La santé à Serbia

Comment fonctionne le système

Serbia runs a Bismarck-style compulsory social health insurance system administered by the National Health Insurance Fund (Republički fond za zdravstveno osiguranje, RFZO). It is financed mainly by payroll contributions (a health insurance contribution rate of 10.3% of salary, split 5.15% employee / 5.15% employer), with the state budget covering contributions for non-working groups (pensioners, children, the unemployed). Around 98% of the population is covered. Entitlement, in principle, extends to all citizens and to people with permanent or temporary residence, but in practice an active insurance card depends on contributions being paid. A growing private sector operates alongside the public network.

Serbia has a fast-growing private healthcare sector concentrated in Belgrade, Novi Sad and other cities, and it is the default choice for most expats and temporary residents who are not enrolled in RFZO. Major providers include MediGroup (a large private network), Bel Medic (an established private hospital with English-speaking staff and 24/7 service) and Euromedik. Private care is modern, has short waiting times (an appointment is usually available within a day or two, including weekends) and is inexpensive by Western-European standards. Indicative self-pay prices: a private GP/short consultation runs roughly €30-60, with specialist consultations typically €50-100. English is widely spoken in these urban private clinics, and some explicitly target international patients.

Serbia's public system provides broad coverage (about 98% of the population) but performs poorly on financial protection: out-of-pocket payments make up a large share of health spending — in the mid-30s of percent of current health expenditure in recent years (about 35.8% in 2021), well above most EU countries — and WHO finds catastrophic health spending is higher in Serbia than in most EU states and has grown in recent years, concentrated among the poorest fifth of the population and households headed by pensioners and other economically inactive people, driven largely by out-of-pocket payments for outpatient medicines. Public facilities can also have long waiting times for non-urgent specialist and inpatient care.