Why you must have health insurance

Photo by Pasárgada Comunicação

UPDATED: 16/12/2021

State health insurance is mandatory for most people in Croatia: students, temporary residents, and citizens alike. If you plan to live in Croatia for any amount of time, signing up for state health insurance in Croatia is inevitable (unless you are an EU citizen with a state policy issued in another EU member country or you are a digital nomad).

There was a time when Croatia required that you sign up for state health insurance as part of your residence application. With the influx of foreigners wishing to live in Croatia long-term, this has changed.

During your application for residence, you must now show that you have some other kind of insurance already. Then once you are approved for residence, you can go to HZZO and sign up for state health insurance.

In this post, we will cover:

The facts are these…

Available health insurance options in Croatia

In Croatia, there are three types of health insurance:

  1. Obvezno zdravstveno osiguranje – public basic health insurance
  2. Dopunsko zdravstveno osiguranje – public or private supplemental health insurance
  3. Dodatno zdravstveno osiguranje – private supplemental health insurance

When it comes to the Croatian government, not all insurance policies are created equal. To meet the health insurance policy requirement for all residents, you must obtain obvezno insurance through HZZO (the Croatian Institute for Health Insurance).

[Read: Health care and health insurance in Croatia]

How to get state health insurance

The procedure and requirements for getting Croatian state health insurance vary a bit depending on if you are a national of the European Union or not. Below we will explain the differences.

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

EU Citizens

If you plan to live in Croatia and are a citizen from an EU/EEA member state, you are allowed to keep your state health insurance policy from your home country for the purpose of gaining residence and living in Croatia once approved.

When applying for residence, you can show your EHIC (European Health Insurance Card) provided by your home country. Your EHIC gives you access to urgent care while in Croatia.

If you want to have access to all healthcare services, then you will need to sign up for HZZO obvezno insurance. To enroll, you must provide a document from your public health insurance provider in your home country that shows you are no longer insured.

This document will vary by country. Call your home state insurance provider and tell them you are moving to Croatia and need to provide Croatia with proof that you are no longer insured by the state policy in your home country. HZZO can check this for you, but it can take a few weeks for them to do it.

You’ll need to take this document to HZZO who will provide you with the necessary documentation to get healthcare. Once you sign up, you’ll be obligated to pay the monthly premium per month UNLESS you are employed by a Croatian employer, in which case they are required to pay your premium on your behalf as part of your salary.

HZZO requires that all new enrollees pay 12 months of premiums for the previous year before moving to Croatia. If you are an EU citizen, you can get out of this only if you can prove you were covered for those 12 months by some other insurance policy.

Croatian Citizens

Croatian citizens that are signing up for HZZO for the first time (and are not employed by a Croatian company) must pay 12 months of back pay. They can get out of this if they can prove that they were insured for the previous 12 months.

Non-EU Residents

If you are not Croatian or an EU citizen and plan to stay in Croatia longer than 90 days, you’ll need to get national insurance through HZZO unless you are a digital nomad. Those on the digital nomad permit have the option to sign up for state health insurance once approved, but it is not required. They may continue to use their private policy if they wish.

It is important to understand that someone cannot simply walk into HZZO and apply. If you plan to stay here, you are probably working with the police (MUP) to obtain residency.

During this process, you’ll need to provide some kind of travel or private insurance as part of your application. Once you are approved for residence, you can go to HZZO to enroll.

Once you are signed up for national insurance, it takes 30 days to 3 months (sometimes longer) to get your insurance card in the mail. If you need healthcare during this time, you can obtain a letter showing proof of your coverage from HZZO.

There is a monthly cost for this insurance option, that is calculated annually based on the salary average. You can see the latest cost here. For new enrollees that are not from the EU, an initial payment totally of 12 months of premiums will be due in addition to the monthly payment going forward. They consider it back payment for the previous year.

How to find the HZZO office

HZZO has regional offices in all major cities, and branch offices for villages and islands. To find your local office, view HZZO’s complete office list. Click on the closest city to you to find the list of regional and branch offices.

What obvezno health insurance covers

“Obvezno” health insurance is public and state-funded. You can learn more about obvezno, how much it costs, and who must pay for it in this post.

Coming from a country like the United States without state health care, a state-subsidized health care option is definitely more affordable. The reality is that it has its advantages and disadvantages like anything else.

Many prescriptions are free or cost very little, but some common ones are not covered such as oral contraception. Visits to a doctor that is partnered with HZZO usually only costs about 10 kuna, or are free if you have the extra dopunsko insurance. Specialists are not always partnered with HZZO. In some cases, Croatians are willing to pay out of pocket to visit specialists to avoid the long waits.

An appointment with a private specialist can cost between 300 and 500 kuna ($45-75 USD) without insurance. If you are coming from the States, these prices are definitely a bargain but they are not if you are from, live, and work in Croatia.

In addition to the optional dopunsko supplement, you can also sign up for a private dodatno policy, which is the highest level of health insurance and covers a variety of additional tests, treatments, and procedures. You can learn about dodatno health insurance here.

Extra insights you should know about Croatian health insurance

It may take some months before your first bill shows up at your house. In my case, it took 7 months. However, that first bill included those 7 months in its entirety so be prepared for a big bill whenever it shows up. If you’re worried about it taking so long to get the first bill, considering that the premiums continue to stack up even without you receiving a bill, just go talk to Porezna uprava (tax office) and request your balance so you can pay it.

It’s important to note that you are obliged to pay the health insurance as long as you are here. It’s not something that you can decide not to pay for 2 years, then start up again. For your health insurance to remain active, you have to make every payment that is owed since you started the policy.

Before you step off the plane, boat, or train into Croatia, it is invaluable to know what to expect especially when it comes to your healthcare. To learn more about HZZO, visit their web site. To learn more about the system and how to navigate it, check our extensive post here.

See other health insurance posts

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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