The Romanian Healthcare System: CNAS Insurance, Family Doctor, Hospitals, Emergencies and Access for a French National

The Romanian system rests on social health insurance. The National Health Insurance House (CNAS) administers the scheme; 43 funds are attached to it, including 41 county funds, the Bucharest fund and the defence and public order fund. These funds do not reimburse the patient: they sign contracts with providers, who bill the care in the basic package directly to the fund. The contribution is collected by the ANAF, the tax administration; the Ministry of Health sets health policy and, according to the CLEISS (the French liaison centre for international social security), the players are split between a national level and a county level (CNAS, insured person’s guide of March 2024; CLEISS, 2021 data).

• Two packages: insured people have access to the basic package (family doctor, specialists, hospital, tests, home care, subsidised medicines, medical devices, rehabilitation); uninsured people fall under a minimal package.
• Contracted providers: only the surgeries, hospitals, laboratories and pharmacies that have a contract with a fund apply the basic package. The lists can be consulted on the funds’ websites.
• National health card: it proves insured status at the doctor’s and at the pharmacy; it is blocked after five wrong PIN entries, and insured status can be checked online on the CNAS website.

The Romania country page brings together costs and coordination agreements.

The tax code sets the contribution at 10% for employees, for those who receive income subject to the CASS and for those who have no income but choose to be insured (CNAS). The CLEISS specifies that anyone legally resident in Romania can be insured provided they contribute. The rates and thresholds for employees and the self-employed are in the page on working in Romania.

• Insured without paying: children under 18, young people aged 18 to 26 who are pupils or students, the spouse and parents without income who depend on an insured person, pregnant women and women who have just given birth, disabled people, retirees, unemployed people receiving benefit and parents on parental leave (CNAS).
• Person without an occupation: they can opt for insurance by filing the single return (D212) with the ANAF. The annual contribution is 10% of six gross minimum wages, calculated on 1 January of the year: for 2026, 10% of 24,300 lei (6 × 4,050 lei), or 2,430 lei, paid 25% when the return is filed and 75% by 25 May of the following year at the latest (ANAF).
• French retiree: they register their S1 form to be covered without a local contribution. See the page on retiring in Romania.

An uninsured pregnant woman becomes insured for the length of the pregnancy and the post-partum period by handing the pregnancy certificate to her fund, with no other expense (CNAS). Situations by status are detailed in the page on healthcare reimbursement in Romania.

The family doctor is the first point of contact with the system. Everyone registers on the list of the doctor of their choice, which they can change after at least six months; registration is compulsory (CNAS, CLEISS). The doctor provides consultations for acute illness, follow-up of chronic diseases, home visits for patients who cannot travel, prevention, prescriptions and medical certificates. An annual prevention package offers, from age 40, up to three consultations a year to assess cardiovascular, cancer and kidney risks.

• Specialists: a specialist consultation takes place on a bilet de trimitere issued by the family doctor or by another contracted specialist. It is not required for emergencies and family planning; some patients with chronic diseases (diabetes, glaucoma, asthma or cancer, for example) consult directly, by appointment, for a periodic check-up.
• Tests and imaging: they are free for an insured person with a bilet de trimitere, in a contracted laboratory. The bilet is valid for 30 days, up to 60 days for prevention and up to 90 days for chronic diseases.
• Teleconsultation: consultations for chronic diseases and for certain infectious diseases can take place remotely, with an electronic prescription sent to the patient.

112 is the single emergency number. The system sorts calls by colour code (red, yellow, green) to determine which ambulance to send according to severity (CLEISS). The public hospital contracted with a fund covers, for the hospitalised insured person, consultations, tests, care, medicines, equipment, accommodation and meals; only high-comfort hotel services, capped at 300 lei a day, and services requested outside the contract are borne by the patient. A bilet de trimitere opens planned hospitalisation; it is not needed for an emergency, childbirth, chemotherapy or radiotherapy (CNAS).

• Uninsured: the hospital covers medical and surgical emergencies until they are resolved and diseases with epidemic potential until the end of treatment.
• Contracted private hospital: a private facility under contract may ask the patient for a personal contribution, equal to the difference between its fee and the fee reimbursed by the fund. It displays its fees and provides an estimate valid for five working days before hospitalisation.
• Travel and repatriation insurance: France Diplomatie (the French foreign ministry) points out that the embassy does not pay medical costs and recommends cover for care and repatriation; the page on repatriation and assistance presents these guarantees.

Only insured people benefit from subsidised medicines, on an electronic prescription and at a contracted pharmacy. The fund pays the compensation percentage applied to the reference price: 90% for sub-list A, 50% for sub-list B, 100% for sub-list C, 20% for sub-list D and 50% or 100% for sub-list E depending on the groups concerned (CNAS). The CLEISS sums up this scale with rates of 20% to 100% depending on the list. A prescription for acute illness lasts at most seven days of treatment, up to 30 or 31 days for a chronic illness, and up to 90 days for a stabilised chronic illness.

• Dental: the consultation is free once every 12 months, for insured and uninsured people alike. Insured people also benefit from treatment of simple cavities, extractions, removable acrylic prostheses and ultrasonic scaling; the services in the basic package are reimbursed at 100% up to age 18 and at 60% or 100% for adults (CNAS).
• Optical and devices: the basic package includes devices for visual impairments, on prescription and by decision of the fund; an adult’s ordinary glasses are not described as reimbursed in the sources consulted. Check with the fund before any purchase.
• Rehabilitation: up to 21 days a year of outpatient physical medicine procedures, 42 days in certain cases (stroke, cerebral palsy, severe burns).

France Diplomatie asks that you be up to date with the French vaccination schedule, in particular for diphtheria, tetanus, polio and measles. Depending on the conditions of the stay, hepatitis A and B, typhoid fever, ACWY meningitis, tuberculosis for children under 15, rabies and tick-borne encephalitis may warrant vaccination (page of 15 September 2026). A France Diplomatie alert also reports a rise in measles cases (13 March 2026).

• Mosquitoes and ticks: West Nile virus is transmitted by mosquito bite and has no vaccine; tick-borne encephalitis occurs mainly in spring and summer, and covering clothing limits the risk.
• Rabies and avian flu: rabies is reported in stray dogs, including in Bucharest; Romania is a stopover for migratory birds. Avoid contact with animals.
• Food hygiene: France Diplomatie recommends bottled water, well-cooked food and swimming in supervised areas.

A person on a temporary stay (tourist, student, temporarily seconded employee) receives with the EHIC (European Health Insurance Card, CEAM in French) the necessary care from the public system’s providers, on the same terms as insured Romanians; it is requested from one’s health insurance fund at least 15 days before departure. A local employee is affiliated by their employer, a self-employed person declares their income to the ANAF, a retiree registers their S1 and a seconded employee keeps the French scheme with the A1 form.

To complement these rights with first-euro cover, direct payment or access to private providers, Expavy helps you compare the options based on your situation, with the page on expat health insurance.