PRESS STATEMENT - Health insurance coverage

Regarding the views expressed publicly about the non-coverage of categories of citizens under health insurance, we are sharing accurate and complete information on the coverage of insured persons.

Macedonia is defined as a social state, and in accordance with the Law on Health Insurance there are several grounds for compulsory health insurance, making the system inclusive and socially responsible. Health insurance is also provided for persons who do not earn income and cannot be insured on any other grounds – whereby the costs of their insurance are covered by the state through a programme in the Ministry of Health.

Currently in Macedonia there are 1.836.667 insured persons, of whom 470.774 insured persons, or every fourth person (25%), are persons who do not earn income. Claims that certain categories of citizens have been left without health care are not correct.

At the same time, work is currently under way on three health insurance reforms.

A working group of the Fund, the Ministry of Finance, the Ministry of Health and the PRO is working on the criteria for persons who do not earn income, where the focus is on two groups of problems: insured persons who have recently lost their jobs and insured persons who have undeclared income (grey economy, work abroad).

The Government, the Fund and UNICEF are analysing the needs and possibilities for independent health insurance for minors up to 18 years of age.

Thirdly, the preparation of a new legal solution by the Ministry of Social Policy, Demography and Youth is in its final stage, with the active participation of the Health Insurance Fund. This legal solution will cover persons working in flexible forms of engagement.

The Fund remains committed to improving the accessibility and fairness of the health system, on the basis of realistic analyses and sustainable solutions!

Number of insured persons by insurance grounds