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

CLEISS’s list of social security agreements mentions no bilateral convention between France and Slovakia: the European coordination regulations, applicable in the 27 EU States and in the European Economic Area, govern the situation. They lift residence conditions, add up periods of activity and organise posting. A French national is treated in Slovakia under Slovak rules, with forms issued by their French fund: EHIC, A1, S1.

The concepts of reimbursement base and out-of-pocket cost help compare contracts. How the system works is presented on the page on the healthcare system in Slovakia.

The employee on a local contract is compulsorily insured with a health insurance company: CLEISS notes health contributions of 4% of salary for the employee and 10% for the employer, with no minimum income for employees. They choose a company among VšZP, Dôvera and Union and a general practitioner. See the glossary entry on the local contract.

The posted employee sent by a French employer stays affiliated to the French scheme for up to 24 months with the A1 form, without registering with Slovak insurance (europa.eu). If they live in Slovakia, they can ask their French fund for an S1 form to register with a company; their family members are covered without contributions if the company treats them as dependants under Slovak law (CLEISS). They can also ask their French fund to reimburse care on presentation of invoices with the S3125 form, at Slovak or French rates. Sick leave certified in Slovakia is declared within 48 hours to the French fund and the employer. See posted worker or expatriate and the glossary entry on the posted worker.

The self-employed person pays their own contributions: 14% for healthcare and 4.4% for sickness cash benefits, on a base of about 67.3% of the average income of year N-2 with a minimum base of €652 per month (CLEISS). The digital nomad who works for a foreign client without setting up comes first under the rule of the country of activity, to be confirmed with their home scheme.

The student on a temporary stay uses their EHIC with contracted providers; for a long course, insured status should be checked with a Slovak company. Before the age of 30, the Caisse des Français de l’Étranger (CFE, the voluntary social security fund for French nationals abroad) offers its youth offer. See student insurance abroad.

The retiree who receives only a French pension and settles permanently in Slovakia without working there requests the S1 form from their pension fund, preferably before leaving (CLEISS), then registers it with a Slovak company of their choice; they receive a card bearing the mention “EU” (slovensko.sk, VšZP). No contribution to the local scheme is withheld; a contribution of 3.2% on the basic pension and 4.2% on the supplementary pension is levied on general scheme pensions when tax residence is outside France, and 7.1% for the self-employed. The retiree stays covered in France.

The spouse and children follow the holder’s status: dependants of the employee, individual S1 of the retiree, or their own insurance. Each family member concerned has their own S1. See expat family insurance and the guide on retiree health insurance abroad.

The Caisse des Français de l’Étranger lets you keep the French scheme on top of the local scheme; the member pays both the country’s mandatory scheme and the CFE, which spares them waiting periods and the loss of pension quarters on returning (ameli.fr, the website of the French Assurance Maladie, the national health insurance). The CFE’s main offer covers GP consultations, medicines, tests, hospitalisation, maternity, dental care, emergency transport and vaccines, including stays of less than three months in France (CFE).

• Waiting period: immediate cover if you join before departure or within three months of settling in; beyond that, a three-month wait for under-45s and six months for over-45s (CFE, exact age to be confirmed with the fund).
• Maternity: the date of conception must be after joining or being attached as a dependant (CFE).
• Return to France: no waiting period for the member (CFE); they open their entitlement with the S1106 form (ameli.fr). See CFE reimbursements and the page on returning to France.

International health insurance with first-euro cover reimburses actual costs within its ceilings, after any deductible, waiting periods and exclusions. It usefully complements the Slovak scheme on dentistry, optical care, non-reimbursed medicines and access to the private sector, which the EHIC does not cover. Contracts are compared on the annual ceiling, the coverage area and the handling of pre-existing conditions.

The tourist presents their EHIC (EPZP) to providers under contract with a Slovak company (VšZP, Dôvera or Union): GP and specialist consultations are covered under third-party payment, with no advance of costs, and hospitalisation is covered on prescription (CLEISS). The EHIC covers neither repatriation nor private care (France Diplomatie, the French foreign ministry). Without an EHIC, the S3125 form lets you request reimbursement on your return. See long-stay travel insurance.

• Consultation: covered for the GP and the specialist under third-party payment; direct access for gynaecologist, dentist, ophthalmologist, dermatovenereologist and psychiatrist (CLEISS).
• Hospitalisation: covered on prescription; sometimes significant patient share for certain complex and costly procedures; emergencies at €2 or €10 depending on the situation (CLEISS).
• Medicines: some reimbursed, others with an average patient share of 10% to 14%; €0.17 for a printed prescription (CLEISS).
• Dental: preventive check-ups and fractures covered, some fillings and dentures partly, dental emergency at €2 for a tourist, other care paid in full (CLEISS).
• Optical: not described by CLEISS; a supplementary contract is worth considering.
• Maternity: employees’ contributions are suspended during maternity or parental leave since 1 January 2024 (CLEISS); a CFE member must have conceived after joining.

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