High-end healthcare in 3 parts

by Brett Andrews

About Croatia Healthcare

Croatia’s universal healthcare system provides a mandatory public system that all residents and citizens pay into monthly. Known as obvezno, this public health insurance scheme is administered by the Croatian Health Insurance Fund (HZZO). Croatia’s system centers around solidarity and reciprocity: residents contribute according to their ability and receive basic care according to their needs. 

Croatia’s health insurance system consists of three parts: obvezno, the mandatory basic public plan; dopunsko, a supplement that covers most copays; and dodatno, private supplemental insurance that covers more robust healthcare needs like specialists and extended hospital stays. Digital nomads and permanent EU residents with state insurance elsewhere are exempt from Croatia’s mandatory state coverage.

Service in the public system is excellent and inclusive, ranking in the top 25% worldwide. Many doctors do speak English. Expats who only carry obvezno should expect to pay copays for most services, including doctor visits, prescriptions, and medical tests.

Two forms of private health insurance supplement the public scheme in Croatia. While the government owns all hospitals, private coverage can offer access to private clinics. Instead, they expand coverage from obvezno by covering copays (dopunsko) or eliminating waitlists for treatment (dodatno). Many expats carry all three insurances for the best medical service available.

Pharmacies, known as LJEKARNA, are identified by the green “+” and can be found in most neighborhoods. Public doctors issue electronic prescriptions that can be picked up at any location with your HZZO card; private doctors issue paper prescriptions. Unlike US pharmacies, ljekarnas only sell medications and other health products.

Finding a Physician

Most expats find an English-speaking general physician (GP) through referral by friend, expat Facebook group, or US Embassy. Everyone must have a GP to use the HZZO public system; your GP is the first point of contact for non-emergency medical treatment. Residents get assigned a GP according to their address; follow this guide to change to your English-speaking doctors.  

Your GP issues an electronic referral (e-uputnica) for all other outside services, including specialists, diagnostic tests, and more. Results for all medical procedures get similarly returned to the GP; you can also track your records via the e-Gradani web portal.

Public Healthcare

Croatia requires all residents to carry obvezno, the state health insurance plan. Expats on a temporary or permanent residency visa must register for it after 90 days in the country. Digital nomads and EHIC holders are exempt from this requirement but may participate.

Monthly obvezno premiums are 16.5% of gross salary—about $85 to $225 per month, per person. This applies to pensioners on a retirement visa. Non-EU citizens may have to pay the previous 12 months’ premiums to the HZZO system (~$850) when first registering for state insurance.

Obvezno coverage subsidizes primary healthcare, specialists, hospital stays and prescriptions, collecting 20% copays per service. Expats can add dopunsko (supplemental insurance) for ~$10 per month to cover these copays. While high quality, public facilities can see waitlists several weeks or months long for outpatient procedures.

Private Healthcare

Dodatno is a private insurance supplement you can buy in addition to the public obvezno plan. Longstanding expats in Croatia recommend carrying obvezno (baseline), dopunsko (copays) and dodatno (robust service) for the highest quality healthcare at the lowest cost.

Insured expats gain priority service in public hospitals, bypassing lengthy waiting lists for procedures. Dodatno also covers sistematski pregled, an early disease detection exam whose wait list can approach two years. Between extra exams and eliminated wait times, adding the private option is well worth the investment.

The Expat in Croatia site says that dodatno premiums range from $170 to $1000 annually, depending on age, services, and current health. You can purchase dodatno from certain Croatian banks or private insurers like Cigna Global.

Out-of-pocket Options

Living in Croatia while uninsured isn’t an option. With Croatia’s mandatory insurance plan in place with HZZO, paying out of pocket is a choice for digital nomads or EU nationals. Even then, you must have health insurance that covers you during your stay. Resident expats can carry obvezno coverage and still pay out of pocket for private doctors and clinics for additional services, if they so choose. 

Healthcare Checklist

• Schedule final appointments with your primary care physician and any specialists you see.
• Research your medications for availability in Costa Rica and find alternatives where needed.
• Stock up on prescription refills until you can get to the pharmacy in Costa Rica. It’s a dance because you’ll save money by filling your prescriptions in country, but it may take time for you to learn your way around. 
• Print out and keep photographic records of all prescriptions. Bring meds in original packaging with a letter from your doctor detailing your condition, the drug, and its generic name.
• Request your medical records and, ideally, upload them to a cloud server where you can access them anywhere. Alternatively, printouts, desktop files, and thumb drives also work.
• Ask your providers for referrals abroad. You never know!
• Maintain private insurance and have cash on hand to handle medical expenses while you apply for residency.
• For public healthcare, you’ll be able to register in the HZZO system during your residency process. Plan on paying about $850 upfront before paying monthly premiums on your obvezno state insurance.
• For private healthcare, apply for private insurance and get physician names. Visit your expat Facebook group or other forums to ask for recommendations. Add dopunsko & dodatno for best cost.
• See your family doctor and get prescriptions and referrals.