Expat insurance and health insurance in Albania

The Albanian healthcare system relies on a single public fund, the Fondi i Sigurimit të Detyrueshëm të Kujdesit Shëndetësor (FSDKSH), the mandatory health insurance institute created by law no. 7870 of 13 October 1994. Initially limited to reimbursing medication, its scope expanded to general and specialist medical care in 2007, then to hospital care in 2009, making it the sole payer for most public health spending, under the supervision of the Ministry of Health and Social Protection. An employee legally hired in Albania — including a foreign national holding a valid work permit — is automatically affiliated by their employer, which opens access to primary care, specialists on referral and hospitalisation within the public network. Hospitalisations remain subject to a 10% co-payment for most profiles, waived for children under 12, people with disabilities, war veterans and patients treated for tuberculosis or cancer.

Funding relies on a mandatory contribution of 3.4% of gross salary, split equally between the employer (1.7%) and the employee (1.7%), which is added to the other branches of Albanian social security managed under a separate scheme. France Diplomatie notes that the country has qualified doctors and several good-quality facilities, both public and private, but recommends that a serious emergency requiring hospitalisation be treated at a private facility or be the subject of a medical evacuation; an assistance contract covering all medical costs, surgery, hospitalisation and repatriation remains necessary for any stay, as these costs can in no way be covered by the French embassy.

• Stay of under 90 days: no visa required for a French citizen holding a passport valid for at least 3 months after the planned return date, or a valid national identity card, based on the regime specific to EU citizens (Albanian law no. 79/2021 and Council of Ministers decision no. 858 of 29 December 2021) — a regime distinct from the seasonal exemptions Albania grants each year to other nationalities, which expire on a fixed date.
• Lost or stolen document: a passport or identity card reported lost or stolen can no longer be used to cross the Albanian border, even if later found; the authorities systematically refuse entry with such a document, with immediate rerouting.
• Stay of more than 90 days: a residence permit must be requested within 30 days of arrival, at the police station of the place of residence.
• Local affiliation: mandatory for any employee working in Albania, via automatic affiliation to the FSDKSH through their employer, including for a foreign employee holding a valid work permit.
• Without local affiliation or private insurance: care is billed at full rate by the facility, public or private, rate varying by facility and not publicly disclosed in a uniform way.
• Student: no EHIC, as Albania is not an EU member (candidate since 24 June 2014, accession negotiations open since 19 July 2022); a student insurance policy or comprehensive travel insurance is essential, as no bilateral agreement steps in.
• Seconded employee: no social security agreement between France and Albania was identified in the sources consulted (CLEISS does not mention Albania on any list of agreements in force), which rules out any conventional continuation of French scheme cover; affiliation to the Caisse des Français de l’Étranger (CFE) and an assistance contract including international health insurance are recommended.
• Retiree: no conventional arrangement for local cover is available, for lack of a bilateral agreement; cover through the CFE or private international health insurance remains the only way to access care under good conditions.

No individual fine is mentioned in the sources consulted for lack of FSDKSH affiliation, but the employer remains required to declare their employee; for the expat themselves, the absence of any Franco-Albanian agreement makes the financial risk higher than elsewhere in the Balkans, with no help from the French embassy in the event of uncovered care.

As Albania is not a member of the European Union (candidate only since 24 June 2014, accession negotiations opened on 19 July 2022), coordination with France does not go through EU regulations 883/2004 and 987/2009. Unlike Bosnia and Herzegovina, North Macedonia, Serbia or Montenegro, Albania was never part of the Socialist Federal Republic of Yugoslavia and therefore inherited no Franco-Yugoslav agreement. CLEISS lists no bilateral social security agreement between France and Albania, neither among agreements in force nor among those signed but not yet applied: Albania appears on none of these lists.

• Temporary stay: in the absence of any agreement, no cover on the spot is available to a French tourist, whatever the length of stay; only travel insurance or an assistance contract taken out before departure allows effective cover.
• Secondment: no secondment form (SE 21-01 or equivalent) exists for Albania, for lack of an agreement; the situation of an employee sent on assignment must be clarified case by case with their French fund before departure, with no exemption from local contributions under a bilateral agreement.
• Long-term move (expatriation): direct affiliation to the FSDKSH via the employer, with no conventional recognition of French insurance periods for opening rights, for lack of a bilateral agreement.
• Retiree: no procedure for local cover by form (SE 21-34/35/36 or equivalent) exists for Albania; a retiree residing locally depends entirely on the CFE or on private international health insurance.

1. Before departure: notify French agencies of your departure (CPAM, CAF, France Travail, pension funds).
2. For any stay, including temporary: take out travel insurance or an assistance contract covering all medical costs and medical repatriation, as no bilateral agreement exists to step in.
3. Before a long-term move or secondment: contact your French fund and, where applicable, the CFE, for lack of a bilateral coordination form applicable to Albania.
4. Check the validity of your passport or national identity card (at least 3 months after the planned return date) and make sure neither document has been reported lost or stolen.
5. For a stay of more than 90 days: apply for a residence permit within 30 days of arrival, at the police station of the place of residence.
6. Employee hired locally: check with your employer that FSDKSH affiliation is effective.
7. Self-employed: affiliate and contribute directly to the FSDKSH.
8. Retiree: contact the CFE before departure, as no conventional local cover procedure exists for Albania.
9. Register with the roll of French nationals living abroad (French embassy in Tirana).