Croatia’s state health care obavezno insurance, what it costs and what is included

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In Croatia, there is both public and private health insurance that can be used with both public and private healthcare providers. HZZO, the state health fund, offers two options for health insurance:

  • Obavezno – Mandatory coverage for all residents
  • Dopunsko – Optional supplemental coverage

Since basic obavezno health insurance is required of all residents, it is important to understand what the costs and covers before moving here. Be forewarned, it might give you sticker shock.

In this post, we’ll cover how everything you need to know about Croatia’s required state health insurance called “obavezno” including:

  • What is included
  • Who must pay for obavezno health insurance
  • What is costs, for all work, citizenship and residence situations
  • Basics of dopunsko supplemental state insurance

This guide can help you plan your personal healthcare costs in Croatia and it can also help future business owners plan for the cost of employees. Employers are required by law to cover the cost of their employee’s basic obavezno health insurance.

What does obavezno state health insurance include?

Obavezno health insurance is offered through the state agency HZZO. This health care coverage is made up of 2 parts:

  1. Zdravstvena zaštita (health care)
  2. Novčana naknada (financial compensation)

Zdravstvena zaštita (health care)

The health care side of obavezno refers to your ability to get subsidized healthcare treatment from doctors or facilities that are in the HZZO system.

Since it is subsidized, you will pay a small co-pay in most cases for doctor or hospital visits as well as for most medications. To eliminate this co-payment, you must sign up for dopunsko supplemental coverage.

With obavezno, you have a right to:

  • Primarna zdravstvena zaštita (primary health care)
    • Family doctor
    • Gynecologist
    • Pediatrician
    • Dentist
    • E-uputnica (electronic referrals for laboratory tests)
  • Specijalističko-konzilijarna zdravstvena zaštita (specialist-consultative health care)
  • Bolnička zdravstvena zaštita (hospital health care)
    • Hospital treatment
    • Uputnica (referral)
    • Putni nalog (travel warrant)
  • Medicines from osnovna lista lijekova (basic list) and dopunska lista lijekova (additional list) as determined by the HZZO
    • E-recept (electronic prescriptions for medicines that can be picked up at a pharmacy)
  • Dental aids from osnovna lista (basic list) and dopunska lista (additional list) determined by the HZZO
  • Orthopedic and other aids from osnovna lista (basic list) and dopunska lista (additional list) determined by the HZZO
  • Urgent health care in other EU member states

Novčana naknada (financial compensation)

In addition to standard health care, you also have a right to financial compensation related to medical issues.

The situations in which you may receive financial compensation from HZZO through your obavezno insurance include:

  • Salary compensation during temporary inability to work
  • Salary compensation due to inability to perform working activities that prevent earning other types of income
  • Compensation for transport costs due to the use of health care from obavezno zdravstveno
  • Compensation for accommodation costs to a parent or a person who’s caring for a child during child’s hospital treatment

Cost of basic “obavezno” public health insurance and who must pay for it

Basic health coverage through HZZO is charged depending on your situation. These are the situations that affect the cost of your health insurance:

  • If you are not employed by a Croatian company and do not collect unemployment
  • If you are employed by a Croatian company
  • If you are an EU citizen
  • If you are unemployed and collect unemployment
  • If you are unemployed and married to an employed person
  • If you are working as a freelancer for a Croatian company
  • If you are retired and earn a foreign pension
  • If you are retired and earn a Croatian pension
  • If you are under 18 years old and the child of a Croatian or EU citizen
  • If you are under 18 years old and the child of third-country citizens
  • If you are a college student and under 26 years old
  • If you are considered “low income”
  • You are in a protected group

Now, we’ll go over each individual situation and cover the health insurance premiums.

You are not employed in Croatia, but don’t collect unemployment in Croatia either

This situation covers a good chunk of the foreigners living in Croatia. Perhaps you live here, but you earn an income that comes from abroad or maybe you’re just financially independent.

In this case, you pay the standard rate of ~550 kuna per month. When you start your policy, you will also need to pay for an extra 12 months for the previous year before you arrived in Croatia, which equals about ~6.600 kuna.

Depending on the basis for you residence permit, the police may only require some kind of travel insurance for your permit application. This is because it’s unclear if you’ll be approved for residency. Once you are approved, you will be required to register for state health insurance.

You are employed by a Croatian company

If you are an employee in Croatia, your company is required by law to pay for your obavezno health insurance as part of your salary. If you own a Croatian company, then you are required by law to pay yourself a salary, which will include pension and health insurance.

In this case, the cost of your health insurance is calculated based on your total salary. In terms of salary, there is neto and bruto. Neto salary is the net amount you get paid on your bank account each month. Bruto salary is the amount you receive on account, plus taxes and pension.

