Benchmarking Employee Benefits in Slovenia – 2021

Compulsory Health Insurance

Insured persons and members of their families are included in compulsory health insurance coverage. The following persons are covered: hired and self-employed workers, farmers, and people receiving benefits (pension, incapacity benefit, survivor’s pension, unemployment benefit, or permanent social assistance). The individuals liable for the registration of the insured person are the legal or physical persons who are defined as responsible for the payment of compulsory health insurance contributions. The insured persons are guaranteed by the law the following: the payment of health services, sick pay during temporary absence from work, and the reimbursement of travel expenses tied to obtaining health services.

Compulsory health insurance does not always cover all health care services and is not at full price. Fully covered services within compulsory insurance include all health programs for children and youth (children are completely covered up to 18 years), students as long as they attend school, family planning, occupational diseases, malignant and other diseases, medical services related to donation and transplantations of tissues and organs, and long-term nursing care. For other services, compulsory health insurance covers only certain percentages of the full price. The insured person or the voluntary health insurance policy covers the balance.