Inclusion in the Compulsory Long-term Care Insurance

Compulsory long-term care insurance is mandatory in the Republic of Slovenia for all persons who meet the conditions prescribed by the Long-term Care Act (ZDOsk-1). According to ZDOsk-1, insured persons for long-term care are insured persons and their family members, if they have reached the age of 18.

Insured persons for long-term care are insured persons for compulsory health insurance based on the regulations governing compulsory health insurance or other regulations, if they have reached the age of 18. Insured persons are also under the age of 18, who are compulsorily health insured on the basis of an employment relationship, independent performance of economic or professional activity, performance of agricultural activity or management function as partners of companies or founders of institutes.

Family members of persons insured for long-term care are family members who, according to the regulations governing compulsory health insurance, are compulsorily insured as family members.

The exception applies to persons who are included in the compulsory health insurance as:

• persons with permanent residence in the Republic of Slovenia, who are insured with a foreign health insurance provider and who cannot use the rights from this title during their stay in the Republic of Slovenia, and family members who are required to have health insurance under them, and
• foreigners who are studying or furthering their education in the Republic of Slovenia and their family members with mandatory health insurance.

These persons are not insured persons for long-term care.

The property of the insured person is acquired by law from the day the prescribed conditions are met, and it is also lost by law when the conditions for insurance are no longer met.

The Health Insurance Institute of Slovenia (ZZZS) determines that a certain person has acquired the status of an insured person based on the insurance application submitted by the person liable for the application. The person liable for the registration must also deregister the person from the insurance when the conditions for the insurance cease. The taxpayer submits the application and deregistration on a single form for the regulation of compulsory health insurance and compulsory long-term care insurance.

Persons who, before reaching the age of 18, are already included in compulsory health insurance as insured persons or as family members in accordance with the regulations governing compulsory health insurance, upon reaching the age of 18 acquire the status of an insured person also in compulsory long-term care insurance. Their application for compulsory insurance for long-term care is carried out by the ZZZS ex officio by entering them into the register of insured persons for long-term care, and issues a decision on this.