Health insurance in Bosnia and Herzegovina (BiH) is shaped by its complex political structure and healthcare needs. Both public and private health insurance systems serve distinct roles, and understanding their differences and similarities is essential, particularly for residents, expats, and medical tourists.
Structural and Administrative Differences
The public health insurance system in BiH is highly decentralized and fragmented, reflecting the country’s post-war administrative divisions. It operates through 13 different health insurance funds across the three main regions: the Federation of Bosnia and Herzegovina (with 10 cantons), Republika Srpska, and the Brčko District. Each region and canton manages its own fund, leading to substantial variations in coverage, services, and co-payment structures. This fragmentation often results in unequal access to healthcare and inconsistent service quality.
In contrast, private health insurance—often provided by international insurers like Allianz, Cigna Global, and April International—is far more centralized and standardized. These plans offer uniform benefits regardless of the policyholder’s location in BiH, making them attractive to both expats and locals who seek predictability and quality.
Coverage and Access
Public health insurance typically covers primary care, specialist consultations, hospital care, and some medications. However, many services require co-payments, particularly outpatient prescriptions, rehabilitation, and certain diagnostic procedures. Due to underfunding and administrative inefficiencies, the system suffers from long wait times, staff shortages, and uneven hospital infrastructure, leading to widespread public dissatisfaction.
On the other hand, private insurance offers quicker access to medical services, often through private clinics and hospitals with better infrastructure. Plans may also include coverage for medical evacuation, repatriation, and international care, features not provided by the public system. Private insurance is especially vital for travelers, digital nomads, and medical tourists, as Bosnia is not covered by the European Health Insurance Card (EHIC).
Cost and Eligibility
Public health insurance is mandatory for employed individuals, funded through salary contributions, while students, pensioners, and the unemployed are generally exempt but still eligible for coverage. Though it may seem “free,” significant out-of-pocket expenses still apply.
Private insurance, in contrast, is optional and requires monthly or annual premiums, often higher than public contributions. However, the value comes in the form of enhanced comfort, reduced wait times, and access to superior facilities. It is also mandatory for expats who need to present proof of coverage for residence permits.
Key Similarities
Despite their differences, both systems aim to ensure healthcare access and provide basic medical coverage to those enrolled. Each offers some form of specialist and hospital care, although the delivery and quality differ significantly. Both also face financial sustainability challenges, with growing demand and limited resources.
Top Public Health Insurances in Bosnia and Herzegovina
Bosnia and Herzegovina operates a decentralized healthcare system structured around its two entities—the Federation of Bosnia and Herzegovina (FBiH) and Republika Srpska (RS)—and the Brčko District. Each entity manages its own public health insurance system, with separate ministries of health and funding mechanisms. Although there is no unified national public health insurance scheme, citizens are typically covered by mandatory public insurance schemes depending on their residence or employment status.
Here are the key public health insurance providers across the country:
1. Health Insurance Institute of the Federation of Bosnia and Herzegovina (Zavod zdravstvenog osiguranja FBiH)(Official Website: https://www.fzozb.ba)
- Cost: Contributions are deducted from gross wages, typically around 12.5%. Unemployed individuals may be covered through social welfare or must contribute a lower flat rate.
- Available Services/Coverage Features: Includes primary care, specialist services, hospitalization, emergency care, maternity services, some dental services, and subsidized medications.
- Open for All or Limited: Open to employed individuals, pensioners, students, the unemployed (through municipal welfare programs), and low-income residents. Registration through cantonal offices is required.
- Core Financial Features: Funded through payroll taxes and government subsidies. Budget constraints can lead to variability in services across cantons.
- Consumer Satisfaction Score: Moderate (approx. 6.2/10). Citizens appreciate the coverage but express dissatisfaction with long wait times and regional inconsistencies in quality of care.
2. Health Insurance Fund of Republika Srpska (Fond zdravstvenog osiguranja Republike Srpske – FZO RS)(Official Website: https://www.rfzo.rsNATO+5)
- Cost: Mandatory payroll contributions at approximately 11%. For the unemployed, the government may cover costs through welfare programs.
- Available Services/Coverage Features: Offers full basic healthcare, specialist and hospital services, diagnostic and therapeutic procedures, as well as some preventive care and medications.
- Open for All or Limited: Available to all residents of Republika Srpska, with registration based on employment or social status.
- Core Financial Features: Funded through payroll taxes and entity-level budget contributions. Offers relatively unified services throughout the entity.
- Consumer Satisfaction Score: Slightly higher than FBiH (approx. 6.5/10). Users praise centralized administration but note issues with understaffing and outdated infrastructure.
