Expat insurance and health insurance in Kosovo

Kosovo does not yet have a mandatory health insurance fund, unlike Albania (FSDKSH) or North Macedonia (FZO). A law establishing such a scheme was passed in 2014, but it still has not entered into force; a new bill, approved by the Kosovar government on 29 August 2024, provides for the creation of a mandatory health insurance fund, with contributions from employees and non-employees and exemptions for children, students, pensioners and the unemployed; its rollout is announced in stages over a five-year period. In the meantime, the public health system is funded by national and municipal taxes, under the joint oversight of the Ministries of Health, Labour and Social Welfare, and Finance. The public network comprises, according to CLEISS, seven regional public hospitals and a university hospital in Pristina; a private sector has developed alongside it, notably around American Hospital Pristina.

France Diplomatie describes a health system that "comprises public structures and several private clinics, whose equipment and quality of care provided vary", and recommends that in case of a serious health problem, repatriation be preferred to local care. An assistance policy or insurance covering all medical costs — including surgery and hospitalisation — and medical repatriation is therefore essential for any stay, as these costs can under no circumstances be covered by the French embassy on site.

• Stay of less than 90 days: no visa required for a French citizen holding a valid national ID card (CNI) or French passport, based on the usual 90 days in 180.
• CNI validity: French decree no. 2013-1188, which extends the national ID card's validity by 5 years, only applies in France; for the Kosovar authorities, the CNI's validity ends on the date printed on the card itself.
• Declaration of place of residence: since 15 March 2026, this declaration is mandatory within three days of entering the territory, online or at a police station.
• Stay of more than 90 days: a long-stay visa to be requested from the Kosovo embassy, then a residence permit to be requested from the Kosovar Ministry of the Interior.
• Travel insurance: an assistance policy or insurance covering all medical costs and medical repatriation is essential for any stay, including a short one, according to France Diplomatie.
• Local affiliation: with no mandatory health insurance fund currently in force, no individual health contribution is today required of an employee or self-employed person settling in Kosovo; the public system remains tax-funded, which does not exempt from private insurance for effective access to care.
• Student: no EHIC, as Kosovo is not an EU member; a student insurance or comprehensive travel insurance is essential, as the France-Yugoslavia agreement opens no on-the-spot cover for an ordinary French student.
• Seconded employee : continuation of the French scheme is possible under certain conditions, on presentation of the certificate of affiliation (form SE 21-01); the maximum duration of this continuation is not specified on the CLEISS pages consulted, to be confirmed directly with that body before departure. Affiliation with the Caisse des Français de l'Étranger (CFE) and an assistance policy remain recommended in addition.
• Retiree: no certificate is issued before departure; local cover, if the retiree has no local Kosovar rights, is processed on site with the Kosovar fund of their place of residence.

No individual fine is mentioned in the sources consulted for lacking health insurance, but the absence of a mandatory health insurance fund currently in force in Kosovo makes the financial risk particularly high for any expat with neither private insurance nor an assistance policy, with no help available from the French embassy for uncovered care.

As Kosovo is not an EU member, coordination with France does not run through EU regulations 883/2004 and 987/2009. It rests on an exchange of letters signed in Paris on 4 February 2013 and in Pristina on 6 February 2013, entered into force on 6 February 2013, by which France and Kosovo agreed, in the context of the succession of bilateral treaties, to continue applying the provisions of the general France-Yugoslavia social security agreement of 5 January 1950. This agreement coordinates all branches of social security except unemployment insurance, for employees of French or Kosovar nationality.

• Temporary stay: for a French tourist with no dual nationality, the agreement opens no on-the-spot cover; only a retroactive reimbursement of unplanned care, optional and not guaranteed, remains possible on return to France. An exception exists for a Kosovar national residing in France, returning home on paid leave: form SE 21-04 A (certificate of entitlement to benefits in kind), requested before departure, covers care during the stay, excluding planned care and repatriation.
• Secondment: the employee can remain on the French scheme under certain conditions; costs incurred on site can be submitted for reimbursement via form S 3125c, or a request sent to the Kosovar body with the certificate of affiliation (form SE 21-01). No maximum duration is specified in the sources consulted.
• Long-term move (expatriation): the employee becomes subject to Kosovar social security legislation; form SE 21-02 (certificate of French insurance periods), requested before departure, allows the Kosovar body to take into account periods already contributed in France. If the family stays in France, they can continue to benefit from health insurance under the employment carried out in Kosovo, via form SE 21-08, to be presented to the primary health insurance fund of their place of residence.
• Retiree: no certificate is issued before departure. A French retiree with no local rights in Kosovo must, once on site, contact the Kosovar social security fund of their place of residence, which checks the absence of local rights before forwarding form SE 21-34 to the French pension fund, which responds via form SE 21-35 (approval) or SE 21-36 (refusal). The accompanying spouse is not covered by this procedure.

1. Before departure: notify French agencies of your departure (CPAM, CAF, France Travail, pension funds).
2. For any stay, including a short one: take out an assistance policy or insurance covering all medical costs (surgery, hospitalisation) and medical repatriation, essential according to France Diplomatie.
3. Check the validity of your national ID card or passport: for the Kosovar authorities, the ID card is only valid until the date printed on it, disregarding France's own 5-year extension.
4. On arrival: complete the declaration of place of residence within three days, online or at a police station (requirement in force since 15 March 2026).
5. Seconded employee: request the certificate of affiliation (form SE 21-01) from your French fund before departure.
6. Long-term move: request form SE 21-02 (certificate of insurance periods) from your French fund before departure.
7. Family staying in France during expatriation: request form SE 21-08 from the local Kosovar fund to maintain health cover in France.
8. Retiree: contact CLEISS or your pension fund before departure to prepare the process, as it can only formally begin once on site.
9. For a stay of more than 90 days: contact the Kosovo embassy in France for the long-stay visa, then the Kosovar Ministry of the Interior for the residence permit.
10. Register with the roll of French nationals living abroad (French embassy in Pristina).