The Healthcare System in Kosovo: Public Funding, Private Insurance and Emergencies

CLEISS recalls it: the 2014 law establishing a compulsory health insurance has not come into force. A bill had been on the government’s agenda since 2022 and was approved on 29 August 2024, a preliminary step to its implementation. It provides for coverage of employees, the self-employed, voluntary insured persons and their dependants (spouse, children under 18, parents and parents-in-law), with exemption from contributions for children under 18, students aged 18 to 28, retirees, the unemployed, war veterans, people with disabilities and social assistance recipients.

In the meantime, care is financed by national and municipal taxes and accessible to all citizens in public facilities, notably emergencies, prenatal follow-up and basic care for children under 18. The Ministries of Labour and Social Protection, of Health and of Finance share oversight, the Tax Administration collects contributions and the Central Bank approves supplementary pension schemes. CLEISS specifies that insured persons must take out health insurance with a private insurer as long as the compulsory scheme is not in place and that those who do not join it will have to pay the full cost of care. The Ministry of Health implements the law and supervises the National Institute of Public Health, the medicines agency and the future fund.

The situation depends on status. A settled employee or self-employed person currently pays no individual health contribution; effective access to care goes through the public sector for free services and through private insurance for the rest, health insurance moreover being among the conditions of the temporary residence permit (law on foreigners). The seconded employee keeps the French scheme under conditions, with the SE 21-01 certificate. A retiree of a French scheme with no Kosovar entitlement can be covered by the Kosovar fund of their place of residence under the 1950 agreement, through a three-step procedure (CLEISS forms SE 21-34, 21-35 and 21-36), with no certificate before departure.

A French tourist is not covered by the agreement’s exception, reserved for Kosovar nationals on paid leave (form SE 21-04 A). France Diplomatie recalls that an assistance contract or insurance covering all medical costs, surgery, hospitalisation and medical repatriation is essential, that the embassy cannot pay these costs and that, for a stay of more than three months, the insurer must confirm that the contract does not lapse beyond 90 days.

France Diplomatie describes a system that “comprises public facilities and several private clinics”, whose equipment and quality of care vary. The only public hospital establishment cited by its health pages is the infectious diseases clinic of the Kosovo university clinical centre (QKUK), in Pristina. The referral arrangements (family doctor, municipal health centres, regional hospitals) should be confirmed with the Ministry of Health and the insurer chosen: the official sources consulted do not detail them.

For a settled French national, the choice lies between the public sector, free for the services provided for by law, and private clinics, accessible depending on the insurance contract. Direct payment should be checked before admission. See the page healthcare reimbursement in Kosovo.

The general emergency number is 112; the police can be reached on 192, the fire brigade on 193 and the ambulance on 194 (France Diplomatie). In case of a road accident, the presence of the police is compulsory to draw up the report, and France Diplomatie notes that the response of emergency services after an accident may be irregular. The French embassy in Pristina can be reached on +33 2 14 16 21 62.

In case of a serious health problem, France Diplomatie recommends preferring repatriation to local treatment. See repatriation and assistance.

The French vaccination schedule must be up to date before settling, and rabies calls for precautions with animals: anti-rabies treatment is possible at the QKUK infectious diseases clinic, which has a few doses of vaccine (France Diplomatie).

Not all medicines are available in Kosovo, notably certain asthma treatments: France Diplomatie advises taking your treatment with you. CLEISS indicates, for the future scheme, that medicines would be reimbursed if prescribed by an approved doctor, generic, justified by an official invoice and bought in a private pharmacy. Pending the compulsory scheme, the patient pays for their medicines, except for benefits covered by a private contract.

The French vaccination schedule must be up to date. France Diplomatie also suggests, depending on the conditions, hepatitis A, typhoid fever, hepatitis B (frequent or long stays) and rabies (young children, stays in rural areas). The risks concern mosquito-borne diseases (chikungunya) and tick-borne diseases (Crimean-Congo haemorrhagic fever, no vaccine), typhoid fever transmitted by contaminated water and food, rabies and winter air pollution, particularly in Pristina, where vulnerable people limit their outings.

Day to day, the usual precautions apply: drinking safe water and avoiding poorly stored food to limit the risk of typhoid fever, protecting yourself from mosquito and tick bites, avoiding contact with stray animals and seeing a doctor without delay after any bite. People with asthma or vulnerabilities consult their doctor before winter and plan a stock of treatment, as air quality deteriorates markedly in the cold season. Parents of young children find out about rabies vaccination before a stay in a rural area.

No daily sickness allowance is paid by an insurance scheme: the employee has 20 days of sick leave a year paid at 100% by the employer, with a medical certificate possible beyond three days. In case of an industrial accident, temporary incapacity is compensated by the employer (70% of salary for at most 90 days, after the first ten days); permanent incapacity and survivor benefits fall under the State-financed pension scheme, and medical care under the future health scheme (CLEISS).

For a French or Kosovar employee compensated in France, transferring residence to Kosovo during sick leave requires prior authorisation from the CPAM (the French health insurance fund) or the MSA, which issues form SE 21-03 A. Presented to the Kosovar fund, it opens benefits in kind under local rules, while daily allowances continue to be paid by the French fund. An extension goes through a medical check organised by the Kosovar fund (forms SE 21-03 B then SE 21-03 C). Only the employed worker is concerned, not their relatives (CLEISS).

Prenatal follow-up and basic care for children under 18 are among the free care in public facilities. The future scheme provides for free health promotion, prevention, vaccination, diagnosis and treatment of diseases, hospitalisation, emergencies, care for women and children, mental health and a list of essential medicines, orthopaedic prostheses and dental care, as well as care abroad with the ministry’s agreement (CLEISS). These benefits are not yet applied: the final content should be checked when the law is adopted.

The arrangements for reimbursement by French Social Security of a seconded employee or a retiree are in the page retiring in Kosovo and in the guide expat health insurance.