May the 24th, 2023 - I tackled navigating Croatian Health Insurance (HZZO) in another article, and while getting insured as a foreigner living in Croatia can sometimes be more of a task than it needs to be, there are numerous benefits to going through the process. One of them, aside from it being mandatory, is that you can utilise your Croatian Health Insurance abroad.

Having HZZO means that you're also insured across the European Union (EU). Should you become unwell, injured, or require medical treatment, having HZZO means you'll get access to it on the same basis as nationals/residents of whatever EU country you're temporarily located in also do. Here's how to make sure that you're covered should misfortune befall you when spending time in another EU member state.

The European Health Insurance Card (EHIC)

An EHIC is provided to all individuals who request one as long as they're insured by the state/public policy in their EU country of residence. This means that, as stated above, by having HZZO, you're entitled to an EHIC. An EHIC is issued by HZZO for free and is typically (but not always) issued for a period of one year at a time. The validity of the EHIC will be displayed on the card.

Do I need to be a Croatian citizen to have an EHIC issued to me by HZZO?

No. In fact, many Croatian citizens who live and work abroad have ended up in hot water for utilising their Croatian Health Insurance abroad despite no longer living or working in the country. You just need to be a legal resident of Croatia who has HZZO in order to be given an EHIC and as such utilise your Croatian Health Insurance abroad. You can find out more about who needs to be insured by HZZO and who doesn't by clicking here.

What does the EHIC cover?

An EHIC will allow you to utilice your Croatian health insurance abroad and access treatment at any public medical facility or hospital in another EU country either for free or at a reduced cost. It covers you if you require urgent medical attention/treatment which cannot be postponed until you leave whatever country you're in. It will also cover you for your pre-existing conditions or chronic health issues as long as the trip you're on isn't a ''medical/healthcare tourism'' trip.

So, if you've gone skiing in Italy and you happen to suffer from hypertension that is being treated already but you experience some issues, you'll be able to use your EHIC to be seen by a contracting doctor in a public healthcare facility. 

If you're visiting historic places somewhere in France and you're diabetic and need some sort of medical attention as a result - No problem.

On that same note, it's worth keeping firmly in mind that the EHIC doesn't cover everything, and it will typically only cover unplanned treatment you need until your return to your country of residence. It will also usually cover maternity care and any pregnancy complications as long as you've not clearly planned to give birth abroad.

What about cancer treatment and the like?

You can also utilise your Croatian Health Insurance abroad through an EHIC if you require chemotherapy, oxygen therapy, treatment for conditions such as asthma, and some other types of ongoing therapy, including dialysis. In such cases, however, you'll need to come to an agreement with the healthcare facility/hospital you'll be using before you travel to whatever EU country it is located in.

Is an EHIC the same as travel insurance?

In short - No. You should always take out a travel insurance policy as the EHIC doesn't act as an alternative to what comprehensive travel insurance will offer you. It isn't going to cover any private medical healthcare or associated costs. It won't cover your repatriation either. Some insurers who offer travel insurance policies to clients now insist that the applicant hold an EHIC and many will waive the excess if you do hold one.

I ended up having to pay for my medical treatment abroad despite having an EHIC, will HZZO refund me?

Usually, yes. If the healthcare you required abroad was urgent, then you can apply for a refund from HZZO when you return to Croatia.

How can apply for an EHIC?

In Croatian, the EHIC is referred to as the EKZO (Europska kartica zdravstvenog osiguranja), and can be applied for either at your local HZZO branch/office or online. It is usually made and available for you to pick up eight days after your application is made.

When applying online, you'll need to fill in your OIB/Personal identification number and your MBO/Insurance identification number, as well as the desired location of your local HZZO office, from which you'll want to pick up your EHIC when it's ready.

If you want to apply for yours online, click here.

For a list of HZZO offices you can either go to to apply for your EHIC in person or to pick up your EHIC from after applying online, click here and select your area/city/town.

What if I stop being covered by HZZO?

If your Croatian Health Insurance coverage ceases for whatever reason, you'll need to return your EHIC to your regional/local HZZO office.

For more on moving to, living in and travelling to and from Croatia, make sure to keep up with our dedicated lifestyle section. An article tackling anything from a specific administrative issue to tips on renting a car or bringing your pet into the country is published every Wednesday as part of our How to Croatia series.

April the 5th, 2023 - If you're the citizen of an EU country or a legal resident of an EU country covered by their public healthcare system, you'll own a European Health Insurance Card (EHIC). You can use this card to access certain types of free Croatian healthcare in some cases. Here's how to use it, and what it covers.

First things first, an EHIC is intended for temporary stays in other EU countries, and is (in most cases) for emergency healthcare/unplanned use only. 

What does that mean?

You've eaten some oysters and now all of a sudden you can't stop, erm... paying a ''visit to the bathroom''. You've decided to try to climb up Biokovo in flipflops and upon falling, your ankle has altered its shape and somehow doesn't support your weight anymore. You went for a relaxing swim in the idyllic Adriatic and stepped on a sea urchin. You get the picture. 

If you come unstuck in some way, injured or unwell and you need medical help, you can use your EHIC to access public Croatian healthcare, at very little cost to yourself. Here's how to navigate that:

Finding a doctor

You'll need to find a doctor who has a contract with HZZO (the Croatian Health Insurance Fund) in order to be treated for whatever your problem is, which clearly is not clearing up on its own but doesn't necessarily require hospitalisation. A doctor with a contract with HZZO will treat you upon the presentation of your EHIC, and you'll often be required to pay a symbolic fee in the form of a copay of just under 1.50 euros (that is one euro, fifty cents) which is 10 kuna.

Medical emergencies

Ambulance transportation to hospital in the case of an emergency is covered by your EHIC/HZZO.

Hospitals

You will be treated in any Croatian hospital which has a contract with HZZO. These are typically state hospitals. In some cases, hospital treatment is not entirely free through the use of an EHIC, and you'll need to pay a copay for each day of your hospital stay, this copay is usually around 13-14 euros per day (approximately 100 kuna). The good news is that patient fees are capped at just over 260 euros (2000 kuna). You will need a referral from a GP (called uputnica in Croatian) to access hospital/specialist treatment.

Dentists

Unlike in some European countries which have socialised healthcare, and the United Kingdom is a good example of this being totally different -- dentists in Croatia who have contracts with HZZO will also treat patients for free or for small copays. This is also true for foreign EHIC holders. You'll be able to be treated under Croatian healthcare by a dentist who has a contract with HZZO, and you'll just pay the same approximate 1.50 (10 kuna) copay for your treatment.

Prescriptions

If you need to be prescribed medication, as perhaps it has been determined you have some sort of bacterial infection and as such require a course of antibiotics, you'll need a prescription from a GP through a pharmacy which has a contract with HZZO. Much like in the case with primary care doctors and dentists, you'll need to pay the symbolic 1.50 (10 kuna) copay per prescription issued.

Caveats

Croatian citizens and Croatian residents who have HZZO still need to pay copays for their treatment in the vast majority of cases, you're not being singled out for being a foreigner. 

The Croatian Health Insurance Fund (HZZO) shouldn't be your point of contact for reimbursement. You need to contact your public health insurer (which issued you your EHIC) back home for any cost reimbursements. 

If healthcare in your country is completely free at the point of use, that doesn't mean it will be in Croatia, hence the previously mentioned very small copayments. It isn't entirely free at the point of use for Croatian citizens/residents with HZZO, so it won't be for a foreign EHIC holder either.

