Croatia’s state health care obvezno insurance – benefits and costs: Guide for 2024

health insurance
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UPDATED: 20.02.2024.

Croatia has public and private health insurance that can be used with public or private healthcare providers. Be forewarned, it might give you sticker shock.

Obvezno is required for residents, so it is vital to understand the costs and covers before moving here. Employers are legally required to cover the cost of their employee’s obvezno.

This guide can help you plan your healthcare costs in Croatia and help future business owners plan for the cost of employees.

In this post, we cover:

The facts are these…

Guide to Croatia’s mandatory health insurance

What does the Croatian obvezno state health insurance include

Obvezno health insurance is offered through the state agency HZZO and is made up of:

  • Zdravstvena zaštita (health care)
  • Novčana naknada (financial compensation)

Health care

Health care refers to your ability to get subsidized healthcare treatment from doctors or facilities in the HZZO system.

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

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

With obvezno, 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)
    • Medical examinations by specialist doctors – view a list in Croatian and English here
    • Uputnica (referral)
    • Putni nalog (travel warrant)
  • Bolnička zdravstvena zaštita (hospital health care)
    • Hospital treatment
    • Uputnica (referral)
    • Putni nalog (travel warrant)
  • Medicines from osnovna lista lijekova (basic list called List A) and dopunska lista lijekova (additional list called List B) as determined by the HZZO
    • E-recept (e-prescriptions for medicines that can be picked up at a pharmacy) – view a guide to medicine prescriptions here
  • Dental aids from osnovna lista and dopunska lista determined by the HZZO
  • Orthopedic and other aids from osnovna lista and dopunska lista determined by the HZZO
  • Urgent or necessary health care in other EU/EEA member states
  • Urgent health care in Bosnia and Herzegovina, Macedonia, Serbia, Montenegro, and Turkey per an international agreement on social insurance – a form is required prior to travel

Financial compensation

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

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

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

Who must pay for the Croatian obvezno and what are the costs

Basic health coverage through HZZO is charged depending on your situation, which may be one of the following:

We’ll go over each situation and cover the health insurance premiums.

You are not employed in Croatia or don’t collect unemployment

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

In this case, you will pay between 90 and 100 euro per month.

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

View a guide to finding a job here and getting travel insurance here.

You are employed by a Croatian company

If you are an employee in Croatia, your company is legally required to pay for your obvezno health insurance as part of your salary. If you own a Croatian company, you are required by law to pay yourself a salary, including 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 in your bank account each month. Bruto salary is the amount you receive in 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 800 euros, then your health insurance cost is 132 euros. This brings the total monthly employment amount that your employer must spend to employ you to 932 euros.

View how to apply for a work permit in Croatia here and a seasonal work permit here.

You are an EU/EEA citizen

EU/EEA citizens can continue to use their existing state health care from their native country as long as they pay into the system in their native country. They can only use their foreign state insurance in Croatia for urgent care. You must return to your home country for regular, non-urgent health care. You will need your EU/EEA health insurance card (EHIC) to get access to urgent care.

[Read: What is a European Health Insurance Card (EHIC)]

If you are an EU/EEA citizen who is no longer paying into the state health program in your home country after moving to Croatia, you must start a new policy with HZZO.

In this case, you will pay between 90 and 100 euro per month. HZZO will request that you provide proof from the state health insurer in your home country that you no longer have a policy.

If you are a UK citizen, we’ve outlined how health insurance will work specifically for you post-Brexit here.

[Read: How EU/EEA citizens (and Croats) can sign up for Croatian state health insurance]

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 (if they quit or got fired). This only applies to those who lost 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

In specific scenarios, the spouse of an employed person can get health insurance at no additional cost based on their spouse’s employment. There are three scenarios within this case.

Scenario #1 – If you are a Croatian citizen, you can be covered by your employed spouse’s health insurance.

Scenario #2 – If you are an EU/EEA citizen, you must have a temporary OR permanent residence to be covered by your spouse’s health insurance. The application procedure is standard. Go to HZZO and apply for health insurance.

Scenario #3 – If you are a third-country national, you can’t be covered by your employed spouse’s health insurance regardless of your spouse’s nationality or your residence status.

[Read: How to get married in Croatia (if at least one spouse is a foreigner)]

You are working as a freelancer for a Croatian company

This is a rare case, yet it still has its unique rate for health insurance. It is a rare case because hiring a freelancer is, quite frankly, a pain in the butt 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 these reasons, freelancers are usually paid in cash to avoid this whole mess (which is not legal, for the record).

When 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.

Learn more about hiring freelancers or working as a freelancer in Croatia here.

You are a digital nomad in Croatia

To qualify for residence in Croatia as a digital nomad, you must have private health insurance coverage for the entire term of your permit (up to 1 year). However, digital nomads are exempt from mandatory obvezno state health insurance in Croatia.

This means that you can sign up for state health insurance after you are approved for residence, but it is not required as it is with other types of residence.

View a guide to Croatian digital nomad residence permit here and frequently asked questions about it here.

You are retired AND earn a foreign pension

It is important to mention that HZZO will only know if you are collecting a foreign pension if you tell them. You MUST notify them. If you don’t know this, nothing may ever come of it, especially if you are not receiving your foreign pension in a Croatian bank account. You may be obligated to pay income tax on your pension depending on Croatia’s treaty with your pension country.

