Health

Krka, pharmaceutical company in Novo mesto produces generic medicinal products. Photo: Primož Lavre

The telephone number for the emergency medical assistance and ambulance service is 112.

The level of health care in Slovenia, provided through the public health service network, which also includes private service providers on the basis of concessions, is entirely comparable with the level of health care in the advanced countries of Europe.

Primary health care services in Slovenia are organised locally, such that they are equally accessible to all people without discrimination.

Health Insurance

The system of health insurance is divided into compulsory health insurance, voluntary health insurance for additional coverage, and insurance for services that are not a constituent part of compulsory insurance.

Compulsory health insurance

The compulsory health insurance covers all population with permanent residence in Slovenia which is covered under the unique compulsory insurance scheme either as mandatory member or as their (family) dependants. Virtually the entire (100%) population is insured.

Compulsory health insurance is provided by the Health Insurance Institute of Slovenia (Zavod za zdravstveno zavarovanje Slovenije). All employed and self-employed persons and all retired persons who receive a pension from a Slovenian insurance provider are insured under the health insurance scheme. The status of insured person can also be obtained by the family members of the insured person if they do not have the possibility of entering the scheme on another basis and if they have permanent residence in the Republic of Slovenia (unless it is defined otherwise by international agreement).

A child is health insured as a family member up to the age 15 years, or up to the age of 18 years if (s)he is not insured in other way, and after this age if he is attending school, i.e., to the end of regular education.

Compulsory health insurance does not always cover all health care services and not in full prices. The following are some of the services granted to be covered in full price by compulsory insurance:

  • all health programs for children and youth: diagnosis, treatment and rehabilitation of diseases and injuries suffered by children, schoolchildren, minors with developmental impairments and students, as long as they attend school;
  • counselling in family planning, contraception, pregnancy and childbirth care to female patients;
  • services pertaining to programmes of preventive care, diagnosis and treatment of infectious diseases, including HIV infection;
  • treatment and rehabilitation of occupational diseases or injuries, malignant diseases, muscular or muscular nerve diseases, mental diseases, epilepsy, haemophilia, paraplegia, quadriplegia and cerebral palsy, as well as advanced diabetes, sclerosis multiplex, and psoriasis;
  • medical services related to the donation and transplantation of tissues and organs, emergency medical treatment, including emergency transportation, nursing care visits, and treatment and care in the home and in social institutions;
  • long term nursing care as home visits, and provision of treatment and home nursing in social care institutions, etc.

In the cases of all other services, the compulsory health insurance covers just certain percentages of their full prices. The difference to the full price shall either be covered by the insured person himself, or can be covered by the voluntary health insurance policy.

Voluntary health insurance

You can also take out voluntary health insurance provided by insurance companies in order to acquire additional entitlements. It is advisable to insure yourself for the difference in the full value of health services that are not covered in full by the compulsory health insurance scheme. The majority of the population is included in a voluntary health insurance scheme.

The Health Insurance Card

The health insurance card is electronic personal document, issued, free of charge, to every person upon the first regulation of the compulsory health insurance status. The card needs to be presented at a doctor visit.

The European Health Insurance Card

Introduced in June 2004, the card substantially facilitates access to medical assistance for EU citizens travelling to another Member State. Furthermore, it guarantees a quick and simplified reimbursement of expenses incurred locally or shortly after return to the place of residence. Since 1 January 2006, the European Health Insurance Card is issued and recognised by all concerned countries and replaces the previously used paper forms.

The European Health Insurance Card is issued to:

  • EU nationals,
  • nationals of the European Economic Area (EEA),
  • Swiss nationals,
  • family members of the above, whatever their nationality,
  • nationals of other countries, who are covered by a social security system in one of the Member States of the EU, the EEA or Switzerland.

Your EHIC should be requested from the national health insurance institutions before leaving for Slovenia.

Benefits

While the main purpose of the European Health Insurance Card is to ensure easy access to health services during a temporary stay in another country, it also provides a series of additional benefits, for healthcare providers, patients and insurers alike. The main advantages of the EHIC may be summarised as follows:

  • facilitated access to health care abroad,
  • quick and easy reimbursement of expenses,
  • security of data,
  • improved reliability,
  • less administration,
  • simplicity – simpler and faster procedures for obtaining healthcare.

It is important to note that the health insurance card does not provide for cases in which a patient intentionally decides to obtain medical treatment abroad. Rather, it is intended to insure people travelling to other countries for a limited period and thus covers medical care which becomes necessary during a stay on the territory of another Member State. When a need for access to healthcare arises, treatment will be provided according to the rules of that particular country (for example if healthcare is free of charge in that Member State, the visiting patient will also be entitled to free medical care when presenting his/her European Health Insurance Card).