The Healthcare System in Albania: How a French National Accesses Care

The European Observatory on Health Systems and Policies describes a largely centralised system: the Ministry of Health and Social Protection directs health policy and coordinates the players, the State is the main provider of promotion, prevention, diagnosis and treatment services, and the Compulsory Health Insurance Fund is the main purchaser of care funded from public money. Funding combines taxes and compulsory insurance, with a tax base weakened by low incomes, the size of the informal economy and collection difficulties. Patients pay the full cost of services in private hospitals.

The country has about forty public hospitals and about twenty private hospitals, the latter mainly in Tirana; more than 2,000 health posts, more than 40 polyclinics and more than 360 primary care centres are recorded, after consolidations linked to internal migration towards urban and coastal areas. The private sector has grown in pharmacies, dental care and certain specialised diagnostics. France Diplomatie describes qualified and competent doctors and several good-quality public and private hospitals, while noting that some emergencies or complex cases may require priority private hospitalisation or evacuation abroad.

The FSDKSH lists the insured: employees, self-employed workers, voluntarily insured people, retirees, disabled people, war veterans, children, pregnant women, recipients of economic aid and jobseekers. Employees contribute 3.4% of gross salary, split half between employer and employee; the self-employed and voluntarily insured contribute on a base equal to twice the minimum wage, set by the Council of Ministers separately for towns and villages; the State covers economically inactive people. Contributions are collected by the tax administration.

For a foreigner, the number of the residence permit, or temporary residence permit, serves as the insured number. The health card is personal and non-transferable and contains the insured person’s identity number. People identified by an identity document appear in the electronic register of the insured, also accessible through the e-Albania portal. The details of registration (decree no. 307 of 2014) and of exemptions from direct payment (decree no. 955 of 2014) are on the Fund’s site. A French resident who works locally is therefore affiliated by their employer; other profiles check the voluntary insurance route with the Fund. See healthcare reimbursement in Albania.

According to the European Observatory, since 2016 all residents have had access to free primary care consultations and to emergencies, whatever their insurance status. Specialist consultations and tests are free or inexpensive when the family doctor refers the patient. The FSDKSH publishes activity statistics for family doctors, with more than a million consultations recorded since the start of a given year and online consultations rising sharply. The most efficient route is to register with a family doctor in the neighbourhood, then ask for a referral to the specialist.

The Mother Teresa University Hospital Centre in Tirana, which presents itself as the largest hospital in the country, is open 24 hours a day every day of the week and links its care to teaching at the faculty of medicine: its site mentions 3,048 employees, including 1,322 nurses, cardiology, oncology, neuroscience, paediatric, infectious disease and telemedicine services, as well as an outpatient consultation centre. The hospital’s site also mentions 110 teaching doctors and 308 specialists from the faculty of medicine. The private sector offers shorter waiting times and greater comfort, at the patient’s or their insurer’s expense. A medical file translated into English speeds up the handling of ongoing treatment.

The FSDKSH specifies that contributions are collected by the tax administration and that the State pays a contribution for economically inactive people, according to a per-capita amount indexed to inflation, set by the Fund and approved by Parliament with the annual budget. The reference texts cited are decree no. 307 of 2014 on the registration of the insured, decree no. 955 of 2014 on exemptions from direct payment and the voluntary insurance regulation. The health card, personal and non-transferable, allows its holder to use the system; its number is the insured person’s identity number, which for a foreigner corresponds to the residence permit number.

The Fund publishes each year the list of reimbursed medicines, as well as lists I (hospital pharmacies) and II (open network). According to the European Observatory, the Albanian tax base remains weak because of modest incomes, the size of the informal economy and collection difficulties: this fragility explains the value of supplementary cover for anyone wanting quick access to private services, whose growth is notable in pharmacies, dental care and certain specialised diagnostics.

The general emergency number is 112 (France Diplomatie, Safety page). The French embassy in Tirana (Rruga Skënderbej 14, +355 44 540703) cannot cover medical costs, and without cover access to care can be difficult, even in a life-threatening emergency. After a road accident with damage above 300 euros, the police must be called to obtain a report; an accident with injuries or deaths leads to 48 to 72 hours in police custody.

The FSDKSH publishes a list of reimbursed medicines, with a list I for hospital pharmacies and a list II for open-network pharmacies; the coverage rates can be read on these lists. France Diplomatie advises taking only what is strictly necessary, in the original packaging, with a prescription using the international non-proprietary name, checking that each medicine is authorised in Albania and never buying medicines from street vendors because of counterfeits. Tap water is generally advised against for drinking: sealed or treated bottled water is preferred.

France Diplomatie recommends keeping the usual vaccines up to date (diphtheria, tetanus, polio, whooping cough, measles). Depending on the length and conditions of the stay, it cites vaccines against hepatitis A and typhoid, hepatitis B for frequent or long stays, rabies (young children, rural or isolated stays) and tuberculosis for children under 15 on a frequent or prolonged stay. Yellow fever is required of travellers arriving from endemic zones.

The risks cited are typhoid, rabies (fatal once symptoms appear: consult immediately after any contact, even if vaccinated) and food poisoning, sometimes serious in Tirana as in the provinces. The Safety page adds the presence of the horned viper, hence the advice to take an extraction kit, and a high prevalence of Lyme disease, hence the tick remover and high socks. Albania lies in a zone of regular seismic activity. See also living in Albania and expat health insurance.