The health insurance premium is 16,5% of your bruto salary amount, then is added on top of bruto. For example, if your bruto salary is 6.000 kuna, then your health insurance cost is 990 kuna. This brings the total monthly employment amount that your employer must spend to employ you to 6.990 kuna.

You can use this calculator to play with the bruto salary to calculate health insurance costs as well as pension and taxes. Please note that if you’re using this calculator to also estimate taxes, keep in mind that the percentage charged for “porez i prirez” varies from city to city.

You are an EU citizen

EU citizens can continue to use their existing state health care from their native country as long as they are paying into the system in their native country. However, they can only use their foreign state insurance in Croatia for urgent care. For regular, non-urgent health care, you must return to your home country. To get access to urgent care, you will need your EU health insurance card.

If you are an EU citizen that is no longer paying into the state health program in your home country after moving to Croatia, then you must start a new policy with HZZO. In this case, you will pay 548 kuna per month plus the initial payment of 6.576 kuna. HZZO may also request that you provide proof from the state health insurer in your home country that you no longer have a policy.

You are unemployed AND collect unemployment from Croatia

Unemployed people can request that their HZZO health insurance premium be covered by the state only if they notify HZZO within 30 days of losing their job. It should be noted this only applies to those that lose their job at a Croatian company. As part of this process, you’ll also have an interview with HZZ (a different agency) upon losing your job.

You are unemployed AND married to an employed person

If you are unemployed and married to someone who is employed by a Croatian company, then you will be automatically covered through your spouse without any additional cost.

You are working as a freelancer for a Croatian company

This is a rare case, yet still has its own unique rate for health insurance. It is a rare case because hiring a freelancer is, quite frankly, a pain in the ass for any Croatian company.

When hiring a freelancer, there must be a contract that defines the amount they will be paid and the term in which it will be paid. On top of this amount, the employer must pay for health insurance, taxes and pension. There are two pension funds, so the company must pay into the pension funds for which the freelancer is registered. Some are only in one, some are in both. For all of these reasons, freelancers are usually just paid in cash to avoid this whole mess.

In the case where a freelancer is hired properly and legally, the health insurance cost is calculated as 7,5% of their bruto payment and is paid for by the employer.

You are retired AND earn a foreign pension

From the start, it is important to mention that HZZO will only know if you are collecting a foreign pension if you tell them. You are obligated to tell them. However, if you don’t know you are obligated to tell them, then it is possible nothing will ever come of it especially if you are not receiving your foreign pension on a Croatian bank account. Please also note that you may be obligated to pay income tax on your pension depending on the treaty Croatia has with your pension country.

If you notify HZZO of your foreign pension, you will be charged 16,5% of your pension payment for health insurance. If you are receiving a pension from a western nation with a higher cost of living, 16,5% can be quite a hefty chunk of money.

Side note: Depending on the treaties Croatia has with your country, you may also be required to pay income tax on your foreign pension. If you wish to consult with an attorney or accountant to find out if you are liable for income tax, contact me.

You are retired AND earn a Croatian pension

The amount you owe for health insurance is calculated based on the amount of your pension in comparison to the average Croatian salary for that year. If your pension is lower than the average salary, you pay 1% of your pension for health insurance. If your pension is higher than the average salary, you pay 3% of your pension.

You are under 18 years of age and the child of a Croatian or EU citizen

Children under 18 years have a right to health insurance (given that their parents or foster parents are EU citizens). The cost of their obavezno policy is covered by the state.

You are under 18 years of age and the child of a third-country citizen

Children under 18 years whose parents are third-country citizens are treated just like their parents. They must have their own health insurance policies with the monthly premium of ~550 kuna. The 1-year of back pay of ~6500 kn must also be paid for each child.

You are under 26 years of age and a student

If a child goes on to college after high school and is under 26, they retain their right to health insurance through their parents or foster parents. The cost of their obavezno policy is covered by the state.

You earn less than the “low income” threshold

Citizens with low income are exempt from paying health care premiums for obavezno. The low income threshold is calculated based on the person’s total income in the previous calendar year, per family member, as it compares to the average national salary.

If it is a family, income must be lower than 1.516,32 kuna per family member per month or 45,59% of the average national salary. If it is a single person, income must be lower than 1.939,39 kuna per month or 58,31% of the average national salary.

You are in a protected group

There are certain groups that can get free basic insurance through HZZO including:

  • Children of dependents that are incapable of living and working independently
  • People with residency in Croatia that are incapable of independent life
  • Family members of dead or missing Croatian armed forces members
  • Disabled members of the Croatian armed forces

Cost of supplemental “dopunsko” public health insurance

Dopunsko is an optional health insurance supplement that covers many co-payments that may be charged when visiting the doctor or filling prescriptions at the pharmacy. To learn more about what dopunsko is and why you should have it, read this post.

There are less variables when it comes to the cost of dopunsko. The cost varies depending on your age and from where you get the policy. You can get it directly from HZZO or you can get it from a bank or private insurance company.