In the case of the chronically ill

If you're undergoing treatment for cancer such as chemotherapy, or you require oxygen therapy or dialysis, you can obtain all of this while in Croatia through your EHIC. You should bring all of the documentation and records of what treatment you need, why, and how much with you, and you should make an appointment with someone who will be responsible for your care in Croatia before arriving. 

You are treated differently to those who simply need to use their EHIC to access emergency treatment for cuts, scrapes or a case of the runs. You will be able to access lifesaving treatment here, regardless of your health issues existing prior to your arrival.

Here is an extensive list of hospitals and doctors which have a contract with HZZO and as such provide treatment to EHIC holders on the same basis as they would Croatian nationals/residents who have HZZO insurance.

For a detailed guide to navigating Croatian health insurance if you are moving to or already live in Croatia, make sure to check out this article.

April the 3rd, 2023 - A considerable number of individuals, 300,000 of them to be more precise, could end up losing their Croatian health insurance as a new law is now in force.

As Poslovni Dnevnik writes, a new law will fully enable the Croatian Health Insurance Fund (Croatian: HZZO) to ''clean up'' the records it holds of insured persons from so-called "fictitious" insured persons. Many such people with ''fictitious'' insurance have now left Croatia, got a job abroad and actually no longer have the right to access public Croatian health insurance. According to estimates by the health administration, that figure could total around 300,000 insured persons, writes Novi list.

Amendments to the Law on Compulsory Health Insurance have now entered into force, which prescribe the obligation for insured persons to report to their local HZZO office in person if they have reached the age of eighteen, terminated their employment, or served military service or a prison sentence. In the case of an application to the employment office, such reporting to HZZO offices is not necessary.

The obligation to report in person to HZZO in order to check the circumstances on the basis of which their Croatian health insurance status was determined (if they aren't registered in the records of unemployed persons of the Croatian Employment Service) is prescribed by new legal provisions for everyone after the age of eighteen, after the end of the school year in which they finished their mandatory education or after passing their final exam, or after the termination of an employment relationship.

According to the new law, all those who have just served military service and prisoners (after having been released from an institution for the execution of criminal and misdemeanor sanctions), as well as from a health or other specialised institution, such as a secure psychiatric hospital, must also report to HZZO.

The aforementioned categories of insured persons must report in person to the nearest HZZO office within 90 days from the date of entry into force of the Act, i.e. no later than June the 29th, 2023. If they don't want to remain without any Croatian health insurance, they will still have the obligation to come to HZZO in person once every three months, except for the times during which their names can be found in the records of unemployed persons at the Croatian Employment Service.

Those who do not fulfill their obligation within the prescribed period, i.e. by the end of June this year, and after that once every three months, will simply be deregistered from compulsory Croatian health insurance ex officio, without issuing any kind of special decision.

According to the new legal provisions, insured persons who have registered a temporary departure outside of Croatia can retain their Croatian health insurance until the end of June at the latest, and HZZO will deregister them from compulsory health insurance ex officio at the end of that period, and as stated above, they'll do so without issuing a decision.

These are mainly emigrants who have now left Croatia and gone to work abroad in the last decade, and yet they have remained on the list of insured persons at HZZO and occasionally use healthcare services when in Croatia. At the beginning of 2022, a comparison of the number of inhabitants in the last population census and the number of people who hold Croatian health insurance showed that there are 200,000 more people insured through HZZO compared to the total number of inhabitants in Croatia.

For more, check out our dedicated news section.

February the 28th, 2023 - The Croatian healthcare system saved my life. This isn't an understatement. 

Back in 2006 when I went into anaphylactic shock in Zagreb due to allergies I was unaware I had, hitna pomoć (the emergency services) arriving when they did and not a minute later meant that I could keep breathing and can now sit and write about it. I depend on HZZO (the Croatian Health Insurance Fund) for access to my medication, I’ve had four surgeries, and countless tests and consultations have taken place in between. I joke that having to juggle several chronic conditions has turned me into a professional patient. 

Over the past 18 months, besides my GP and dentist, I needed to see a gynaecologist, a urologist, a gastroenterologist, a pulmonologist, an otorhinolaryngologist, a psychiatrist, a neurologist and an anaesthesiologist.  It was a particularly tough time in which my body decided to just go into self-destruct mode. I got through it, but came out with my eyes more open than ever before having witnessed how devastating relying on a system that is so wrongly neglected can be.

General practitioners - a journey that began 19 years ago

I took my first GP for granted. I remember how my allergies were the first thing listed on my “karton” (medical file) in capital letters and highlighted so that nobody could get it wrong. She was considerate and noticed symptoms I didn’t even complain about. I was safe with her. Later she retired and I moved away from Zagreb.

My second GP was a different story. She’d prescribe me medication during consultations and then pause to ask me, “What are you allergic to again?” This made me worry enough to check the ingredients on all prescribed medication before taking anything. Once she prescribed a pill which those suffering from asthma were (strongly) advised not to take. The second time she gave me a tablet which she reassured me didn't contain any ingredients I was allergic to. I went home, I took it, then minutes later my eyes started burning and my airways tightened up. It wasn't bad enough to go to make me go to the emergency room, but I did make a firm decision to change my GP after that. My criterion wasn’t to find a doctor who cares, only one who wouldn't accidentally kill me.

Good GPs are hard to come by. If you're lucky enough to land one, you should expect that you'll end up needing to wait a while for consultations and they will be hard to get a hold of via phone. If you have time, it’s okay. Otherwise, people save themselves the frustration by opting for ''okay enough'' doctors or simply paying out of pocket.

The deeper you dive, the murkier the water gets...

It may all look great if you’re generally healthy and only need a doctor for the occasional infection or unfortunate accident. I’ve read accounts from foreigners needing to go to the emergency services at the hospital and coming out praising the treatment they receive. Yeah, but… Go there three or four times, hand the technicians at the porta a local name, then sit and wait, and boy will you wait.

I once sat at the ER for hours whilst an older woman kept screaming in complete anguish on the other side of the door. “Ajmeeeee! Ajmeeee! Ajmeee!” (“Ajme!” means “Oh my!”) I couldn’t see her nor in any way know what the problem was, but her pain reverberated through all of us sitting there in the waiting room. We could hear and occasionally see medical personal shuffling around her but clearly nobody was offering this woman comfort. Instead, business went on as usual. After a day spent at the hospital, doing a run around and some tests, I got up and left before I saw a doctor. The psychological strain of hearing that poor woman scream for hours on end was more painful than the physical pain and distress I was feeling. “I’d rather die at home than be here,” I thought. 

I’ve had a dental technician dig in my mouth without gloves for an x-ray. A filling gone wrong resulted in the loss of a tooth...

Last year I went to see a specialist, the head of his department. I entered while he was on his mobile phone in a private conversation. I sat in front of him for fifteen minutes, without him even acknowledging my presence with so much as a gesture for me to wait, before he decided to start the consultation.

A routine gynaecological exam

Gynaecological exams are uncomfortable at best. You just want it over with. I once arrived for an appointment to find that my regular doctor wasn't there and the nurse proceeded to tell me that she was not returning. There was a substitute doctor in her place (most of my unexpected bad visits happened with subs I didn’t plan to see).

I went into my usual routine of undressing, getting into position, closing my eyes and waiting for it to be over. I noticed that it was strangely painful for a routine check-up (the most painful thus far) so I looked down. I was horrified that this man was “down there” and not wearing a mask. This was in the middle of the pandemic when we were still wearing masks everywhere and not just at the clinic. He didn’t give me any feedback so I waited and then asked him if everything was okay. Affirmative. We spoke about medications and I explained my allergies to him. This part was the cherry on top: He prescribed a medication with an ingredient I am allergic to.