3. Health Insurance Fund of Brčko District (Zdravstveno osiguranje Brčko Distrikta)(Official Website: https://www.bdcentral.net)
- Cost: Similar structure to the entity funds, with contributions from employment-based taxes and government subsidies.
- Available Services/Coverage Features: Full access to medical services including emergency care, chronic disease management, maternity care, and preventive services.
- Open for All or Limited: Open to all legal residents of the Brčko District, with registration managed locally.
- Core Financial Features: Operates on a smaller budget with tighter oversight, which allows for better control but fewer advanced services.
- Consumer Satisfaction Score: Around 6.7/10. The smaller size allows for more personal service, though resources are limited.
Top Private Health Insurances in Bosnia and Herzegovina
The private health insurance market in Bosnia and Herzegovina is smaller and less developed compared to the public system, but it is gaining traction, especially among expatriates, business professionals, and those seeking quicker access to higher-quality care. Private insurers often provide more comprehensive and flexible plans that include private hospital treatment, international coverage, and services not fully covered by public insurance.
Here are the top private health insurance providers active in Bosnia and Herzegovina:
1. Allianz Bosnia and Herzegovina(Official Website: https://www.allianz.ba)
- Cost: Premiums vary widely depending on coverage level, age, and health status, typically starting from around €200 to €600 annually for basic individual plans.
- Available Services/Coverage Features: Comprehensive health insurance including outpatient care, hospitalization, specialist consultations, diagnostic tests, dental care, and emergency medical evacuation. Customizable riders are available.
- Open for All or Limited: Open to residents, expatriates, and corporate clients with tailored plans for individuals and groups.
- Core Financial Features: Offers direct billing with partnered hospitals locally and internationally, flexible payment options, and additional accident and travel insurance packages.
- Consumer Satisfaction Score: Approx. 7.8/10. Known for reliable claims processing and wide network access.
2. April International(Official Website: https://www.april-international.com)
- Cost: Plans start around €250 per year for basic health coverage, increasing with added benefits like maternity or chronic illness coverage.
- Available Services/Coverage Features: Global health insurance plans with comprehensive medical coverage, including outpatient, inpatient, specialist care, maternity, mental health, and repatriation.
- Open for All or Limited: Available to individuals, expatriates, and corporate clients, including non-residents.
- Core Financial Features: International direct billing, 24/7 multilingual customer support, and flexible policy structures for varying needs.
- Consumer Satisfaction Score: Approx. 8.0/10. High marks for international coverage and customer service responsiveness.
3. Cigna Global(Official Website: https://www.cignaglobal.com)
- Cost: Premiums start at about €300 annually for basic coverage, with tiered plans (silver, gold, platinum) allowing more extensive benefits and wider provider networks.
- Available Services/Coverage Features: Offers outpatient and inpatient care, maternity, dental, vision, mental health, prescription drugs, and medical evacuation.
- Open for All or Limited: Available globally, including Bosnia and Herzegovina residents and expatriates.
- Core Financial Features: Flexible plan options, direct billing with numerous providers, and worldwide coverage including emergency evacuation and repatriation.
- Consumer Satisfaction Score: Around 8.3/10. Praised for comprehensive coverage and 24/7 customer service.
4. UNIQA Insurance Bosnia and Herzegovina(Official Website: https://www.uniqa.ba)
- Cost: Individual health plans generally start at approximately €180-€500 annually, depending on coverage and age.
- Available Services/Coverage Features: Offers private outpatient and inpatient care, specialist consultations, diagnostic services, dental care, and additional health support.
- Open for All or Limited: Available to individuals and corporate clients within Bosnia and Herzegovina.
- Core Financial Features: Local direct billing agreements, flexible payment plans, and multi-tier policy levels.
- Consumer Satisfaction Score: About 7.5/10. Appreciated for personalized client service and local network.
5. Europ Assistance Bosnia and Herzegovina(Official Website: https://www.europ-assistance.com)
- Cost: Starting premiums range from €220 annually for basic plans.
- Available Services/Coverage Features: Health insurance with additional focus on travel health, emergency assistance, repatriation, and evacuation services.
- Open for All or Limited: Available for residents and travelers in Bosnia and Herzegovina.
- Core Financial Features: Strong emergency and evacuation support, worldwide coverage, and flexible payment terms.
- Consumer Satisfaction Score: Approx. 7.7/10. Valued for its emergency services and quick claims processing.
READ MORE: Private and public health insurance of Luxembourg (Make informed choices)
