Budget of 836 million euros and a rise in transparency in 2025
The Health Insurance Fund presented the key results for 2025: a budget increase of 6,13%, an increase in the capitation point for family doctors by 33% and first place in transparency among state institutions.
INSURED PERSONS
In 2025, the Fund covers a total of 1.841.530 insured persons, an increase of 1.993 new persons. The structure includes 558.469 active workers, 358.716 pensioners and 630.914 family members. The trend of ageing among the insured population is evident — pensioners are increasing faster (+1,5%) than active workers (+0,2%).
FINANCIAL RESULTS
The budget of the Health Insurance Fund (HIF) for 2025 reached 51,5 billion denars (approximately 836 million euros), with annual growth of 6,13% compared with the previous year. Revenues amount to 52,08 billion denars, while expenditures are 51,49 billion denars. Health services absorb 86,4% of total expenditures — 44,5 billion denars (approximately 723 million euros).
In the five-year period 2021–2025, the HIF budget increased from 35,5 to 51,5 billion denars, with average annual growth of almost 8%. In a regional context, with 4,95% of GDP or 5,31% including the Ministry of Health, Macedonia is in the middle of the list for public health expenditure in South-East Europe.
PRIMARY HEALTH CARE
In April 2025, the capitation point for family doctors was increased from 75 to 100 denars — an increase of 33%, which represents the highest increase in the last decade. This is aimed at improving sustainability and retaining doctors. There are 1.495 family doctors working in the system, providing coverage of 0,81 doctor per 1.000 insured persons.
The capitation point for gynaecologists has been increased to the same level (+33%), while for dentists it rose by 23%. The Fund identifies regional inequalities — especially in the Polog Region, where coverage by gynaecologists is below the national average — and is directing efforts towards targeted resolution.
HOSPITAL CARE AND SPECIFIC SERVICES
In 2025, 194.230 hospital cases were recorded, an increase of 2,15% compared with 2024. The average length of hospitalisation is 4,86 days. Contracts with public health institutions amount to 32,49 billion denars (+10,5%).
In the area of biomedical assisted fertilisation (BAF), 1.051 vouchers were realised. The reform in this area expands rights — up to 6 attempts, without the need for a referral and with the introduction of electronic delivery of decisions. A total of 251.454 dialysis treatments and 3.620 cardiovascular interventions were performed, while 290 patients received treatment abroad.
MEDICINES
In 2025, 27,33 million prescriptions were realised (+4,53%), with a total value of 3,6 billion denars. The average number of prescriptions per insured person is 14,8 annually.
INSTITUTIONAL ACHIEVEMENTS
The HIF is ranked first as the most transparent institution in Macedonia according to the Agency for Free Access to Information — a rise from 45th place in 2024. In 2025, the Fund also marked the 25th anniversary of its establishment (17 October 2000).
As part of the legislative reforms, the deadline for treatment abroad has been shortened (from 45 to 30 days), and digital delivery has been introduced for BAF decisions. A total of 7.844 inspections were carried out in health institutions.
“In 2025, the HIF demonstrated its commitment to transparent management of public funds, increasing access to health services and supporting primary health care. With a budget of 836 million euros and 1,84 million insured persons, the Fund remains a pillar of Macedonia’s health system.”For additional information:
Health Insurance Fund of Macedonia
5 Macedonia St., 1000 Skopje
www.fzo.org.mk | [email protected]
