Healthcare Reimbursement in Romania: Who Reimburses What Depending on Your Situation

As France and Romania are members of the European Union, their social security schemes are coordinated by Regulation (EC) 883/2004: no bilateral agreement needs to be consulted, and a worker falls under the legislation of a single country, in principle that of their place of activity. The carte Vitale does not work at a Romanian doctor. Proof of rights is the national health card for a resident insured person, the EHIC (European Health Insurance Card, CEAM in French, called CEASS in Romania) for a temporary stay, or a portable form (A1, S1) for a lasting stay. The EHIC entitles you to necessary care from the public system’s providers, on the same terms as insured Romanians; it covers neither rescue and repatriation, nor private care, nor planned treatment (europa.eu).

The most frequent situations are the employee on a local contract, the seconded employee, the self-employed person, the retiree and the person without an occupation, to which are added the student, the family, the CFE member, the first-euro policyholder and the tourist. The notions of reimbursement base and out-of-pocket cost help you compare cover. How the care network works is described in the guide to the Romanian healthcare system.

The locally employed worker is declared by their employer and insured by the CNAS, funded by the 10% contribution on gross salary, with no minimum or maximum base (CLEISS). In the event of sick leave, daily allowances are paid for up to 183 days a year: 55% of the calculation base for leave of up to 7 days, 65% for 8 to 14 days and 75% from 15 days since August 2025 (CLEISS). Family doctor care, specialists on referral and hospitalisation are covered in the basic package. See the glossary entry on the local contract.

The seconded employee sent by a French employer remains attached to French social security, with the A1 form valid for a maximum of 24 months, which the employer obtains before departure (europa.eu). The EHIC guarantees direct access to the providers of the State of secondment; sick leave is sent to the French fund within 48 hours; if the family lives in Romania, it asks the French fund for the S1 document (CLEISS). Costs advanced can be reimbursed on return with form S3125. See secondment versus expatriation and the glossary entry on the seconded employee.

The self-employed person settled in Romania pays 10% of net income to the CASS, for income between 6 and 60 minimum wages (24,300 to 243,000 lei in the CLEISS 2025 scale), and can take out a voluntary sickness and maternity insurance for allowances, at 1% of the income set in the contract. They declare their income to the ANAF through the single return; contributions are detailed in the page on working in Romania.

The retiree who receives only a French pension, settles permanently or for more than six months a year in an EU State and carries out no activity there asks their pension fund for the S1 form; no local scheme contribution is withheld. If tax residence is outside France, a health contribution of 3.2% on the basic pension and 4.2% on the supplementary pension is levied on general scheme pensions, and 7.1% on those of the self-employed; without tax residence outside France, the CSG, CRDS and CASA (French social levies) apply (CLEISS). Dependants may have their own S1. See the guide to the S1 form: how to use it and the page on retiring in Romania.

The student on a temporary stay receives necessary care with the EHIC. For a stay of more than three months, registration with the IGI (the General Inspectorate for Immigration) requires proof of enrolment, of resources and of health insurance; pupils or students under 26 are insured without contribution when they fall under the Romanian system (CNAS). See student insurance abroad.

The spouse and children of an insured person are covered without their own contribution when they have no income: the CNAS cites the spouse, parents without income who depend on an insured person, and children under 18. For a retiree or a seconded employee living in Romania, the family’s S1 document is obtained from the French fund. See expat family insurance.

The person without an occupation who stays more than three months shows, for their right of residence, sufficient resources and comprehensive health insurance. They can opt for local insurance by filing the single return (D212): the CASS is 10% of six gross minimum wages, or 2,430 lei for 2026, paid 25% on filing and 75% before the following 25 May (ANAF). Bridging cover protects them while affiliation is being processed.

The CFE member contributes to a voluntary social protection body for French nationals abroad, which offers sickness-maternity-disability, work accident and retirement insurance. It is added to the Romanian scheme of an employee or a self-employed person, and serves as a support for stays in France and the return. Enrolment conditions and waiting periods should be checked with the body. See the guide to CFE reimbursements.

International health insurance with first-euro cover reimburses actual costs within its ceilings, after any deductible, waiting periods and exclusions. It opens access to private providers, which the EHIC does not cover, with direct payment depending on the contract, and may include repatriation.

The tourist presents their EHIC to the providers approved by the Romanian fund: basic medical services are covered, emergency dental care too, and emergency hospitalisation takes place on prescription; costs not covered by the EHIC can be claimed back on return with form S3125 (CLEISS). Travel insurance that covers hospitalisation, repatriation and rescue usefully complements the EHIC. See long-stay travel insurance.

An expat who returns contacts the health insurance fund they belonged to before leaving to reopen their rights. With no activity on arrival, they generally show stable residence in France; with an employment contract, affiliation takes place without delay. A retiree holding an S1 can return to be treated in France whatever the reason (CLEISS). CFE members check with the body the conditions for resuming with no waiting period. See the guide to reducing the waiting period and the page on returning to France.

• Consultation: the family doctor contracted with the CNAS is funded by the fund; a contracted specialist consults on a bilet de trimitere (referral slip). The EHIC gives the same rights for necessary care. A private provider without a contract is paid at the full rate, with reimbursement depending on the contract for international insurance.
• Hospital stay: the public hospital under contract covers care, tests, medicines, accommodation and meals; high-comfort hotel services, capped at 300 lei a day, remain at the insured person’s expense (CNAS). The CLEISS indicates, for a patient holding the EHIC, a co-payment of 5 to 10 lei per stay (page of 2022).
• Medicines: compensation is 90% (sub-list A), 50% (B), 100% (C), 20% (D), 50% or 100% (E) of the reference price; a retiree whose pension does not exceed 1,830 lei a month is entitled to 90% on sub-list B (CNAS, rules of July 2023). The patient’s share is the difference.
• Dental: one free consultation every 12 months for insured and uninsured people; services in the basic package are reimbursed at 100% up to age 18 and at 60% or 100% for adults (CNAS). The CLEISS indicates emergency dental care covered with the EHIC.
• Optical: the basic package includes devices for visual impairments on prescription; the official sources consulted do not describe general reimbursement of glasses for adults. International contracts set a ceiling per period.
• Maternity: leave lasts 126 days, including 42 compulsory days after the birth, with an allowance of 85% of average gross contributory income over the last six months (CLEISS). The family doctor follows the pregnancy: one consultation a month from the third to the seventh month, then every two weeks; the obstetrician provides one consultation per trimester (CNAS). A CFE or international contract generally provides seniority conditions for maternity.

The reimbursement guide and the page on expat health insurance give benchmarks; Expavy helps you weigh these options against your situation.