Health Insurance in Slovakia: Who Is Entitled to What and How Much It Costs

Health insurance in Slovakia is compulsory by law — with no exceptions. But the system is set up so that some people pay through their employer and barely notice it, while others pay 30–100 euros a month out of their own pocket. The difference depends on your status, and it is worth understanding before you actually need a doctor.

Two types of insurance: how they differ

There are two fundamentally different systems in Slovakia:

• Public insurance (verejné zdravotné poistenie) — a full system covering treatment, specialists, hospital stays and prescription medicines. Contributions are usually paid by your employer together with you, and for some categories of people by the state.
• Commercial insurance (komerčné zdravotné poistenie) — for those who do not qualify for the public system. Cover is narrower, you pay the whole cost yourself, and the price depends on the level of cover.

The key point: you do not freely choose between them. If you fall under public insurance, you are obliged to join it. If you do not, you have to buy a commercial policy.

Who is entitled to public insurance

Public insurance is compulsory for anyone with permanent residence (trvalý pobyt) in Slovakia. You have to register within 8 days of receiving it.

But even without permanent residence you are obliged to have public insurance if one of the following applies:

• you work for an employer whose place of business is in Slovakia, and your agreed monthly income is not below the minimum wage;
• you carry out, or are entitled to carry out, business activity (živnosť, SZČO) and you hold a residence permit;
• you are a foreign national under the age of majority studying full time at a Slovak university;
• you are a child under 18 with a residence permit and at least one legal guardian who has public insurance in Slovakia;
• you hold a scholarship from a programme of the Slovak government, the EU or the Ministry of Education, and the scholarship is awarded for more than a month.

An important nuance: being obliged to have insurance does not mean you are the one who pays. The payer may be your employer, you yourself as a business owner — or the state.

When public insurance does not apply

You are not covered by public insurance if you are insured in another EU country. The same applies if you have trvalý pobyt in Slovakia but work abroad and are insured there, or if you stay abroad continuously for longer than 180 days.

What people with odídenec status are entitled to

This is a separate and often confusing situation, so let us go through it in detail.

If you have temporary refuge (dočasné útočisko) and no public insurance, you are entitled to emergency medical care and necessary medical care. The scope of this care is set by law: for children and teenagers since 1 January 2023, for adults since 1 September 2023.

How to get into the public system. If you have a job with an agreed income not below the minimum wage, you enter the public insurance system — to do so you need to submit an application (prihláška poistenca) to the insurer of your choice.

Children. Children under 18 with Odídenec status whose parents work and are insured in Slovakia are entitled to public insurance until they turn 18.

For more on the status itself and how to extend it, see the article on how to extend an odídenec document.

The three public insurers: which one to choose

Three insurance companies operate in Slovakia and by law they must cover the same basic scope of care. They differ in service, bonus schemes and their network of contracted doctors.

• VšZP — state-owned, the largest, with the widest network of doctors. It has an online application for foreigners working in Slovakia and a separate section for people with temporary refuge status.
• Dôvera — private, with a strong mobile app and a separate section of information for Ukrainians.
• Union — private, and the only one of the three that also offers commercial insurance for foreigners.

What to look at when choosing: whether the doctor you need is in the contracted network (especially if you have already found a Russian-speaking specialist), how convenient the app is, and what bonuses are offered for preventive check-ups. You can change insurer once a year — the application is submitted by 30 September and the change takes effect on 1 January.

Commercial insurance: what it costs and who needs it

If you do not meet any of the conditions for public insurance — for example, you came on a visa and neither work nor study — you need commercial insurance. Without it your residence will not be granted or extended.

Cost: roughly 30–100 euros a month, depending on the level of cover, your age and the insurance company.

What it covers: treatment in Slovakia and emergency care in the Schengen countries. The scope is noticeably narrower than public insurance: some procedures, chronic conditions and pregnancy may be excluded or limited — read the terms before signing.

Commercial insurance for foreigners is offered above all by Union and Axa, and in some cases by other companies as well.

How to arrange it, step by step

1. Work out your status. Do you work with an income at or above the minimum wage? Do you have a živnosť? Do you have trvalý pobyt? If yes, the public system is for you.
2. Choose an insurer from the three and submit an application (prihláška). With VšZP you can do this online.
3. Meet the deadline. When you receive trvalý pobyt, you have 8 days. When you start a job the employer usually submits the application, but check that they have actually done it.
4. Get your insurance card and register with a general practitioner — without one you will only reach specialists by paying the full cost.
5. If public insurance does not apply to you — arrange a commercial policy before you file your residence documents.

What happens if you have no insurance

• Treatment at your own expense. One day in hospital without insurance can cost hundreds of euros, and a major operation several thousand.
• Problems with documents. A policy is a compulsory attachment to a residence application. Without it a residence permit will not be issued or extended.
• Debt to the insurer. If you are obliged to be insured but have not submitted an application, contributions are charged anyway — and the debt builds up with penalties.

Where to get free advice

If your situation is unusual and you are not sure which category you fall into, do not guess — ask for free.

The IOM Migration Information Centre provides free legal and social advice to foreigners, including in Russian and Ukrainian. Phone 0850 211 478 (from Slovak numbers), Telegram and Signal +421 908 767 853. Hours: Mon, Tue, Thu — 9:00–12:00 and 13:00–17:00; closed Wed and Fri. Advice is given by phone and email; in-person visits by appointment.

More contacts for free help are in the list of specialists and organisations.

Check current conditions and forms on the official websites: submit an insurance application to VšZP and insurance conditions for foreigners at Union.

If you need a commercial policy, it is easy to compare the terms of different insurers in one place: compare offers on Netfinancie.

Affiliate link: if you take out a policy, we receive a commission from the insurance company. This does not affect the price you pay.

A separate topic is pregnancy and childbirth in Slovakia: that article explains what insurance covers during antenatal care and in the maternity hospital.

Besides health insurance there is a second compulsory part — social contributions and pensions in Slovakia.

Frequently asked questions

Can I choose commercial insurance if I qualify for the public system?

No. If you fall under compulsory public insurance, you are obliged to join it. Commercial insurance is only for those who do not qualify for the public system.

I work on a živnosť. Who pays my contributions?

You do, as a self-employed person. Contributions are paid monthly, and after you file your tax return they are recalculated. For more on contributions and taxes, see the article on taxes in Slovakia.

What should I do if I lose my job?

The obligation to be insured does not disappear. You need to inform your insurer that your status has changed — otherwise debt will build up. If you register as a jobseeker, the state may pay your contributions.

Does insurance cover the dentist?

Partly. A preventive check-up once a year is covered, and so is part of the treatment — but implants, veneers and cosmetic work are almost always paid for out of your own pocket. More detail in the section on dentists.

How can I tell whether I am actually insured?

Call your insurer or check your status in its mobile app. If your employer forgot to submit the application, you may not find out until your first visit to a doctor.

This information has been compiled from public sources, including materials from the IOM Migration Information Centre, and is current as of August 2026. Rules change — check the current conditions before submitting documents. For questions that concern you personally, consult a specialist in the field.