I hear more and more women say they go to private gynaecologists following bad experiences in the system.

The coronavirus crisis

Both my husband and I are asthmatic. When asthmatics were included on the government list of high risk patients to be among the first to receive COVID-19 vaccines, I called to place us on the list.

“Where do you live?” The operator asked.

“Janjina.”

“Okay. We’ll notify you when the vaccine becomes available to you.”

Weeks passed and I heard about other chronically unwell patients already receiving their booster shots in other parts of the country. Could it be where we live?

As it turned out, yes. We were listed in the system as residents of our village and would therefore be notified when the vaccines would become available here. Before that happened we contracted COVID-19 and developed a more severe clinical picture which almost landed me in the hospital and took months for both of us to recover from. Had somebody told me to ask to be listed under ''Dubrovnik'' and we would have made it onto the list and simply taken a 1.5 hour drive for our vaccines. I don’t blame the operator. I blame an ineffective system.

Finding a good doctor

Najdoktor.com features doctors with ratings and reviews by patients. It has become my first step in finding new doctors. I won’t accept a rating of less than four stars, and only due to waiting times and personnel, otherwise I want five stars. Anything below that and you’re taking a risk. Unfortunately not all doctors are listed, especially those in rural areas and smaller towns and cities.

The current situation is an unfortunate side effect of Croatia’s brain drain. When I'm lucky enough to get to a very good doctor and they’re still young, panic sets in as I wonder if they’ll decide to go work abroad at some point. If they’re reaching retirement age I panic because I know how difficult they'll be to replace. Our choice, especially in rural areas, is not between good, okay and bad doctors; it is sometimes only between bad doctors who will mostly make okay decisions and no doctor at all. The reality is that okay decisions still save lives (let’s not talk about the bad ones).

Money keeps you alive and where you live matters

I used to be able to depend on the Croatian healthcare system for all my healthcare needs. This has become impossible, so now I’ve switched to a system of prioritising. If it’s high on the priority list, I'll pay. If it’s not so urgent then I'll wait my turn in the system. It’s a juggle in which every element is crucial because I couldn’t possibly pay for everything out of pocket.

I was extremely reluctant to start paying for anything because I was unwilling to let go of the ideal that healthcare is a human right afforded to all citizens. For years I believed that ideal to be a reality in Croatia because I lived it. In most cases I’m paying for speed and not better care. Many of the doctors who work privately come from the public sector so you won’t be seeing a better doctor; just you’ll get to see them sooner.

Your options if you require a brain MRI, for example, are to either wait ten months (or four months if your doctor says it’s urgent) or get it done the next day if you’re willing to pay 240 euros privately. It could be devastating if you don’t have the months or the euros at hand.

I also find that people are making more and more trips to Zagreb. There is a bigger pool of doctors and hospitals, making it much easier to get what you need. The other thing that helps, as with all things in this place, is “veze”, otherwise known as connections. If you know the right person you can get to what you need sooner without paying.

In an ideal world

I’d like doctors to look me in the eyes when they meet and examine me, not stare straight at the screen and start typing as I speak. I’d like more authentic listening and practical solutions and fewer prescriptions. I’d like to leave the hospital feeling like a recognised human being and not one of thousands that nobody noticed. Unrealistic? I don’t think so. But it may be a thing of the past.

I get that doctors have to switch off to stay sane. If they were to invest emotions into every patient they wouldn’t make it or be able to work. It makes sense. However, I feel that a system that is increasingly forcing people to switch off is a clear sign that it is broken for them too.

Where are we headed?

The Croatian healthcare system as it is creates an unhealthy environment for patients, doctors and all personnel.  Healthcare workers are primarily accountable to the system that employs them, leaving us all to have to navigate through its obscure web to get anything done. We need healthcare practitioners to be accountable to us first, the patients whose wellbeing is in their hands.

The problem has been present in the media for years. I’ve been following it in the Dubrovnik region in particular. I always find it funny that reporters mostly interview senior citizens when they pose questions to the public about healthcare. Baka or djed (grandmother or grandfather) will tell you that doctors are not as good today as they used to be and we have a big problem. We nod our heads and perhaps even roll our eyes because they say that about everything. For as long as you're healthy, this is probably a normal reaction. As a “young” person struggling through this system I want to point out that they are not exaggerating and the stories I hear from other chronically ill patients confirm my worries.

I don’t know if it’s going to get better. The way I see it is that if you want the equivalent quality of care compared to what you could get in this country ten to fifteen years ago through state-funded health insurance, then you'll have to pay for it today. Medical tourism will likely fuel this as more foreigners will be willing to pay what for them is a low rate and good doctors will be incentivised to leave the public sector.

Nevertheless, having the good doctors remain in Croatia although in the private sector is better than losing them altogether to emigration. I hope we can save this system and fix the cracks; otherwise Croatia will increasingly become a place where a person’s paycheque dictates their access to healthcare.

For more, check out our lifestyle section.

November the 18th, 2022 - If you've ever been in need of a Croatian GP but just not been able to get anyone to get you on their list because they're all full, you likely know how frustrating it is. Especially if you've already got that dreaded ear infection. Here's what HZZO (the Croatian Health Insurance Fund) advises.

As Poslovni Dnevnik writes, if you want to change your general practitioner, you've found the database of general doctors on HZZO's website, but you only get rejections, you might be left scratching your head. As a rule, the choice of Croatian GP is made according to the place of your residence and the nearest healthcare institution, and you have the right to a new doctor one year after your last choice of doctor if you're unsatisfied.

An insured person (by HZZO) can check if a Croatian GP is taking on new patients in several ways. This information can be obtained at your regional HZZO office in person. You can also contact the e-mail address This email address is being protected from spambots. You need JavaScript enabled to view it., the Croatian Institute for Health Insurance (HZZO) tells tportal.hr. People insured by HZZO can also contact the directorate of health centres in a particular area, and it is also possible to check which GPs have places for enrollment on the HZZO website.

According to the current rules, the minimum number of insured persons who can be assigned to a team in general/family medicine is 1,275, the standard number is 1,700, and the maximum is 2,125 insured persons.

A person's chosen doctor can refuse to take on an insured person only if they have a maximum number of insured persons determined by the general act of the HZZO (for pediatrics 1190 insured persons, for dental health care 2375, and for women's healthcare 9000) under their care already, or, if between the chosen doctor and between the insured person(s) in question, there is a disturbance in mutual relations that makes it impossible to carry out medical treatment.

Insured persons who suspect that they have been improperly refused registration by Croatian GPs can also report the situation to HZZO or to the regional office responsible for their place of residence. In cases of unjustified refusal of patient registration, the competent regional office/area service of the HZZO can carry out an inspection based on the petition of the insured person, and in case of irregularities, it is able to impose the measure provided for in the contract.

GPs and doctors of dental medicine can, on the basis of gaining special approval from HZZO, contract the implementation of healthcare for a new member of an individual family whose family members are mostly treated by that healthcare provider, even in the case when the team has the maximum number of insured persons under their care.

An HZZO insured person can make a change/alter their choice of their chosen doctor by filling in the information on the statement that they can pick up in the office of the doctor they have chosen. The chosen doctor then also enters their data on the declaration form and certifies it with the signature and seal of the healthcare institution or practice in question.

