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

According to CLEISS, health insurance is managed by the Health Insurance Fund of Montenegro (FZOCG, Fond za zdravstveno osiguranje Crne Gore), supervised by the Ministry of Health, which manages care and pays benefits through about twenty local agencies. The Government of Montenegro lists seven general hospitals: in Bar, Berane, Bijelo Polje, Cetinje, Kotor, Nikšić and Pljevlja. France Diplomatie describes average and limited public care, a private sector that covers only certain specialties, staff who rarely speak English and a level of assistance below that of the European Union.

For an expat, the frequent combination pairs the affiliation linked to employment, where it exists, with a private or international contract that opens access to practitioners on the coast, medical evacuation and repatriation. See expat health insurance to compare the options.

CLEISS states that those insured are employees, self-employed workers, farmers, retirees, registered unemployed people and social assistance recipients. Dependants are the spouse, children up to 26 if studying and other dependent family members permanently unable to work. There is no specific scheme for the self-employed, who contribute for the same risks as employees, except unemployment. The sickness-maternity contribution is 8.50% of gross salary on the employee side and 2.30% on the employer side, and 10.80% for a self-employed person; the insured pay 1% of their pension for health insurance. The CLEISS page contains no condition on length of residence: the affiliation arrangements for a foreign resident should be confirmed with the fund.

A French employee who works locally is affiliated by their employer; before leaving, they ask their French fund for form SE 21-02 (certificate of insurance periods), to hand to the Montenegrin insurer. Their dependants with no French rights of their own can be covered through their Montenegrin job and register with the CPAM (local health insurance office) of their residence with form SE 21-08. The Franco-Yugoslav agreement of 1950, maintained for Montenegro by the agreement of 26 March 2003, also covers the case of posted workers and retirees: see healthcare reimbursement in Montenegro.

The care pathway is structured by the family doctor: the insured person freely chooses a contracted general practitioner for at least a year, as well as a family dentist, a gynaecologist for women and a paediatrician for children. A specialist consultation and hospitalisation are made on the general practitioner’s prescription, valid for 30 days for the specialist; the patient chooses the establishment within the network (CLEISS). The seven general hospitals listed by the government are spread across the cities of the country, from Bar to Pljevlja.

France Diplomatie recommends, for any care that goes beyond first aid, returning to France for treatment. It specifies that staff rarely speak English: an interpreter or a French- or English-speaking relative makes the first consultations easier, and a translated medical file speeds up the handling of ongoing treatment.

CLEISS describes a contribution of about 20% for a consultation with the general practitioner, gynaecologist, dentist or radiologist, and of 40% for a specialist. Exempt are children under 18 (or 26 if studying), pregnant women and up to 12 months after childbirth, people aged 67 and over, disabled people, the seriously ill, social assistance recipients and emergency care. Medicines are reimbursed when prescribed and on the fund’s list.

France Diplomatie recalls that only a list of authorised medicines is available, so that some cannot be bought locally, and that supply is weaker in isolated areas. Medicines are sold in private pharmacies, health centres and at the Institute of Public Health; counterfeits mean you should never buy from street vendors. You should take what is strictly necessary in the original packaging, with a prescription using the international non-proprietary name, check that each product is authorised in Montenegro and build up a stock in advance for long-term treatments.

Care is free during pregnancy, childbirth and the following 12 months; child follow-up examinations are compulsory at 6 weeks and 6 months. Maternity leave of 365 days includes at least 28 days before childbirth and 70 days after, with a breastfeeding break of 120 minutes a day in case of early return. The allowance equals 100% of the last salary, within a monthly ceiling and floor revised regularly (CLEISS). The sickness daily allowance represents 70% of the salary or of average income over the last 12 months; the employer pays it for the first 60 days, then the fund for 10 months at most.

Work accidents, commuting accidents and listed occupational diseases are covered by the fund, with allowances at 100% of average salary during total incapacity, with no qualifying period; a disability pension requires at least 50% incapacity, with a monthly minimum for total disability.

CLEISS mentions an allowance for the help of a third person, funded by the State with no means test, and compensation for bodily injury calculated on a flat-rate base that rises with the degree of incapacity. The State also funds a daily allowance in a day centre for a disabled child, and a monthly allowance is paid to the parent or guardian of a child receiving a disability allowance. Child follow-up examinations at 6 weeks and 6 months are compulsory.

For any question on opening rights or the list of reimbursed medicines, the insured person contacts one of the fund’s local agencies (about twenty); the French embassy in Podgorica and the French embassy in Albania, competent for passports and identity cards, can advise on consular procedures. Supplementary cover or an international contract opens access to practitioners outside the fund’s network.

112 is the common emergency number: free, reachable from any phone, even with no credit or network. 122 is the police, 123 the fire brigade and 124 the ambulance (France Diplomatie, Safety page). The French embassy in Podgorica (98 George Washington boulevard, +382 78 900 123) has limited capacity to help in a crisis and cannot pay medical costs: without insurance, access to care can be difficult, even in an emergency. Emergency care is exempt from co-payment for the fund’s insured people. The guide repatriation and assistance presents repatriation cover.

France Diplomatie recommends keeping the usual vaccines up to date (diphtheria, tetanus, polio, whooping cough, measles) and, depending on the conditions and length of the stay, enquiring about hepatitis A, typhoid, hepatitis B for frequent or long stays and rabies for young children, rural areas or areas far from large cities. The risks cited are typhoid, transmitted by water, food or person to person, and rabies, almost always fatal once symptoms appear: avoid contact with dogs, cats, bats and stray or wild animals, and consult immediately after any possible exposure, even if vaccinated.

Precautions concern hand hygiene, choosing safe or bottled water, cooking meat, fish and dairy products, swimming in supervised areas and protection against heat, sun and pollution. The Safety page also reports numerous summer fires and a seismic risk. See also living in Montenegro.