The cost of dopunsko usually varies from 40 kuna to 80 kuna per month.

There are some groups of people who are entitled to free dopunsko. These groups include:

  • Children under 18 years
  • People with disabilities resulting in 100% body damage
  • People with mental or physical diseases who can’t perform certain activities on their own
  • War veterans with at least 30% body damage
  • Parents with 3 or more children under 18 years
  • Victims who experienced sexual violence during Domovinski Rat (Homeland War)
  • Organ donors
  • Blood donors – Women must give more than 25 times and men must give more than 35 times.
  • Low income people – As defined by the thresholds defined earlier in this post.

EU citizens whom are using health insurance from their home country cannot get dopunsko because it is considered a supplement to the obavezno policy through HZZO. If you don’t have obavezno, you cannot get dopunsko.

Other health insurance options

There is a higher level supplemental insurance above dopunsko called “dodatno”, but the is a private-only policy so we won’t dive into the costs of this here since it isn’t public, but you can read about it on this post.

What was your experience with HZZO health care? Tell us in the comments.

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10 thoughts on “Croatia’s state health care obavezno insurance, what it costs and what is included

  1. Jerry Vlasic
    May 31, 2020 @ 6:15 pm

    If you are retired AND earn a foreign pension, I see the cost can be much higher. Is the cost the same (16-plus%) if you are a Croatian citizen and earn a foreign pension, or does this higher cost only apply to non-Croatian citizens who earn foreign pensions? I enjoy your website.

    {reply}

    • Expat in Croatia
      June 1, 2020 @ 10:29 am

      Hi Jerry,

      Thanks for following!

      The amount a Croatian citizen receiving a Croatian pension owes for health insurance is calculated based on the amount of your pension in comparison to the average Croatian salary for that year. If your pension is lower than the average salary, you pay 1% of your pension for health insurance. If your pension is higher than the average salary, you pay 3% of your pension.

      Regards,

      Sara

      {reply}

      • John Nesbitt
        June 2, 2020 @ 5:57 pm

        Hi Sara,

        I wanted to ask a question regarding health insurance costs. I am considering moving abroad and am interested in Croatia. If I have just my social security from the states, how would that factor in in terms of health care costs if I disclosed it as such?

        Any insight is appreciated.

        Best,

        John

        {reply}

        • Expat in Croatia
          June 3, 2020 @ 1:39 pm

          Hi John,

          Thanks for the question!

          In this post, we have a section for foreigners receiving foreign retirement. This would apply to you since you are receiving social security. Look for the section called “You are retired AND earn a foreign pension”.

          Regards,

          Sara

          {reply}

  2. Amelia Green
    June 20, 2020 @ 6:22 pm

    Hello Sara,
    I am from the US and will be attending college in ZG in the fall. I am under 26 years old. How do I apply for health insurance and how much should I pay?

    Thanks,
    Amelia

    {reply}

    • Expat in Croatia
      June 22, 2020 @ 11:18 am

      Hi Amelia,

      Thanks for the question!

      You will pay the standard rate of ~550kuna per month for health insurance. You can apply at the closest HZZO office to your residence in Croatia. You’ll need to show that you are residing in Croatia or that you are in process of applying for residence. MUP can provide you with the necessary proof.

      Regards,

      Sara

      {reply}

  3. Erin
    July 24, 2020 @ 5:51 am

    In regards to childrens’ right to insurance: Assuming two third-country nationals jump through all of the necessary hoops to obtain the 1 year residency permit and pay the lump sum for the previous year as well as the monthly ongoing cost, will their children be insured? Or will this couple incur an additional previous year lump sum due plus ongoing monthly costs for each child?

    {reply}

    • Expat in Croatia
      July 31, 2020 @ 12:17 pm

      Hi Erin,

      Thank you for the question! After receiving it, we called HZZO to confirm the answer to this. Children of third-country nationals are not covered through their parents. They must have their own policies, which includes the monthly premium PLUS the previous year payment. They are treated just like their parents. We’ve updated this post accordingly.

      Regards,

      Sara

      {reply}

  4. Michael Zulim
    August 11, 2020 @ 5:24 am

    Hi, question on insurance on a foreign pension. Is that 16.5 % per month of my salary or is it a yearly cost? Do I have to provide them with a pay stub or such as my pension would be pretty high for Croatian standards. Does a US pension need to pay taxes in Croatia? Thank you

    {reply}

    • Expat in Croatia
      August 13, 2020 @ 1:31 pm

      Hi Michael,

      It is 16,5% of your monthly pension income, which is proved by some kind of pension income statement. Yes, it is an EXTREMELY high amount to pay for health insurance, which is why most pensioners just don’t tell HZZO about their foreign pension.

      Croatian residents are “supposed” to report their worldwide income.

      Regards,

      Sara

      {reply}

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