The right to health care from compulsory health insurance is ensured under the same conditions for all insured persons of the Croatian Health Insurance Fund (HZZO).
Primary health care
Insured persons realise their primary health care rights at selected primary health care physicians of family medicine, gynaecologists, paediatricians and dental practitioners.
Exceptionally, an insured person on temporary stay outside his or her place of residence (e.g. official travel, vacation) has the right to use primary health care, apart from establishing temporary incapacity to work, at any contracted doctor of primary health care in the place of temporary stay and in the same extent as at his or her selected primary health care physician.
Specialist-consilium health care
Insured persons generally realise their specialist-consilium health care at the nearest contracted health institution or at the nearest contracted private practice practitioner according to their place of residence or stay, based on referrals issued by their selected primary health care physicians.
Hospital health care
Insured persons realise their hospital health care at contracted hospital institutions for the treatment of patients suffering from acute, sub-acute and chronic diseases, based on referrals issued by their selected primary health care physicians.
Exceptionally, hospital health care, in cases of emergency medical assistance, is realised without a referral.
Insured persons generally realise their hospital health care at the nearest contracted hospital institution according to their place of residence or stay, which has concluded an agreement with the Croatian Health Insurance Fund.
Insured persons, within the scope of the right to healthcare from compulsory health insurance, have the right to medicines as defined by the basic and supplementary list of medicines of the Croatian Health Insurance Fund.
The Basic list of medicines contains the most effective medicines for treatment of all diseases, in medical and economic sense.
The Supplementary list contains medicines of higher price level when compared to the prices from the Basic list, whereby the Croatian Health Insurance Fund ensures coverage of the costs in the amount of the lowest price of the equivalent medicine defined by the Basic list of medicines.
More information is available at:
Contracted hospital institutions are obliged to receive you as soon as possible and, in cases of life threatening, immediately. Upon completion of the treatment, the hospital is obliged to issue hospital discharge documents and a personal invoice.
After the completion of the treatment, you are obliged to immediately contact your selected physician, not later than within three days, and deliver the hospital discharge documents. You can deliver the said documents either personally or through a family member or a third person.
As an insured person you are obliged to participate in the costs of the health care used, for services that are not fully insured at the expense of the Croatian Health Insurance Fund. In order to cover the costs of participation, a person with regulated compulsory health insurance at the Croatian Health Insurance Fund may enter into a supplementary health insurance contract with the Croatian Health Insurance Fund. More information is available at http://dzo.hzzo.hr/
As an insured person of the Croatian Health Insurance Fund, you can exercise the right to necessary or urgent health care in these states on the basis of the European Health Insurance Card or the replacement Certificate. You can use health care in the aforementioned manner at contracted health institutions or at contracted physicians in the state of stay, at the expense of the Croatian Health Insurance Fund. The nature of your temporary stay in the aforementioned states is of no importance, and health care is exercised in the same way regardless of whether you reside in the said states for private reasons, as a posted worker, during a study, professional training or for any other reason. Necessity or urgency of the services required is assessed by a physician who is contacted for help.
If you stay in these countries for private reasons, you are entitled to use the emergency health care on the basis of a contractual certificate issued by the Croatian Health Insurance Fund before your arrival to the contracting state. The certificate is issued on the basis of form 4 (“Registration - cancellation of the insured person’s stay in the third countries”). Form 4 is available at: http://www.hzzo.hr/wp-content/uploads/2013/10/ObvUpl_Tisk4_17122013.pdf?b32def If you are going to stay in a contracting state as a posted worker sent by your employer based in Croatia, then your employer is obliged to register your temporary residence in the contracting state at the Croatian Health Insurance Fund and submit the form 4 as well as all other necessary documentation. The list of concluded agreements with names of certificates of the right to health care as well as the scope of rights for persons who stay in the contracting state for private reasons is available here, and for workers posted to temporary work in the contracting state is available here.
In case of a temporary stay for private reasons in a country with which the Republic of Croatia has not concluded an international agreement (the so-called third country), as an insured person of the Croatian Health Insurance Fund you have the right to use emergency health care at the expense of the Croatian Health Insurance Fund if you have filed your registration of temporary residence in the form 4 with the Croatian Health Insurance Fund before you went abroad and if you have paid a special contribution for the provision of health care services abroad. You are obliged to settle the used emergency health care personally, and after your return to Croatia you have the right to file a claim for the reimbursement of costs at the competent regional service or local office of the Croatian Health Insurance Fund. You are required to enclose the original invoice and a copy of the medical documentation relating to the used emergency health care. In the same way, the right to emergency health care in the so-called third country, at the expense of the Croatian Health Insurance Fund, is also realised by workers who are posted to temporary work in a third country by their employer based in Croatia. At the same time, before posting the workers abroad, the employer is obliged to submit the application to the Croatian Health Insurance Fund in form 4 (with enclosed other prescribed documentation) and pay the special contribution for the provision of health care services abroad. More information on how to use health care abroad is available at: http://www.hzzo.hr/lijecenje-u-inozemstvu/