The Ministry of Health oversees the health service and the Health Insurance Fund (HIF) collects the contributions, allocate funds, supervise and contract healthcare providers.
All citizens are entitled by law to equal access to healthcare.
The health insurance fund reimburses the costs for prescription medicines, although patients may have to make co-payments up to 20 percent of the cost.
Citizens who belong to vulnerable groups of society are exempt from charges. You and your family may be entitled to reimbursement of travel and subsistence expenses if for example you are hospitalised outside of your local area.
If you have to be treated outside of Macedonia, you will have to make co-payments of 20 percent for your treatment and medication. If you need prostheses or orthopaedic appliances, you have to pay 50 percent of the cost.
The HIF take into account a person’s income status, when assessing the amount of co-payments they must make. Children up to age 18 and OAPs also pay reduced so-payments.
Citizens can take out additional private insurance to cover services not provided by the state system. You are not allowed to opt out of the compulsory state system. Few people in Macedonia have the means to take out private healthcare.
Doctors are the first point of contact with the state health system. Citizens can register with the doctor of their choice; however, people seeking state medical care must make sure that their doctor is contracted into the HIF scheme.
If you are treated by anyone other than a state funded doctor, you will have to pay the fees yourself. Doctors are allowed to work in both sectors (private and public) at the same time and can use state facilities for their treatment.
It is important to note that not all doctors are trained in general practice.