medicine doctors) in state clinics
  • Health care for services of gynecologists in state clinics
  • Health care for services of dentists in state clinics
  • Specialist-consultative health care
  • Daily hospital
  • Daily hospital surgeries
  • Laboratory, radiology, and other specialist diagnostics
  • Physical medicine and rehabilitation services in clinics
  • Physical medicine and rehabilitation services at home
  • Hospital treatment
  • Orthopedic and other aids on the basic list
  • Dental aids due to the basic list
  • Prescription medicines from the basic list of medicines (list A called “osnovna lista”)
  • Prescription medicines from the additional list of medicines (list B called “dopunska lista”), if agreed
  • Medical treatment abroad if it is approved by the HZJZ

Why should you get dopunsko health insurance

If you need regular healthcare, then you should absolutely have this supplemental insurance. If you have kids, you should have a policy for yourself and for each child. I don’t know much about kids, but I hear they tend to get hurt and sick with frequency.

I’ll admit, it took me nearly 7 years to get on board with dopunsko. I figured that since I don’t have kids or any serious health problems, then it didn’t make sense to pay 70 kuna per month when my monthly out-of-pocket health care costs are less than that.

I’ve since learned that is not a good reason at all. If my greatest fear of getting hit by a car in a crosswalk comes to fruition, then dopunsko will save me from paying a single kuna at the hospital.

What happens after you sign up

You’ll receive an insurance card in the mail. When you go to the doctor or pharmacy next, you’ll present this new card so you can avoid or reduce the co-payment.

A little tip: You may get asked if you have the orange card (narančasta kartica) instead of dopunsko. The reason is that the HZZO supplement card is orange. However, the supplement cards with private insurers vary in color.

Next time you get asked “imate li dopunsko”, you can say emphatically “IMAM!”.

via GIPHY

How to check the status of your dopunsko

If you are unsure of the status of your dopunsko state health insurance (if you got it through HZZO), you can always check your policy on the HZZO web site here. All you need is your OIB number. This page will tell you if your policy is valid or not.

[Read: How to get an OIB Croatian Identification Number]

View our other health insurance posts


Source:
https://dzo.hzzo.hr/dopunsko-zdravstveno-osiguranje-na-teret-proracuna-rh

Please note: All information provided by Expat in Croatia is only for the purposes of guidance. It does not constitute legal or financial advice in any form. For legal advice, you must consult with a licensed Croatian lawyer. For financial advice, you must consult with a licensed Croatian tax advisor or accountant. We can recommend one if you contact us.

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