Healthcare System in Slovenia: The Public ZZZS Fund, Family Doctor, Hospitals, Emergencies and Vaccinations

According to CLEISS, a single public insurer provides Slovenia’s mandatory and universal health cover. The Ministry of Health regulates the system and owns the public hospitals, primary care falls to the municipalities, and private providers are numerous, particularly dentists and general practitioners. The scheme is funded by contributions from employees, employers and other groups of insured people.

The ZZZS (Zavod za zdravstveno zavarovanje Slovenije, the Health Insurance Institute of Slovenia) reimburses care provided in public establishments and by private doctors who hold a concession and are part of the network on the same terms (ZZZS). It has 10 regional units and 45 branches. Slovenia devotes nearly 10% of its GDP to health, and life expectancy at birth exceeds 82 years (World Bank). For care item by item, the page on healthcare reimbursement in Slovenia gives the detail.

Cover applies to residents, people carrying out legal paid activity and their family members (CLEISS). For an employee or a self-employed person, affiliation goes through the employer or by direct declaration: the sickness contribution reaches 12.92% of gross salary, with 6.36% for the employee and 6.56% for the employer (CLEISS). Pensioners of a foreign scheme are among the categories of insured people listed by the ZZZS, as are people who live in Slovenia while being insured abroad without being able to exercise their rights there.

• Flat-rate health contribution: since 1 January 2024, the optional supplementary insurance that covered the patient’s share has given way to a mandatory fixed-amount contribution, set at around €40 per month (CLEISS). The amount is set each year by the Minister of Health (ZZZS).
• Exemptions: certain categories, such as minors, are exempt from the contribution; the position of a national insured in another country, for example a retiree holding the S1 form, should be confirmed with the ZZZS before settling in.
• Temporary stay: the European Health Insurance Card (EHIC, EKZZ in Slovenian) gives access to care from contracted providers; a provisional replacement certificate, valid for three months, has the same effect (CLEISS).

Outside the social security framework, France Diplomatie reminds that an assistance contract or insurance covering all medical costs, including surgery, hospitalisation and repatriation, remains essential for anyone not covered locally, as the embassy does not bear these costs.

The patient freely chooses their family doctor and can change every year (CLEISS). This general practitioner is the entry point to the system: a prescription is needed to consult a specialist, except for paediatricians, dentists and gynaecologists. For a hospital stay, the patient freely chooses their establishment, but a prescription is required, except in an emergency.

• Registering: a newcomer approaches a practice contracted by the ZZZS, whose list of providers can be consulted on the insurer’s website.
• Non-contracted providers: care received from a private doctor with no contract with the ZZZS is entirely at the patient’s expense (CLEISS).
• Maternity and children: pregnancy care, preventive examinations, children and students up to age 26 benefit from full cover (CLEISS).

The major establishments are public: the Ljubljana university medical centre is the country’s main establishment, and the Maribor one is its second university hub. France Diplomatie gives the contact details of the Ljubljana hospital (Zaloška cesta 2) and of the medical centre’s emergency department (Zaloška cesta 7), as well as a medical emergency number for adults in Ljubljana. For any accident or illness, 112 directs you to the appropriate service, with the local police reachable on 113.

Outside emergencies, admission to hospital requires a prescription from a GP or a specialist, and an insured patient may be redirected to another establishment depending on the specialty. For hospital expenses, the patient’s share can reach 30% of the cost for an admission or specialist outpatient care (CLEISS), a point that the flat-rate health contribution helps anticipate. For stays in the mountains, France Diplomatie reminds that rescue is free.

Three lists govern the reimbursement of medicines (CLEISS). Those on the positive list are covered at 70%, with full cover for children and certain conditions such as diabetes, cancer, multiple sclerosis or epilepsy; the intermediate list gives a 10% reimbursement; medicines on the other lists are not reimbursed. Medicines supplied during a hospital stay are not billed to the insured person.

CLEISS recommends buying prescribed medicines from a pharmacy contracted by the ZZZS. France Diplomatie advises taking only the medicines you need, in their original packaging, with a prescription stating the international non-proprietary name, checking that they are permitted in Slovenia and never buying medicines from street vendors because of the risk of counterfeits.

Dental care is covered at 100% for children and students and at 80% for other insured people, with 20% at the patient’s expense; dentures are covered at 10% (CLEISS). For technical aids, such as optical, orthopaedic or hearing devices, cover is 70% after an insurance period of up to six months, with no waiting condition for children and victims of an accident at work.

Medical transport is reimbursed up to €28.22, and meals (€16 per day) and accommodation (up to €48 per day) are reimbursed for a journey of more than 12 hours (CLEISS). The gap between these rates and the real cost explains the appeal of supplementary expat health insurance, which international insurance contracts offer with or without a deductible.

France Diplomatie advises bringing French vaccinations up to date (diphtheria, tetanus, polio, whooping cough, measles) and mentions, depending on the conditions and length of stay, hepatitis A, typhoid and tick-borne encephalitis, with hepatitis B for frequent or long stays.

• Tick-borne encephalitis: a virus transmitted mainly by tick bites in spring and summer; there is no specific treatment, with prevention relying on avoiding bites and on vaccination for stays in rural or wooded areas.
• Lyme disease: treated with antibiotics, all the more effectively the earlier they are started; see a doctor after a rash appears around a bite.
• Rabies: avoid suspicious animals, preventive vaccination sometimes advised for young children, immediate consultation after a risk exposure.
• Water and food: handwashing, thorough cooking of food, safe water.

Before leaving, a doctor or an international vaccination centre specifies the appropriate boosters. To complement this with first-euro insurance, Expavy helps you compare contracts according to status and budget.