For more, make sure to keep up with our news section.

November the 10th, 2022 - Americans are investing a huge sum of money in a brand new Zabok medical centre, but just how much of a role with the Croatian Health Insurance Fund (HZZO) play in it all?

As Poslovni Dnevnik/Marija Crnjak writes, although many details about the establishment of the new Zabok medical centre, which will be a centre for the treatment of malignant diseases, have yet to be defined, the University of Pittsburgh Medical Centre's (UPMC) investment of about 15 million euros in Hrvatsko Zagorje is the first investment of this magnitude by foreign investors in Croatian healthcare.

The announcement about the investment that will be realised in cooperation with the General Hospital Zabok and the St. Catherine Special Hospital (Sv. Katarina), owned by Dragan Primorac, comes at a time when the state seems to have decided to strengthen cooperation between public and private healthcare.

This is further evidenced by the public support that the founders of the future Zabok medical centre received when signing the cooperation agreement from the government representatives, and support for such projects will also be given by the new legal regulations that will direct patients to private institutions in the country instead of urging them to seek treatment abroad, regardless of whether they have contracts with HZZO or not.

However, we have yet to see how many services from the new Zabok medical centre will actually be made available to Croatia's residents who are HZZO insured individuals. Namely, as confirmed by them, HZZO wasn't officially contacted regarding the possibility of contracting services with the future Centre for Oncology.

For the American investors, however, this is certainly an investment in health tourism, considering that they will be able to gain the market of Croatia's entire wider region, as well as the whole of Europe. It is also the largest American healthcare institution that employs 92,000 employees and 5,000 doctors, with a massive annual budget of 23 billion dollars.

There are a total of 40 hospitals within the UPMC chain, and in addition to over the USA, they are currently present in Italy, Ireland, China and Kazakhstan. As they claim from St. Catherine, this large investment will provide Croatian patients with diagnostic and therapeutic services completely equivalent to those in the USA, in accordance with the existing prices set by HZZO.

The new Zabok medical centre will be located on the premises of the Zabok General Hospital, which the hospital has been renting out to the St. Catherine Special Hospital since back in 2008. It spans 2,200 square metres. In addition, two linear accelerators will be built for radiation purposes, the location has already been defined, and permits need to be obtained for this. The plan is to complete the brand new medical centre in a period of about one year.

"This is primarily about a huge step forward in the transfer of the latest knowledge and technologies from the USA, the kind of which we can only dream of. When we talk to Croatian oncologists, they believe that in a few years, with the support of UPMC, Croatia could be at the very top of the EU in terms of oncology services," Jadranka Primorac, a member of the administrative council of the St. Catherine Special Hospital stated.

She added that this type of therapy and treatment, as well as state-of-the-art diagnostics in cooperation with UPMC, must be available to every Croatian resident. "It is the beginning and the end of everything. If you look at EC strategies, one of the key steps forward is to make this kind of therapy available to everyone, regardless of their ability to pay. Among other things, this is why we have HZZO,'' she explained.

Zabok is apparently now preparing negotiations with the state insurer, HZZO, which so far has not quite fulfilled all the efforts of private institutions to offer their services to the Institute's policyholders in greater numbers. One of the key obstacles was often the too low price of the services covered by HZZO, and since these are new services that didn't even exist within the Croatian healthcare system, those prices have yet to be established.

Negotiations with HZZO will certainly be one of the most important steps for future partners. Director of the Zabok General Hospital, Tihomir Vancina, pointed out that there are still a number of operational and technical matters to be resolved, from space to personnel engagement.

"We agreed in principle that we want to build the Zabok medical centre, and now we need to see how to implement it all," stated Vancina, who believes that everything can be done in the space of one year, especially considering that the investment has been under consideration for four years since the UPMC team was in Zabok for the first time. "This will be a huge step in improving the quality of the treatment on offer.

In the Zabok General Hospital, we have departments where our oncology patients can have part of the procedure, but for the rest they have to go to Zagreb, which will not be necessary in the future. The cancer survival rate in the USA is significantly higher than it is here in Croatia, precisely because of the available therapy that we're now bringing to the country. For the state, this is an ideal model, because it doesn't have to invest in space, equipment and personnel, it only has to pay for the services," concluded Vancina.

For more, make sure to keep up with our dedicated news section.

November the 2nd, 2022 - For foreigners and even those with Croatian citizenship who are moving here, the stress of navigating the sometimes needlessly complicated world of Croatian health insurance tends to come as a surprise...

Nobody wants to think of themselves becoming unwell, developing a hernia or breaking a bone, but it happens. You might eat one too many oysters and need to be in extremely close proximity to a very well functioning toilet, you could jump off a rugged Adriatic cliff and land in a less than ideal position in the sea below, or you might step on the notorious ‘jež’. The jež, or sea hedgehog, isn’t some sort of mythical Croatian monster from times gone by, it is a mere black sea urchin, there are loads of them and they do nothing but sit around all day, but they don’t half pack a punch (or stab, which is more accurate) if you accidentally step on one. 

Health insurance in Croatia is regulated by HZZO, or in English, the Croatian Health Insurance Fund. Much like the rest of Europe, Croatia has a universal healthcare system with private options available too. This doesn’t mean that healthcare is free in Croatia, it isn’t, we all need to do our bit and pay into it to ensure we can all be cared for should we need to be.

Health insurance in Croatia is compulsory, which means everyone resident on the territory of Croatia should have a regulated compulsory health insurance status. That isn’t saying that we all do, many of us don’t, and much like many other ‘mandatory’ things in Croatia… well… the use of the term is a little skewed. That said, you should have it, if for no other reason than for your own peace of mind. 

So, who technically needs to be insured in Croatia?

Long story short - Everyone. Short story long - There are more complications to this than there needs to be, and there are 59 different categories of insured persons!

Let’s start with the basics. In Croatia, there are three types of healthcare coverage. One is obvezno (mandatory), the others are dodatno and dopunsko, which act as additional coverage on top of your obvezno insurance. Think of it in levels; 1) Obvezno 2) Dopunsko 3) Dodatno.

Universal healthcare coverage is the norm all over Europe, with the British NHS being a not perfect but absolutely enviable tax-based model where nothing is paid at all at the point of use regardless of what needs to be done. Croatia’s socialised health insurance system is similar in the sense that it is based entirely on the principles of solidarity, meaning that all residents of Croatia, be they foreign or Croatian, are expected to contribute to the fund according to their respective abilities to pay for it. Everyone is paying for everyone else, and for the system to exist, and in turn they receive healthcare services according to their needs, from the prescribing of antibiotics for that pesky trachea infection that makes you sound like a chain smoker to open heart surgery that you need because you quite literally are a chain smoker.

You don’t need to pay if you’re under 18 years of age, you’re incapable of living an independent life, if you’re a disabled member of the Croatian Armed Forces, or if you’re the direct family member of a missing or dead member of the Croatian Armed Forces.

There are some other exceptions with more detailed explanations, but assuming you’re a foreign resident, you’re highly unlikely to be any of the above, so I’ll move on and offer a brief look at what the different types of Croatian health insurance mean and include.

Obvezno zdravstveno osiguranje is the most basic of the basic must-haves in Croatia. It’s the one everyone living in Croatia is meant to have from HZZO. You don’t need it if you’re an EEA citizen or permanent EEA resident who is covered by national health insurance in another EEA member state. This goes back to what I mentioned previously about not being allowed to be insured in two EEA member states at the same time.