[Read: Do I need to open a bank account in Croatia?]

If you notify HZZO of your foreign pension, you will be charged 16,5% of your pension payment for health insurance since people with foreign pensions and prebivalište or permanent residence in Croatia are charged that amount. If you receive a pension from a Western nation with a higher cost of living, this can be quite a hefty chunk of money.

Tax administration calculates the exact amount for each individual. The percentage of health insurance is 16,5% of your pension. They will calculate the exact amount based on your pension, but the basis for calculation can’t be lower than the lowest monthly base and higher than the average salary. The lowest amount to pay is approximately 80 euros, and the highest is approximately 210 euros.

Contributions for people with a foreign pension are defined in Articles 130-134 of the Zakon o doprinosima (Law on contributions), which is available here.

NOTE: Depending on Croatia’s treaties with your country, you may have to pay income tax on your foreign pension. If you wish to consult with a tax advisor to determine if you are liable for income tax, contact us.

[Read: What are retirees looking for in Croatia?]

You are retired AND earn a Croatian pension

The amount you owe for health insurance is calculated based on the amount of your pension compared to the average Croatian salary for that year. As of April 2023, the obligation to contribute to health insurance is abolished for Croatian pensioners.

[Read: How to retire in Croatia]

You are a child of a Croatian or EU/EEA citizen younger than 18

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

You are a child of a third-country citizen younger than 18

Children under 18 years whose parents are third-country citizens and temporary residents are treated just like their parents. They must have health insurance policies with a monthly premium between 90 and 100 euro. The 1-year of back pay must also be paid for each child.

Only children of third-country citizens who are also permanent residents may be covered by their parent’s health insurance policy.

[Read: How to apply for temporary residence in Croatia based on family reunification]

You are a student younger than 26

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 if those parents are EU/EEA or Croatian citizens or third-country nationals with permanent residence. The cost of their obvezno policy is covered by the state.

[Read: How to study & gain student residence in Croatia]

You earn less than the “low-income” threshold

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

If it is a family, income must be lower than 331,81 euro per family member per month or 45,59% of the average national salary. A single person’s income must be lower than 415,42 euro per month or 58,31% of the average national salary.

You are in a protected group

Certain groups can get free basic insurance through HZZO, including:

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

What to do after being granted permanent residence in Croatia?

Once you are granted permanent residence in Croatia, you have the same rights to health insurance in Croatia as Croatian citizens. You are no longer treated as a foreigner, and you must change the status of your obvezno. You don’t have to change it if you are insured through the company where you work.

[Read: Rights of permanent residents in Croatia]

To change the status, contact the HZZO and sign up for the obvezno health insurance on another basis. If you don’t notify them, HZZO will send you the Rješenje – a notification explaining you are signed off from health insurance and must change your status (sign up on another basis).

There are over 50 categories on which people can sign up for obvezno health insurance in Croatia, defined in this rulebook.

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

How to check the status of your Croatian state health insurance

If you are unsure of your obvezno or dopunsko status, you can check your policy on the HZZO pages here. All you need is your OIB number. The page will tell you if your policy is valid or expired.

Who must pay the back pay when first signing up for Croatian health insurance?

HZZO requires that certain people pay a year of premiums for the previous year when first signing up for state health insurance, which costs approximately 1.000 euros. This can be frustrating, but it is based on a pragmatic reason.

Once someone signs up for HZZO, they are entirely insured. There is no waiting period until your health insurance kicks in. You can immediately get care, surgery, diagnostics, or whatever you need.

If you’ve just arrived in Croatia and immediately got surgery, you would not have paid enough into the system to cover that cost. The Croatian healthcare system cannot support that. To avoid a scenario where people cannot take advantage of the system, new insurance applicants must pay a year of health insurance premiums for the previous year when they were not in Croatia (in some scenarios).

EU/EEA and Croatian citizens who have had an EU/EEA state health insurance policy for the previous 12 months can get out of this back pay. They must bring a written confirmation to HZZO proving the exact period during the previous 12 months when they were insured outside Croatia. The back pay will be prorated if you were covered only a portion of the previous 12 months.

For example, a German citizen was insured by German state insurance for 10 of the previous 12 months before signing up for HZZO. They will have to back-pay premiums for 2 previous months and not the whole year.

[Read: Why you must have health insurance in Croatia]

What if you neglect to sign up for Croatian obvezno?

Having obvezno health insurance in Croatia is required, but there is no fine or penalty for not having health insurance.

If an adult person signs up for the first time and they have never been employed and signed up for health insurance, they would have to pay it retroactively for one year or less, depending on the situation.

Other health insurance options in Croatia

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. It can be covered by HZZO or a private company.

A higher level supplemental insurance is called dodatno, but it is private-only. Another option is a travel health insurance called putno.

View our guides on other Croatian health insurance:

View our other health insurance posts


Sources:
Doprinosi – Mirovina
Zakon o doprinosima
Mirovinsko

Please note: Information provided by Expat in Croatia is only for the purposes of guidance. It does not constitute legal or financial advice in any form. Croatian laws and bureaucratic rules often change, and each personal case is individual, so different rules may apply. For legal advice, contact us to consult with a licensed Croatian lawyer. For financial advice, contact us to consult with a licensed Croatian tax advisor or accountant.

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