Have you ever wondered about the healthcare systems in Romania? Do you want to know more about the public health system and about the option of making a private health subscription at a private hospital or even a private health insurance?

Find out more from our lawyers, below!

The situation of the health system in Romania

Romania has a public health system which anyone can access for free in case of an emergency. For example, if you’ve been in a car crash, you’ll be transported to the hospital, doctors will investigate you and will help you to get healthy without paying any fees.

Also, part of the Romanian health system, if you pay your contributions on time, you are insured in the public health system, for any type of visit. According to Romanian law, as long as you are paying the contributions, you need to enroll on a general practitioner’s (family doctor) lists who will take care of your general health and he can also refer you to a specialist in order to have an in depth analyze of your conditions, if necessary.

Am I insured in the public health system? What are the requirements to be insured?

In order to be insured in the public health system, there are usually 3 common ways:

• you need to either be an employee, in this case your employer retains a part of your salary and pays it to the Romanian state, therefore you are insured based on the tax declarations submitted by your employer, you don’t need to pay anything. However, you should make sure the health authority has your CNP number registered;
• you can be a freelancer or the owner of a company and if you surpass minimum dividend threshold of 4.500 euro (the certain threshold in 2023), you have to pay the minimum contribution to the Romanian health system;
• you can be insured on demand by paying 450 euro to the state for 1 year of health insurance;
• if you are under 18 years old or you are student in Romanian University and as long as you are under 26 years old, you are insured by law.

There are more situations in which you can be insured, but these are the most important ones.

What are the current healthcare contributions?

At present, there is a 10% contribution to the health system for all employees, which is not capped, so it does not have a limit off of your salary.

If you are a freelancer, there are 3 brackets that if your revenue surpasses, you will pay 10% of the value of the bracket. The threshold for these contributions is:

• 4500 Euro
• 9000 Euro
• 18000 Euro

So, at the moment if you are a freelancer, each time you surpass these brackets you are going to pay 10% of the bracket. There are some discussions at the moment in order to eliminate the backets for the freelancers and have the same taxation as employees, but there is no official decision.

How can I check if I am insured?

Regarding the insurance status, do note that the Romanian public health system works based on your CNP number, so once you have a residency permit you will have a CNP number. The CNP number is the national person identification number.

Based on the CNP number you can check your insurance status with the national health system. If you search SIUI CNAS you will find the national health system website on which you can check your status, here.

If you are paying the contributions and you do not find yourself in the system, do note that you will need to go to the local health insurance house to get your CNP into the system.

What are the differences between public health insurance and private clinics subscription?

The answer to this question will be given in a personal note. In Romania, the private health system works technically like the national health system.

The short answer to the question if a subscription to the private system makes sense economically is no, not really. There are many private hospitals that are enrolled in the public system; therefore, you will get all the benefits (appointments by phone, free consultations) and you will go to the private hospital for these services. Basically, you’ll have two insurances at the same time, but the subscription to the private clinics it’s just a subscription.

The disadvantages of having a private subscription are also notable, you will be paying even if you don’t use the subscription, many of the hospitals require you to go to a prior consultation before having access to a specialist, so you are still wasting time with the process.

Therefore, the best way, from a personal point of view, is to be enrolled in the public health system, preferably to have the family doctor (as we call it in Romanian; as a better translation I “general practitioner”) at a private hospital and when necessary, pay out of pocket if you need certain services.

Differences between public health insurance and private health insurance

The private health insurance is better than the private clinic subscription as you have access to more clinics, you are not tied up to one clinic and usually they offer multiple benefits like going directly to a specialist. The private health insurance also has a direct payment to the clinic, so you would just mention your CNP number and they will find you in the system and bill the insurance company.

Be aware that as an expat it is mandatory for you to enroll and pay the contribution to the health system even if you are not using it. So as an expat it’s mandatory to have the state health insurance.