Dopunsko zdravstveno osiguranje is a bit like a beefed up version of obvezno. It’s supplemental and totally optional, and you can take out a policy either as a public or private health insurance policy. You can get it from either HZZO or even from a bank or independent insurer. It eliminates most copayments for medication prescriptions, visits to the doctor, diagnostic workups, tests, and hospital stays should you need hospitalisation for any reason. If you’re someone who is, for example, diabetic, or suffers from some other sort of chronic condition such as hypertension which needs constant medication and frequent monitoring, this would be a good option. Copayments in Croatia are small, but why pay them if you can avoid it?

Dodatno zdravstveno osiguranje is the top of the range when it comes to Croatian health insurance. It covers absolutely everything and isn’t on offer from HZZO but from independent insurers and banks. This policy covers preventive care, visits (as many as you need) to all kinds of specialists, additional treatments, any laboratory test you can imagine, and extended hospital visits should you (God forbid) need that. You won’t need to pay anything out of pocket whatsoever if this is your policy of choice, and once again, it’s great if you’re someone who does suffer from some sort of chronic ailment that needs medicating and/or a watchful eye kept on it.

Now we’ve covered that, you might be wondering how you enrol into HZZO

First, you need to find the HZZO office for your area of residence, a full list can be obtained by accessing hzzo.hr and selecting ‘English’ in the top right corner. Alternatively, you can ask at MUP during your residence procedure.

Once there, you’ll need to explain that you’re a resident in Croatia and you’d like to enrol for obvezno health insurance.

If you’re a citizen or permanent resident of the EEA and as such you have an EHIC, you technically do not need to enrol in HZZO because you shouldn’t be publicly insured in two EEA member states at the same time. You absolutely can enrol in HZZO should you so wish, but you’ll need to provide proof that you’re no longer insured by the other EEA country in question. This is where things can get tricky.

When Britain was part of the EEA, many, many British residents of Croatia had endless issues trying to enrol into the Croatian healthcare system because the NHS is not health insurance but a right automatically afforded to people born and living in the UK, and because the document HZZO wants (proof of no longer being insured in the UK) seems to be as elusive as the abominable snowman. Many people have never heard of such a document and have absolutely no idea what is being sought. Now the UK is no longer an EEA member state, that awkward problem is hopefully a thing of the past.

It’s technically HZZO which needs to seek this document, not you. If they ask you for it, let them know that you're not the one who needs to be chasing it, they are.

If you manage to bypass this requirement, or you’re simply not asked, and you’re an EEA citizen or permanent resident, you can be enrolled into the Croatian health insurance system. Your first step is filling in the form to sign up which will be given to you or be made readily available at the office. 

A back payment, for a year in which you weren’t even in Croatia…

This might sound utterly preposterous, and to many people it does appear quite ridiculous, but there’s logic here, so hear me out. Some people (such as those who aren’t being signed up to HZZO) by their employers, need to pay ‘back pay’ to HZZO for the previous year. So this is 12 months of premiums, all in one go. But I wasn’t even here?! I hear you cry. I know, it seems like a complete con, but the reason behind it is this: what if you turned up, enrolled for free, got hit by a bus on your way home and then needed major surgery? What if you have a chronic health condition you failed to mention and started eating the system out of house and home as it were? Insulin, blood thinners, inhalers, statins, the works! That wouldn’t be fair on the people paying into the system, while you’ve paid nothing and yet you’re reaping the rewards of a socialised medical system.

Of course, one sincerely hopes that they will never be hit by a bus, struck by lightning, attacked by a shark, be knocked unconscious by a falling brick or anything else of the sort, but these are things we unfortunately cannot predict, and nor can HZZO. If you have a chronic health condition which will require the use of the system for prescription medication and therapies, you should also be paying your part into the system in order to be on a level playing field with everyone else paying their contributions.

I truly understand that it might seem like an absolute con and a half to be asked for a document that nobody seems to have ever heard of, such as ‘release from health insurance in another EEA country’, and then once you’ve fought that battle, be asked to pay for the health insurance you would have needed to pay for had you been here over the past 12 months, but you didn’t and couldn’t have, because you were not here… Yeah, I’ll give you that, it seems a bit like someone is taking the Michael, as they say in England, but hopefully the above explanation makes it seem a bit more rational.

I’ve been hired by a Croatian company, do I need to go and enrol at HZZO?

No. Your employer is obliged by law to do this for you using what’s known as a T-2 application form. You don’t have anything to do with this process.

Getting a health insurance card

As soon as you finish enrolling at the HZZO office, or as soon as your employer is finished enrolling you, you’re insured. You’ll be given paper confirmation of that fact by the clerk, and you can use this if you do need medical help as proof of you being insured by HZZO. You will get a proper plastic card attesting to that fact in the mail eventually, this can take weeks to months to arrive, so don’t panic if it doesn’t turn up for a while, you’re insured regardless and it will.

How do I find a GP?

Got a cough that just won’t go? Eaten one too many seafood platters and become best mates with the toilet? Found a weird rash you can’t leave alone? Your GP needs to be your first port of call unless it is an emergency, in which case, well, the emergency room needs to be your first port of call. 

From ear infections to ingrown toenails and everything in between, GPs, or as they’re called in Croatia ‘family doctors’ (doktor opće medicine/obiteljski liječnik) are the ones who will prescribe the antibiotics, sprays, prescription ointments and so on. 

Most people have a GP, a paediatrician for their kids if they have them, a gynaecologist if you’re a woman, and of course, the one who tells you off for eating too many sweets - a dentist. 

Let’s not get ahead of ourselves with all of the different doctors. Here’s how to find and get registered as a new patient with a GP

HZZO’s website (hzzo.hr) has a list of GPs. You’ll need to go through the list of those in your area and call them to ask them if they’re taking on new patients. Alternatively, you can use word of mouth, which is worth its weight in gold in Croatia for just about everything. GPs can’t turn you down if they are taking on patients, which is good news. But be aware, they might not pick up the phone when you call, and the GPs with a great reputation among the local bakas (grandmothers) will likely not be able to take you on.

Once you find a GP and are accepted as a new patient, you’ll fill in a form which you’ll get from the doctor’s office, and then you’ll need to give it to the doctor. They then fill in their part, and send it off to HZZO. That’s it, you’re done.

Your GP will be the one you visit first with your health complaints which aren’t medical emergencies. They are qualified to run certain tests, and also to make a decision as to whether you need to be referred for more tests, scans, and/or to a specialist at a polyclinic or a hospital. If you do need to see a specialist for further diagnostics and tests, you’ll be given what’s called an uputnica (a referral). This used to be a slip of paper and it’s now digital (yes, Croatia is actually catching up, believe it or not), and is called an e-Uputnica.

How do I find an English speaking doctor?

English is very widely spoken in Croatia, and most educated people speak it excellently. Most doctors speak some degree of English, some with complete fluency. In smaller areas, especially down on the coast or in the Dalmatian hinterland, you might come across doctors who speak very little to no English, however. The British Government’s website (GOV.UK) and its Croatia page has a handy tool you can use to find the names of English speaking doctors, as does the US Embassy’s website.

In case of emergency

As stated, if you’re experiencing a medical emergency, go straight to the nearest hospital with your health insurance card or the piece of paper HZZO gave to you after you enrolled, don’t wait on your GP. If you’re a mere tourist with no intention of becoming a resident, take your passport and your EHIC. This is now a GHIC if you’re British.

