Health insurance

What it means

Public health insurance is compulsory insurance that pays for healthcare. In Slovakia it is provided by health insurers, among which the insured person chooses and may switch once a year. As a rule, everyone permanently resident or employed in Slovakia is insured.

Contributions are paid by employees and employers on wages, by sole traders on their income, by self-payers with no other income, and for certain groups, such as children, pensioners or parents on maternity leave, by the state. The law sets the rates, and they differ for some groups.

Advances are paid during the year, and after the year ends the insurer carries out the annual reconciliation, comparing the advances paid with the actual liability. For low-income employees the contribution allowance reduces contributions.

How it works in practice

When an employee starts, we notify their health insurer that we have become a payer of contributions, and we report again when they leave. Each month we send the insurers statements of advances and pay contributions by the deadline linked to payday.

For sole traders we monitor the level of advances, which are based on the previous year’s income but at least the minimum assessment base. After the annual reconciliation the advances change, so we tell clients the new amount and remind them to adjust their standing order.

Where someone has several sources of income, such as employment and a business, contributions are calculated on the total and settled in the annual reconciliation. We prepare an estimate for such clients so that the result does not come as a surprise.

What to watch out for

Health insurers enforce arrears through an arrears statement and enforcement proceedings. A debtor may have restricted access to some planned treatment, and larger debts can lead to being placed on a list of debtors.

Someone who leaves employment and neither starts a business nor registers with the labour office also becomes a self-payer. The duty to notify the insurer of the change within the statutory period is often overlooked, and arrears then grow with penalties.