Expat insurance and health insurance in Slovakia

Slovakia has no single fund: unlike Poland or the Czech Republic (a single dominant fund or several funds with similar terms), mandatory health insurance there is managed by three funds in regulated competition — the Všeobecná zdravotná poisťovňa (VšZP), historically the public fund and the largest, and two private funds, Dôvera and Union. All three funds must offer the same benefits basket set by law and cannot practise any risk selection: every resident must be accepted. Each insured person freely chooses their fund upon registration and can switch once a year. Note: a merger agreement between Dôvera and Union was signed on 14 July 2026, still subject to approval by the regulatory authorities; Union members would automatically move to Dôvera on 1 January 2027, unless they choose otherwise.

The benefits basket funded by the funds covers outpatient care (GPs and, without prior referral, gynaecologists, dentists, ophthalmologists and psychiatrists), hospital care, emergencies (numbers 155 and 112), maternity, listed medicines and medical devices, and emergency medical transport. A flat-rate co-payment remains due for certain procedures (emergencies, unlisted medicines), and dental care beyond the basic package — like optical care — remains the patient’s responsibility, whichever fund they belong to. The major public and university hospitals belong to the state or the regions; they coexist with private facilities, whether contracted or not.

• EU citizen: no visa required, free movement with a valid passport or ID card, Slovakia having been a member of the Schengen area since 2007.
• Registration with the foreign police: mandatory for any stay longer than 90 days, on presentation of a valid passport and proof of address, with issuance of a residence permit.
• Joining a health insurance fund: mandatory for every permanent resident. For an employee, the employer declares and withholds the contribution (16% of gross salary, of which 11% is paid by the employer and 5% by the employee) for the fund chosen by the employee among the three approved funds (VšZP, Dôvera, Union).
• Choosing and switching fund: free choice on registration; a fund switch is possible once a year, with the request to be filed before 30 September to take effect on the following 1 January.
• Self-employed: direct registration and contribution to the chosen fund, at a rate of 16% of declared income, with no minimum assessment base.
• Without registration or European cover: care is billed in full by the facility, public or private, at a rate that varies by facility and is not publicly disclosed in a uniform way.
• Student: the EHIC is sufficient for a temporary stay (such as Erasmus); beyond that, local registration (with choice of fund) or a supplementary student insurance remains recommended during the administrative transition period.
• Seconded employee : up to 24 months (extendable), stays on the French scheme via form A1, exempt from local registration.
• Retiree: form S1 from their French pension fund before departure, for cover under the Slovak system (with choice of fund) without a new contribution of their own.

No individual fine is provided for as such in case of failure to register, but the employer has a legal obligation to declare their employee; for the expat themselves, the risk remains primarily financial, with no assistance from the French embassy in case of uncovered care.

As Slovakia has been an EU member since 2004, there is no classic bilateral agreement with France: coordination relies on EU regulations 883/2004 and 987/2009, as for other member states. Slovakia has also been a member of the Schengen area since 2007 and of the eurozone since 2009, unlike Poland, the Czech Republic and Bulgaria, which keep their national currency.

• Temporary stay: the EHIC (EPZP in Slovakia) gives entitlement to the same cover as a local insured person with providers contracted by the three Slovak funds; if the card is forgotten or lost, a provisional replacement certificate (PRC), valid for 3 months, gives the same rights.
• Secondment: form A1, staying on the French scheme for up to 24 months (extendable), exempt from local registration.
• Long-term move: direct registration with the health insurance fund chosen among the three approved funds (via the employer for an employee, directly for a self-employed person); form S1 for a retiree, covered by the Slovak system without a new contribution of their own.
• The EHIC covers neither repatriation, nor planned care, nor a long-term move; on return, a stay not covered in advance may be reimbursed retroactively via form S3125, within the limit of actual costs.

1. Before departure: notify French agencies of your departure (CPAM, CAF, France Travail, pension funds).
2. Seconded employee: request form A1 from your French fund before departure.
3. Retiree: request form S1 from your pension fund before departure.
4. Before departure or on arrival: request the EHIC (EPZP) to cover the transition period.
5. On arrival, for a stay longer than 90 days: register with the foreign police and obtain a residence permit.
6. Choose your health insurance fund among the three approved funds (VšZP, Dôvera, Union) and register.
7. Employee: check with your employer that the contribution is declared and withheld from the signing of the employment contract.
8. Self-employed: register and contribute directly to the chosen fund.
9. To switch funds later: file the request before 30 September to take effect on the following 1 January.
10. Register with the roll of French nationals living abroad (French embassy in Bratislava).