Things to be aware of

Everyone resident in Croatia is supposed to have a GP. Does everyone have one? No. Can everyone get hold of theirs on the phone or via email if they do? Also no. 

Obvezno (mandatory health insurance) does not cover birth control, cosmetic surgery, abortion, or the expenses of medical treatment sought because of some sort of religious conviction or personal preference that isn’t deemed medically necessary.

Unless you have dodatno health insurance (or dopunsko, in a wide array of cases), you may need to pay a small copayment for certain medications, procedures or hospital stays. This is usually a symbolic sum.

Contraception and abortion in Croatia

Contraceptives

Condoms are available in all kinds of stores, from Lidl to newsagents, and even in Tisak kiosks. There are various brands on offer just like all over the world.

I mentioned above that contraceptives aren’t covered by obvezno health insurance in Croatia. Some brands of contraceptive pills, however, are covered if you have taken out a dopunsko policy, but generally you need to pay out of pocket for them and you’ll also need a gynaecologist to give you the green light (and a prescription) following a pelvic examination and a few general health questions to check all is well. The gynaecologist can be a state healthcare provider or a private one, it doesn’t matter at all.

When it comes to intrauterine devices (IUD), you also need to pay. You can get certain types at certain pharmacies and gynaecology practices. Following the purchase, a gynaecologist needs to perform the procedure and insert the IUD into your uterus following the ‘green light examination’ I mentioned above. They may want to examine you again and ask some questions before beginning the procedure to double check.

Plan B and C

Levonorgestrel, more commonly referred to as the morning after pill (Plan B) is available to purchase at all pharmacies (a pharmacy is called a ljekarna in Croatian). Health insurance doesn’t come into this. You can just go and purchase it. It prevents pregnancy in an impressive 95% of cases if taken within 24 hours, and you don’t need to speak to a doctor, nor do you need a prescription.

Mifepristone is a drug often used in combination with another drug called misoprostol to induce a medical abortion and manage early miscarriage. This is known as Plan C, you need a prescription and it can be used until the 10th week of pregnancy in Croatia. Once the prescription is taken to a pharmacy, they aim to have it within one to two days, after which you must take it for a period of four days. After that, you’ll need to go back to the gynaecologist who will perform another pelvic examination to make sure the termination is complete.

Abortion

This is still a touchy subject in Croatia, but abortion is legal and has been for a very long time. If you’re determined to have an abortion and you’ve passed the 10 weeks of pregnancy mark, you need to be absolutely certain of your decision, and while you don’t need any counselling like you do in certain other countries, even the more liberal ones, you do need to convince your doctor you’re 100% sure, as well. 

Once you’ve made your intentions clear, you’ll be spoken to about something called the Commission of First Instance, consisting of a gynaecologist, another doctor, and a social worker or registered nurse. The commission then either chooses to approve the abortion if it is medically necessary to save the woman's life or preserve her state of health, whether that threat to her health is present during the pregnancy, or during the delivery itself.

What does that mean?

An abortion after 10 weeks will likely be approved if what will become a baby is likely to, or will definitely be born with a congenital defect or if the unwanted pregnancy is the result of a crime such as incest or rape. The Commission's decision may be appealed to a Commission of Second Instance, whose decision is final. This sounds daunting, but it doesn’t even come into it in situations where the woman's life or health is in immediate danger or the abortion procedure has already begun. 

Once you’ve been given the green light, you’ll be referred for the procedure, which typically lasts around 40 minutes as long as there are no complications or bumps in the road, and is typically carried out at a hospital. The facility set to carry out the abortion must have a obstetrics and gynaecology department.

Abortions aren’t free, and they are typically not covered by HZZO. You’ll need to fork out a few thousand kuna for the gynaecological exam, blood tests, and the procedure itself.

Things to note

Certain types of IUD are free of charge and covered by HZZO entirely if the woman in question suffers from anaemia as a result of blood loss during abnormally heavy periods.

There are numerous types of contraceptive pills available in Croatia, ask the gynaecologist which one is right for you based on your own medical history, possible medical issues, and potential hormonal issues. If you have had issues with a particular brand in the past, make sure to mention it.

Some pharmacies can refuse to sell Plan B (the morning after pill) on religious grounds. It sounds absolutely beyond comprehension, but it can and does unfortunately happen. If this happens to you, go to another pharmacy.

There is something called ‘conscientious objection’ in Croatia, and much like the above case with Plan B and some pharmacists, some doctors use it to refuse to agree to refer a patient for an abortion, or to carry out the procedure. If this does happen to you, don’t waste your time pleading your case, save yourself the energy and seek out another doctor.

The tide appears to be turning when it comes to the issue of abortion in Croatia. Back in the pandemic-dominated year of 2020, the Ipsos Puls agency conducted a poll in which 81% of respondents agreed with the statement that a woman should have a right to choose regarding pregnancies, giving birth or abortions, of which 68% completely agreed and 13% mostly agreed.

On a much lighter note, you can get free tests for sexually transmitted infections (STIs) through HZZO.

If you’re prescribed some medication, you’ll pay a very small copayment when picking it up from the pharmacy. The amount is symbolic.

Additional information in more specific cases, such as cross-border healthcare, can be accessed by visiting HZZO’s National Contact Point page, or emailing them at ncp-croatia@hzzo.

Alright, I’ve found a doctor, how do I go about finding a dentist?

Dentists are those kinds of people you just don’t even think about until you can’t stop thinking about them, either because your tooth has suspiciously just started hurting or because you’ve parted with your hard earned cash, all for a tiny filling you won’t even be able to see and what feels like a smack in the face.

They don’t evoke pleasant thoughts, nor do their whirring tools, but they’re very necessary. 

If you’re a tourist in Croatia, you just quite literally need to find one, see if they have an appointment free for you, pay out of pocket for what you need to be done and then be on your merry way, hopefully never to return again. In all honesty, the same can be done as a resident who has Croatian health insurance. If you’re willing to pay out of pocket, you can’t be bothered to go flicking through the dentists which have contracts with HZZO and you need help right now, you’re free to do as you like and go to whoever will treat you. 

Dental care in Croatia is typically of a very high standard, and the prices are very favourable compared to what many people are used to paying elsewhere. This has become such a trend that Croatian dental (and health in general) tourism has been blossoming, with some polyclinics having earned stellar reputations among locals and foreigners alike, be they coming for necessary work or cosmetic procedures.

Finding a dentist who has a contract with HZZO

If you want to find a dentist who has a contract with HZZO and it isn’t cosmetic work you’re after, you’ll be able to be treated for free, although you might need to pay a very small contribution in participation costs.

Cosmetic dentistry

Croatia is making quite the name for itself in this regard, and there are, as I mentioned a little while ago, numerous polyclinics springing up offering excellent services for very favourable prices. Dentists in Croatia study at the School of Dental Medicine in Croatia, which is the only one of its kind in the country, and the care they provide is of high quality. Foreigners from all over the world come to Croatia to get their dental work done, enjoying stays in hotels, sightseeing and the gastronomic scene (as long as they can eat, of course!) all while completing their treatments. 

Croatian dentistry has an absolutely brilliant reputation internationally, and with very good reason.

For more on navigating the practicalities of life in Croatia, make sure to keep up with our How to Croatia articles each week by following our lifestyle section.

October the 28th, 2022 - This week in Croatian politics, we've had everything from insults, Slovenia's opinions on Croatian Schengen entry and wage increase proposals to healthcare reforms, Milanovic's latest actions, and Nancy Pelosi.

