Healthcare and health insurance in Croatia: Guide for 2022

UPDATED: 19/08/2021

Croatia has a universal healthcare system providing a form of mandatory public insurance to all people. The population is covered by a basic health insurance plan (called “obvezno”) as required by law and administered by the Croatian Health Insurance Fund (known as “HZZO”). Optional health insurances called “dopunsko” and “dodatno” are also available.

Croatia’s social health insurance system is based on the principles of solidarity and reciprocity, by which citizens are expected to contribute according to their ability to pay and receive basic health care services according to their needs.

In this post, we cover:

The facts are these…

Who must participate in health care expenditures

In Croatia, you must have health insurance which is not free of charge. [Read: Why you must have health insurance] All Croatian citizens and residents are required to participate in health care expenditures.

However, certain groups of insured people are exempt from health care costs including:

  • Children under the age of 18
  • Children of dependents that are incapable of living and working independently
  • Croatian residents incapable of independent life
  • Family members of dead or missing Croatian armed forces members
  • Disabled members of Croatian armed forces

Mandatory health insurance doesn’t cover the costs of elective health care services including:

Available types of health insurance in Croatia

In Croatia, there are three types of health insurance:

  1. Obvezno zdravstveno osiguranje
  2. Dopunsko zdravstveno osiguranje
  3. Dodatno zdravstveno osiguranje

Obvezno health insurance

Obvezno health insurance is the public basic mandatory health insurance in Croatia. It is prescribed by the state agency HZZO and is required for all residents in Croatia – unless you are an EU citizen or permanent EU resident who holds state health insurance in another EU/EEA member state.

You can view lists of all available inclusions of primary health care in Croatia here.

[Read: Croatia’s state health care “obvezno” insurance, what it costs and what is included]

[Read: How to sign up for state health insurance in Croatia]

Dopunsko health insurance

Dopunsko health insurance is an affordable, optional public or private health insurance supplement. You can get it from either HZZO or a private bank or insurer. It eliminates most co-payments for prescriptions, doctor visits, diagnostic tests, and hospital visits/stays.

[Read: What is “dopunsko” and why you should have this health insurance]

Dodatno health insurance

Dodatno health insurance is the highest level of health insurance in Croatia. It is private supplemental health insurance only offered by banks and private insurers. This policy covers specialists, additional treatments, preventative care, laboratory tests, and extended hospital visits.

[Read: What is “dodatno” health insurance]

Administration of the healthcare system

The steward of the health system is the Ministry of Health, which is responsible for health policy, planning and evaluation, public health programs, and the regulation of capital investments. The Ministry of Finance also plays a key role and is responsible for the planning and management of the government budget.

Healthcare institutions in Croatia include:

  • Clinical Hospital Centers (klinički bolnički centar)
  • Clinical hospitals (klinička bolnica) – View a list here
  • Clinics (klinika) – View a list here
  • Polyclinics (poliklinika) – View a list here
  • General hospitals (opća bolnica) – View a list here
  • Special hospitals (specijalna bolnica) – View a list here
  • Spas (lječilište) – View a list here
  • Health center (dom zdravlja) – View a list here
  • Departments (zavod) – View a list here
  • County Institutes for Emergency Medicine (županijski zavod za hitnu medicine) – View a list here

There are hundreds of healthcare institutions in Croatia, including ~79 hospitals and clinics with ~25.285 beds, caring for more than 760.000 patients per year. Ownership of hospitals is shared between the state and the counties of Croatia.

There are ~5.792 private practice offices, and a total of ~46.020 health workers in the country, including ~10.363 medical doctors. There are ~79 emergency medical service units.

Responsibilities of the Croatian Ministry of Health

The Croatian Ministry of Health is responsible for:

  • Protection from infectious and non-infectious diseases, and ionizing and non-ionizing radiation
  • Health and safety of food and items of general use
  • Construction and investment in health care
  • Establishment of health institutions and private practices
  • Organization of state and other professional exams for health professionals, their specialist training, recognition of the title of “primarius”
  • Naming health institutions: reference centers, clinics, clinical hospitals, and clinical hospital centers
  • Administrative supervision of the work of the Croatian Health Insurance Fund, Croatian Red Cross, and Chambers
  • Health inspection supervision of the work of health care institutions, health care workers, and private practices
  • Registration of medicines
  • Pharmaceutical inspection and supervision of the production and trade of medicines and medical products
  • Sanitary supervision of the production, trade, use, and disposal of poisons
  • Production, trafficking, and consumption of narcotics
  • Sanitary supervision of people and activities, buildings premises, plants, and devices that may affect human health in any way adversely
  • Sanitary supervision of international traffic at the state border

What is HZZO – Croatian Health Insurance Fund

Croatian Health Insurance Fund is called “Hrvatski zavod za zdravstveno osiguranje” or HZZO in short. It is a public institution under the Ministry of Health of the Republic of Croatia in charge of all types of health insurance in Croatia. It was founded in 1922.

HZZO has many regional and branch administration offices in Croatia with ~2.400 employees. If you have to solve a private administration issue from the field of healthcare, you will probably have to go to HZZO. For example, they are in charge of enrollment and termination of health insurance.

