Methods and Proceedings for Claiming Health Services

Medical services covered by the compulsory health insurance in the Republic of Slovenia may be claimed within the framework of a public health network, i.e. in public health institutions (health centres, hospitals, pharmacies), and from private doctors (general practitioners, specialists, dentists, pharmacists) who have concluded a contract with the ZZZS. In the case medical services are claimed from private doctors who concluded no contract with the ZZZS, the services must be paid for in full. The information about the providers who have concluded a contract with the ZZZS is available on web pages and also at the ZZZS regional units or subsidiaries.

List of health care providers in Slovenia (contract with ZZZS)

Urgent medical treatment and urgent medical assistance are fully covered by compulsory health insurance and therefore require no additional payments. In addition to these services some others are fully covered by compulsory insurance. Other necessary services are only provided free of charge to a certain percentage, so that for some medical services the difference to the full price has to be paid which depends on individual cases and amounts to from 10 % to 90 % of the value of the medical service or appliance.

In the case foreign insured persons will have to pay for the costs of medical services because they will not have the necessary document on hand or because they will claim medical services from a private doctor without a contract with the ZZZS, they will be able to submit a request for the reimbursement of costs based on Article 34.2 of the Council Regulation (EGS) 574/72 in they native country.