The Croatian Health Insurance Fund's HDZ boss referred to Croats as arrogant in his speech about healthcare not being free

The director of the HZZO, HDZ member Lucian Vukelic has referred to Croats as arrogant because "they think healthcare is free". The HDZ member at HZZO's helm also made sure to refer to himself as somewhat arrogant, too, just for good measure.

"We have a lot of relatives in America, as soon as you see them, they say: 'Thank God I'm healthy'. They say that because healthcare costs serious money in America. In America, you pay for your healthcare out of your own pocket. Our people here are arrogant, and I must say that even I was arrogant, people in Croatia say 'it's free'. It's not free. Healthcare in Croatia isn't free, healthcare in Croatia also costs money," he said.

Vukelic failed to really explain what the point of saying any of that actually was, but he seemed to imply that there is a widespread opinion across Croatia that healthcare somehow doesn't cost money. Moreover, Vukelic himself said that a third of Croats who work annually pay 26 billion kuna from their wages for basic health insurance, so they certainly know that healthcare isn't free.

Of course, there's also the question of what we actually get out of this healthcare we're paying for, which HDZ member Vukelic claims is expensive. It would perhaps be okay if, given that Vukelic is already more than happy to admit that we all pay dearly for our healthcare, he explained why every now and then people are forced to collect money for their treatment, why pregnant women sometimes have to take their own toilet paper to maternity hospitals with them, why the waiting times for often basic examinations are so long and why medical staff are leaving Croatia.

Only later, when asked by a journalist about his statement, did the HDZ member try to justify himself by calling himself arrogant as well, which is absolutely true, but it is also true that he called other people arrogant with the thesis that "our people say that healthcare is free", which honestly, they don't. When they see how much of their wage is shaved off for it each month, they definitely do not.

A man who takes home a monthly salary of over 18,000 kuna, who drives a 300,000 kuna Mercedes, who has an official car, who owned a 150,000 kuna 2001 Harley Davidson until 2019 and who claims his ''communication skills are excellent'' but makes sexist remarks on a TV show (Otvoreno) about women talking a lot should perhaps quiet down before calling others arrogant.

On the topic of healthcare, Health Minister Vili Beros has announced reforms to the system

Beros has presented his healthcare reform package, and it's extensive. Preventative examinations will be introduced, with pilot projects beginning next year in two Croatian counties, the number of specialisations in primary healthcare will be widened, there will be revisions for national preventative programmes for malignant diseases, a focus will be placed on melanoma, hospital system changes are set to come in, and there will be an emergency helicopter service fully established and up and running (or flying) by 2024.

This is just a little bit of what was presented and discussed. You can read more details in this article.

Are Croatia and Slovenia set to start falling out over Schengen entry?

The topic of Croatian Schengen entry is hotting up as the country's Eurozone accession rapidly approaches, but is neighbouring Slovenia ready to throw yet another spanner in the works? 

An expert in European Union law from the Faculty of Law in Maribor, Janja Hojnik, was a recent guest of Novi Dan on N1 where Croatia's entry into Schengen, among other things, was discussed. Hojnik noted that, as far as it seems, the Slovenian Government has not decided to block Croatia's entry into Schengen in any way.

"It has been determined that it is a mutual benefit for Croatia to enter the Schengen zone. The plan is for Slovenia to also ratify the agreement on Croatia's entry into Schengen," she said. She also commented on the announcement, which was published yesterday in the Ljubljana-based newspaper Delo, that Slovenia will issue a unilateral note stating that Croatia, by entering the Schengen area, accepts the arbitration ruling which was reached in the past regarding a territorial dispute.

"Recently, I was on Slovenian television and they asked two ministers for their comments on those statements and one minister said that it was all misinformation, and the Minister of Justice said that the Government hadn't even commented on it and that she knew nothing about it, that this statement should be confirmed in parliament, and there is no information from the Foreign Policy Committee about it. We can only speculate whether it will be brought to the Slovenian Government itself or to parliament. I think it would be a little unusual if it were inserted into the Act on Ratification. This is not the norm and the European Commission would probably ask Slovenia what it all means. I don't think that ratification with this condition is possible. I don't see any legal consequences to this. Such a statement can't be part of European Union law, and it doesn't have any legal consequences even in international law,'' explained Hojnik.

When speaking about the arbitration agreement between Slovenia and Croatia, she said that the task of politics is to resolve relations between neighbours, not to deepen them.

"I'd like Slovenia and Croatia to solve this problem themselves, without any external factors getting involved. Schengen is probably the last thing where Slovenia could have a veto. It is in Slovenia's interest that they aren't on an external border. I see it as the responsibility of politics to find an agreement,'' she said.

Plenkovic says he's going to regulate work on Sundays and raise the minimum wage. Again.

PM Andrej Plenkovic recently discussed the state of the economy, ongoing inflation, the consequences of the global coronavirus pandemic and of course, Russian aggression against Ukraine. Digitalisation and the green transition, two topics that keep coming up, were also touched on. Perhaps what attracted the most attention of all, however, were the discussions on banning (or should I say regulating) work on Sundays (remember that?) and of course, talk of raising the minumum wage. If you've spent any time following the domestic political scene, neither of the aforementioned and farily worn out topics will come as a surprise to you.

"We're going to regulate work on Sundays and the minimum wage will go up,'' says Plenkovic, who announced that his government would make several steps forward in both this and in other regards in the coming weeks. "We'll regulate work on Sundays and we've come up with a rational, well-balanced proposal," Plenkovic assured, adding that the minimum wage will also increase from next year to 4,220 kuna net, and a proposal for an additional tax on extra profits is being prepared in order to more fairly share the burden of the ongoing crisis. He also announced the continuation of the social dialogue with the trade unions, with whom intense conversations have been happening of late.

He noted that in just two months, the Republuc of Croatia will be among the fifteen countries in the world that are in NATO, the European Union, Schengen and the Eurozone, and that negotiations with the Organisation for Economic Cooperation and Development (OECD) have been launched.

Plenkovic uses yet another opportunity to troll President Zoran Milanovic (SDP)

If you've spent any time in the City of Zagreb over the last few days, you'll have noticed that getting anywhere by road proved impossible for about 48 hours. The Crimea Platform Summit was being held right here in the Croatian capital, and for road users, the problems were very much in evidence. Plenkovic recently discussed how this extremely significant summit went, making no effort to hide his satisfaction with how it unfolded, and once again offering words of support to Ukraine.

It didn't stop there. If you follow Croatian politics, you'll know that Andrej Plenkovic (HDZ) and Zoran Milanovic (SDP), the Prime Minister and the President of Croatia, make sure to miss no chance to insult or troll each other, and this was no exception. Plenkovic made sure to make his feelings clear on Milanovic's earlier comments about Nancy Pelosi and the aforementioned summit.

"I think you're more than aware of just how important, useful and excellent an event like this that we organised actually is for the courageous, correct and moral foreign policy of the Croatian Government. This topic of whether or not someone went to Makarska just isn't the subject of my interest. He can explain that one himself,'' Plenkovic said, referencing Milanovic having gone to the aforementioned part of Central Dalmatia.

''I guess you can see who has been saying what over the past few years. I don't know what sort of rally he'll decide to go to, maybe he'll go to one Russia organises. Mrs. Pelosi didn't waste her time on irrelevant things, and neither did we," Prime Minister Plenkovic concluded, having made a very clear jab at Milanovic with the Russia comment. Gordan Grlic Radman, the Minister of Foreign Affairs, also touched on the topic of Milanovic, claiming that ''people are calling and asking what Croatia's position actually is'' in regard to the Russia-Ukraine war.

