Self-payer

What it means

A self-payer is a person who pays their own health insurance contributions because no employer pays them, they are not compulsorily insured as self-employed, and the state does not pay for them either. In Slovakia health insurance is compulsory for everyone with permanent residence, so someone always has to pay.

A typical self-payer is someone between jobs who is not registered as a jobseeker, a person living on rental income or investment income, or someone who has stopped trading and has no other basis for insurance. A company shareholder who receives only dividends can also become a self-payer.

A self-payer pays monthly advances at least on the minimum assessment base, which is derived from the average wage, with the exact amount set by law each year. After the year ends, it is settled in the annual reconciliation, which may show an underpayment or overpayment.

How it works in practice

For clients ending employment or a business, we point out that the change of payer must be reported to the health insurer within the statutory deadline. If not, the insurer discovers the obligation later and assesses the arrears plus late-payment interest.

For directors and shareholders who draw neither salary nor fees from the company, we check whether they have another basis for insurance. If not, they become self-payers and must pay the advances themselves, however well the company is doing. This also applies to shareholders living on profits and dividends.

A self-payer with other income during the year, such as rent, reports it in the annual reconciliation, and the insurer recalculates contributions from total income. It is wise to budget for a possible top-up, especially if rental income has risen significantly.

What to watch out for

The most common mistake is assuming no contributions are due without income. Contributions are payable on the minimum base, and if the person is not registered with the labour office or otherwise covered, arrears build up for months and the insurer later collects them with interest.

Unpaid contributions also have practical consequences. The insurer may limit a self-payer in arrears to emergency care only until the debt is settled. Regularly checking the contribution account is therefore worthwhile.