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

CLEISS’s list of social security agreements mentions no bilateral convention between France and Slovenia: the European coordination regulations, applicable in the 27 EU States and in Iceland, Liechtenstein and Norway, govern the situations. They lift residence conditions, add up periods of activity and allow posting. In practice, a French national is treated in Slovenia under Slovenian rules, with the help of forms issued by their French fund: EHIC, A1, S1.

The Slovenian system remains one with patient charges: the basic scheme covers only part of the care, as described on the page on the healthcare system in Slovenia. The concepts of reimbursement base and out-of-pocket cost help compare contracts. The effects of a status on cover should be chosen before departure, according to employment, length of stay and budget.

The employee on a local contract is registered by their employer with the ZZZS. They pay 6.36% of their gross salary for sickness, the employer 6.56%, and they pay a flat-rate health contribution of around €40 per month, revised each year, which replaced optional supplementary insurance in 2024 (CLEISS). They choose a contracted family doctor and are reimbursed under local conditions. 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 the Slovenian funds (europa.eu). If they live in Slovenia, they can ask their French fund for an S1 form to register with the ZZZS; their family members are covered without contributions if the local fund treats them as dependants under Slovenian law (CLEISS). They can also ask their French fund to reimburse care on presentation of invoices with the S3125 form, at Slovenian or French rates. See posted worker or expatriate and the glossary entry on the posted worker.

Sick leave certified in Slovenia is declared within 48 hours: the Slovenian doctor’s certificate goes to the French fund, which decides on payment of daily allowances, and to the employer (CLEISS).

The self-employed person registers directly with the ZZZS: total contributions reach 40.20% on a minimum base of around €1,500 per month, revised each year, of which 12.92% for sickness, plus the flat-rate health contribution, due even with no turnover (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 (an exchange programme, for example) uses their EHIC with ZZZS-contracted providers. For a long course, local affiliation or dedicated insurance should be looked into before the start of term; the ZZZS publishes a page on this. 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 Slovenia, without working there, requests the S1 form from their pension fund, preferably before leaving (CLEISS). Each family member who may benefit (minor child, spouse, PACS partner) has their own S1; the Slovenian fund decides on their status as dependant. Benefits are those of Slovenian law, with no local health contribution on the pension. In return, 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; 7.1% for the self-employed. The arrangements for any flat-rate health contribution for an S1 holder should be checked with the ZZZS. The retiree stays covered in France and can be treated there for any reason.

The spouse and children follow the holder’s status: dependants of the local-contract employee, individual S1 of the retiree, or their own affiliation. Children and students up to age 26 benefit from full cover of many types of care (CLEISS). 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 is aimed at over-30s who are not yet retired and 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). No medical inquiry is required.
• Maternity: the date of conception must be after joining or being attached as a dependant (CFE).
• Return to France: the member has no waiting period and rejoins their scheme (CFE); they open their entitlement with the S1106 form with their fund (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 Slovenian scheme by covering the 10% to 90% patient share, dentistry and dentures (covered at only 10% by the ZZZS), optical care and evacuation. Contracts are compared on the annual ceiling, the coverage area and the handling of pre-existing conditions.

The tourist uses their EHIC with contracted providers: they pay only the patient share, with no advance of costs under third-party payment; without an EHIC, a non-contracted private doctor bills the full amount (CLEISS). On return, the S3125 form lets you request reimbursement at Slovenian or French rates, up to actual costs. France Diplomatie also recommends an assistance contract covering hospitalisation and repatriation. See long-stay travel insurance.

• Consultation: patient share of 10% to 90% depending on the service; full cover for children, preventive examinations and emergencies; a specialist is consulted on prescription, except paediatricians, dentists and gynaecologists (CLEISS).
• Hospitalisation: up to 30% of the cost at the insured person’s expense, on prescription outside emergencies; medicines supplied during the stay are not billed (CLEISS).
• Medicines: positive list at 70% (100% for children and certain diseases), intermediate list at 10%, other lists at 0% (CLEISS).
• Dental: 100% for children and students, 80% for others, 10% for dentures (CLEISS).
• Optical and technical aids: 70% after an insurance period of up to six months, with no waiting period for children and victims of an accident at work (CLEISS).
• Maternity: pregnancy-related care is fully covered by the ZZZS; 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.