Nancy Pelosi praises Croatia for its humanity towards Ukraine and refers to the country as a leader in the diversification of energy sources

Nany Pelosi said that Croatia could offer Ukraine a lot owing to its relatively recent experience of war, and she also said that this country is a leader in the diversification of energy sources. Pelosi issued a warning that energy has become a means of blackmail in Russia's horrendous aggression against Ukraine, before thanking Croatia and Plenkovic for their leadership in the field of energy.

"Croatia is a small enough country to be resilient, but big enough to be significant in terms of security, democracy, peace and values," Pelosi believes, adding that the diversification of energy sources is helping to save planet Earth. Plenkovic said that with the construction of the LNG terminal on Krk, Croatia has now ''finally resolved" a four-decade-long debate in energy circles and that by deciding to increase its capacity, the government has "enabled Croatia to become an energy hub'' for natural gas.

Pelosi also said that the Croatian capital is the "perfect" place for the summit to be held, emphasising the very strong Croatian-Ukrainian friendship and the help that Zagreb continually provides to Kyiv as it goes through such terrible times.

For more on Croatian politics, make sure to keep up with our dedicated section, and keep an eye out for our A Week in Croatian Politics articles which are published each Friday.

August the 16th, 2022 - Replacements of certain medicines are set to arrive on the Croatian market as making savings becomes extremely necessary in the enfeebled Croatian healthcare system.

As Poslovni Dnevnik/Josipa Ban writes, counting the pennies within the wider Croatian healthcare system, especially in the consumption of medicines, is now more needed than ever. We've been witnessing accumulated debts for medicines for decades now, which, after numerous rehabilitation attempts by the Ministry of Finance, are still far from reduced. In fact, they only grew enough to reach slightly more than six billion kuna at the end of April this year.

HUP - the Association of Pharmaceutical Manufacturers have been warning about some of these debts for some time, noting that they definitely can be reduced. The Croatian healthcare system's annual savings could rise from the current 300 million to as much as one billion kuna if consumption were to increase and the procedure for including generic drugs on HZZO's list of drugs for the Croatian market was finally accelerated.

There are some substitute drugs that come to the Croatian market when the patent rights to the original drug eventually expire. As their placing on the Croatian market means more competition, the price of the medicine also drops at the same time. The situation here, at least according to data from back in 2019, is that 61 percent of the volume in the consumption of prescription drugs across the Republic of Croatia is made up of generic drugs, and they only account for 5% of the total healthcare sector's budget.

"Although this percentage has been increasing over the years, it's still somewhat lower than the EU average, which stands at 67 percent. This shows us that there is still a great potential for the use of generic drugs in this country,'' they emphasised from HUP- the Association of Medicines Manufacturers, whose members, in the period from 2010 to 2020, invested a total of 5.4 billion kuna. As far as biosimilar medicines are concerned, the situation is much worse, and back in 2019 they occupied a modest 13 percent of the Croatian market.

A complicated procedure...

One of the reasons for the lower consumption of generic and biosimilar drugs, which causes higher expenditures for such medicines, is the procedure that manufacturers must go through in order to get on HZZO's drugs list.

Jerko Jaksic, president of the PharmaS Management Board and president of the HUP Association of Drug Manufacturers, explained that the process of placing a generic drug on the Croatian market takes approximately one to two years.

"The first stage is the registration of the drug with HALMED or, for biosimilar drugs, with the European Medicines Agency (EMA). After approval from HALMED or EMA, it takes up to six months for the HZZO to place the drugs on their list. Although the situation is somewhat better than it was around ten years ago, that part of HZZO could and should be accelerated. What I mean by that is that following HALMED and EMA approval, these medicines should automatically be included in the lists of medicines, without any additional administrative steps because there's no need for them. Unfortunately, here too we have an example of resistance to changes and adaptation of the system, as well as the classic slowness of the administration,'' pointed out Jaksic, adding that automatic inclusion would speed up processes and the arrival of medicines on the Croatian market, as would cheaper drug therapies for patients in three to six months.

"It would also bring savings of several tens of millions of kuna on an annual level for the entire Croatian market," said the president of the PharmaS Management Board. HUP noted that the role of generic and biosimilar drugs is extremely important for both the healthcare system and the patients themselves.

"In fact, these drugs make many key therapies available to more patients, and for the same or at a lower cost than before their introduction. For example, two to three boxes of prescription drugs issued in Croatia come from the generic industry, and the share of generic drugs in the cost of all drugs is only 27 percent. If we look at the pharmacy system, the share of generic drugs is 65 percent, and this accounts for less than 40% of the drugs budget," they explained.

Great potential

In addition to all of the aforementioned, there is no fear for the patient because prescription drugs and generic drugs are the most organised part of the healthcare system. Jerko Jaksic noted that their importance has long been recognised by GPs. However, hospital doctors are not yet following suit.

"Hospital doctors have a lower level of knowledge of generic and especially biosimilar therapies, they also lack a developed awareness of the financial savings they can enable. There's a great untapped potential there, above all in the sense of using cheaper generic and biosimilar therapies in order to reduce costs for hospitals,'' said Jaksic.

There are, therefore, several mechanisms that we must change in order to accelerate the introduction of generic and biosimilar drugs on the Croatian market, and thereby contribute to significant savings.

"It's necessary to systematically implement the existing regulations for the determination of the price of drugs, to include generic drugs on HZZO's drugs list faster, and to enable the faster penetration of generic and biosimilar drugs into the wider hospital system,'' the HUP Association of Drug Manufacturers believes.

With these measures, along with measurements of treatment outcomes, they say, savings in the healthcare system can reach up to 1 billion kuna per year. So, the ruling party has a solution. But is the will there?

For more, make sure to check out our dedicated lifestyle section.

August the 13th, 2022 - There have been some absolutely horrific stories about the state of the Croatian healthcare system of late, and so it might seem as if nothing within the four walls of a hospital can be trusted. While that is absolutely not true at all, it is more than understandable that people fear potential illness. Some good news is that HZZO will now foot the bill for a test that can be done in a private facility, without all of the long waiting times typically associated with busy, overworked state hospitals and other healthcare facilities.

Magnetic resonance imaging, commonly known as MRI, can reveal an extremely wide array of issues going on within the human body in a remarkably clear way. This type of scan is used for all sorts of health issues, and the waiting times associated with them are sometimes bafflingly long. A new plan for which HZZO (Croatian Health Insurance Fund) will gladly foot the bill may relieve some of that pressing problem, which is an issue for both hospitals and of course for the patients.

As Poslovni Dnevnik writes, in order to reduce the usually extremely long national waiting list for magnetic resonance imaging (MRI), HZZO came to what will be to most a very welcome decision on entering into a contract with Medikol Polyclinic.

As reported by the aforementioned polyclinic, according to that decision, HZZO will provide the Medikol Polyclinic with a list of patients who are on the waiting list for MRI scans in hospitals for a variety of different reasons, and the Medikol Polyclinic will provide them with magnetic resonance imaging through a referral by December the 31st, 2022. MRI scans carried out via this new agreement with HZZO will be available in Zagreb, Cakovec, Split and Osijek.

''We will be able to accept referals only from those patients who are already on waiting lists for MRI scans in hospitals and are on the list provided by HZZO,'' they wrote from Medikol when it announced the new plan on its Facebook page.

For more on healthcare in Croatia, make sure to check out our dedicated lifestyle section.