If you have to visit HZZO, usually, you have to go to the HZZO administration office according to the address of your Croatian residence. Every Croatian county has several HZZO administration offices that are usually located in larger cities.

[Read: HZZO List of Local Health Insurance Offices]

How to get a family doctor

A family doctor is the first person you have to visit when you are sick or have a medical issue. Croats called them “doktor obiteljske medicine” or “obiteljski liječnik” or “doktor opće medicine”. If you live in Croatia, you must have a family doctor.

Croatian residents are usually assigned to a family doctor according to the address of their residence. However, people insured by the HZZO have the right to pick certain doctors on their own including:

  • Family doctor
  • Dentist
  • Gynecologist (women)
  • Pediatrician (parents for their children)

If you are not satisfied with your family doctor or you’d like to change them for another reason, you can do it once a year.

Below are the steps for changing your family doctor. Steps are the same when changing a dentist, gynecologist, and pediatrician.

Step #1 Find the doctor

Find a new potential family doctor. Croats usually like to hear the experiences of their friends or relatives before picking the right doctor.

If you don’t know how to find a family doctor, view a list of all family doctors in Croatia available here.

A list of dentists in Croatia is available here.
A list of gynecologists in Croatia is available here.
A list of pediatricians in Croatia is available here.

[Read: How to find an English-speaking doctor]

Step #2 Contact the doctor

Contact your desired family doctor to check whether they have a free place for a new patient = YOU. It is best to call them. You can also explain your situation if you think that it may help to get the desired doctor.

A family doctor cannot deny your request if they have free places. However, if the doctor has a very good reputation, the chances they have free client spots open are low.

Step #3 Fill out the form

Fill out the form called “Izjava o izboru/promjeni izabranog doktora” (Statement on the selection/change of the chosen doctor).

This form is available here or at the doctor’s office. You must fill out only the part of the form that includes information about you.

Step #4 Visit the doctor

Visit the doctor and bring them the form. They will fill out the rest, verify the form, and send it to the HZZO.

Step #5 Wait

Now you have to wait for the HZZO to make the change. You don’t need to inform your current family doctor about the change. HZZO will notify them for you.

After your current family doctor receives a notification from HZZO, they must deliver your medical documentation to your new family doctor within 3 days.

How the Croatian healthcare system works

Everyone must have a general practitioner (family doctor) if they intend to use the state health insurance policy, as explained in the previous section.

Your general doctor should always be your first stop when seeking treatment. At the initial visit, the general doctor will do an analysis and recommend further treatment, testing, and referrals, as needed.

To gain access to hospital, diagnostic, or poliklinika services, a referral from a public general practitioner that has a contract with HZZO is required. This referral is called an “uputnica”, phonetically pronounced “oo-poot-neat-suh”. It is also often called “crvena uputnica” (red referral) because it is red.

An uputnica is an order of sorts, used for diagnostics such as blood and urine tests, prescriptions, further medical examinations, and even surgery. Your family doctor provides the uputnica, which is why that is your first stop. For example, if you have to visit a dermatologist, first, you must get an uputnica from your family doctor and then visit the dermatologist. [Read: List of doctors and doctor offices in English and Croatian]

Uputnica is critical when using the Croatian healthcare system. They are used at every level of healthcare, from simple blood tests to the anesthesia required for surgery. Until October 2020, uputnica from family doctors was issued in paper form. Since then, uputnica is issued in a digital form and it is now called “e-uputnica”.

So, after your doctor issues an e-uputnica, it will automatically be sent to the next doctor you have to visit (a specialist), a laboratory (if you have to do a blood test), or where ever you have to go next. While issuing e-uputnica, your family doctor can also pick the term of your further medical examination or you can do it via the e-Građani online app.

Once you do the medical examination and get results, they will be automatically sent to your family doctor. You can also view results via the e-Građani online app.

Croatian healthcare costs

Health care contributions in Croatia are mandatory for all employed citizens and are paid for by their employers. Dependents of employees obtain their health care coverage through contributions paid for by working members of their families if they meet certain requirements. Self-employed workers in Croatia are also obliged to pay health care contributions on their own.

Croatian residents have the option to obtain health services with private health care providers who are not HZZO contracted partners, either through direct payment or through supplemental insurance which covers the payment.

All residents of Croatia are required to have obvezno insurance through HZZO even if they choose not to use it or if they choose to use private insurance – unless you are an EU/EEA citizen or permanent residence with state health insurance from another EU/EEA member state.

Health insurance premiums do not vary based on residency status but may change at the prerogative of HZZO. Check out this post to find the premium for your specific situation.

What has your experience been like with Croatian healthcare? Tell us in the comments.

See other healthcare posts


Sources:
https://hzzo.hr/
https://zdravlje.gov.hr/arhiva-80/ministarstvo-zdravlja/djelokrug/709
https://zdravlje.gov.hr/arhiva-80/ministarstvo-zdravlja/zdravstvene-ustanove-u-republici-hrvatskoj/656
https://zdravevijesti.hr/kako-odabrati-lijecnika-opce-prakse/
https://hzzo.hr/poslovni-subjekti/novosti/e-uputnice-zamijenile-papirnate-uputnice

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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