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Romania International Health Insurance / Healthcare System |
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Romania is situated in the south-eastern part of central Europe, bordering the Ukraine, Hungary, Serbia, Bulgaria, Moldova and the Black Sea. Since the 1989 revolution affecting eastern European countries, Romania has gone through political, social and economic reform, joining the European Union (EU) in 2007 and becoming a republic with a two-tiered government.
Compared too many fellow EU member states, the Romanian healthcare system is sub-standard. Generally speaking, the standard of healthcare in Romania suffers from certain inadequacies and the healthcare culture and procedures differ in comparison to other European national healthcare systems. There can be a shortage of basic medical supplies, which is especially notable outside the main Romanian cities. Although western style healthcare providers will be located in the capital Bucharest and other major cities, it advisable to be selective when choosing a healthcare provider.
Since the collapse of the Iron Curtain in 1989, the Romanian healthcare system has been reformed to meet the demands and the needs of the population. From 1998, a mandatory Social Health Insurance System has been adopted in Romania, which provides citizens of Romania with healthcare coverage in the country. Over recent years, the Romanian healthcare system has evolved to become more efficient by decentralization from central government control, with the generation of funding for the healthcare system through autonomous institutions.
Due to the reforms in the Romanian healthcare system, the Ministry of Public Health (MoPH) no longer has direct control of the country's funding of the healthcare network. However, it still is responsible for developing national healthcare policies, regulation of the healthcare system, implementing healthcare standards and ensuring the improvement of public health. As part of the reforms, new institutions have been introduced to supply and finance the Romanian healthcare system.
The National Health Care Insurance Fund (NHIF) is an autonomous public entity in Romania, with the responsibility for administrating and regulating the Romanian social health insurance system. Previously, between 2002 and 2005, the NHIF was governed by the MoPH, but was given independence in a move to improve and decentralize the running and financing of the Romanian healthcare system. The NHIF’s main function, in the Romanian healthcare system, is to oversee the District Health Insurance Funds (DHIFs), which are authorized to collect contributions and pay reimbursements to qualifying patients.
The DHIFs were introduced in 1999 and now play a major role in the provision of healthcare services. The NHIF will allocate funds to the DHIFs. In the past, the DHIFs were charged with the duty of raising social health insurance contributions from employer and employees under their jurisdiction. The DHIFs used to retain the majority of the funds generated, with the remaining being given to the NHIF for redistribution purposes. Now a special government body – affiliated to the Ministry of Finance (the Fiscal Administration National Agency) – collects the Romanian social health insurance contributions on a
national level, with the DHIFs only collecting contributions from people such as the self-employed.
Citizens of Romania, covered under the state-social insurance scheme, are entitled to receive a basic healthcare package, which includes access to health services, medical devices and pharmaceuticals. The NHIF and the MoPH agree a benefit package for insured citizens annually; this needs final approval by the Romanian government. However, the yearly mandate must protect patients’ rights in Romania which are covered in the Law on Patient Rights that include the patient’s right to choose healthcare provider.
There are certain fees a Romanian citizen will have to pay towards public healthcare services. While a referral from a doctor for secondary or tertiary healthcare is free, without a referral a patient is required to pay all medical costs. In recent years – due to financial pressures in the Romanian healthcare sector – there has been an increase in patient fees for healthcare services and treatment, although citizens belonging to vulnerable groups are exempt from any public healthcare costs.
The NHIF will allocate monies to the DHIF in accordance with the number of insured persons and population levels in an allocated region for inpatient, ambulatory and dental care. Patients may be required to make co-payments for certain healthcare services and medications. Informal payments play a role in the Romanian public healthcare system, with patients sometimes required to pay for healthcare services.
Healthcare services are overseen by the DHIFs, which will enter into agreements with public and private Romanian healthcare providers – covering hospitals, ambulatory care and primary care – and establish partnerships to provide healthcare services to Romanian citizens.
The majority of Romanian healthcare providers are under contract with the DHIFs. Family doctors – as they are called in Romania – offer primary healthcare services; patients must ensure that doctors are contracted by the DHIFs, otherwise they will be required to pay for treatment received. Doctors are the first point of contact for healthcare services in the Romanian healthcare system and can refer a patient – if deemed necessary – for specialist healthcare services or hospital treatment. A referral is required by a patient, if they
wish to receive hospitalized services free of charge. Citizens in Romania are free to choose the doctor and hospital for treatment purposes.
Secondary and tertiary care is provided through either rural, regional, district or specialist hospitals. Depending on the patients’ requirements and location, the family doctor will refer the patient to the appropriate healthcare facility for further treatment. District and specialized hospitals are present in the larger towns and cities providing healthcare, including intensive care, neurosurgery and cardiovascular treatment. There are a number of teaching hospitals in Romanian cities providing an extensive range of specialized medical treatment, although standards of care, quality and cleanliness vary. International visitors are advised to be careful in choosing a hospital for medical treatment; in general the standard is better in the capital Bucharest compared to the rest of the country.
There have been reports about staff in publicly operated healthcare facilities expecting to be tipped for ‘services provided’. Also in-patients, in a Romanian hospital, will sometimes need to supply their own meals.
As part of the Romanian healthcare reform undertaken in 2002, control of the vast hospital network was transferred from the MoPH to local councils, apart from some tertiary care units. At the same time a new law was enacted to allow public hospitals in Romania to provide private wards, with some privately operated healthcare providers renting rooms for patients as part of their healthcare service.
The Sanador Medical Center is a privately run healthcare provider in the capital Bucharest offering a broad range of medical services. This center was opened in 2001 and has evolved with the provision of two clinics and a fully-equipped medical laboratory; it has back-up, medical reserves at the emergency hospital Floreasca. The healthcare provider is one of a few privately operated healthcare facilities in the capital, which has the ability to provide an extensive range of medical services, with specialized medical professionals and state-of-the-art medical equipment.
The BIO-Medica International SRL was set up in the capital in the early 1990's and provides healthcare services to an international standard delivering a high quality of medical service. Bio-Medica is able to provide patients with a range of medical care and has private rooms available at the Bucharest emergency hospitals where they can carry out medical procedures. There is also an affiliation with the first private ambulance service in Romania, which caters for extreme medical emergencies. There are a broad range of healthcare specialists providing patient care in a variety of medical services. BIO-Medica is also able to offer VIP health services for patients in a luxury style room.
Generally medical professionals in Romania are well trained and educated. There are a number of well established teaching hospitals such as the Carol Davila University of Medicine and Pharmacy which is based in the capital Bucharest – this is comprised of three collages for training in medicines, dentistry and pharmacy. Romania’s well established network of teaching hospitals – and success in delivering qualified medical staff – together with links to other EU member states – has lead to highly trained doctors and nurses seeking better paid employment elsewhere in Europe.
Romania's healthcare system does have reciprocal health agreements in place with some other European countries, which entitles member countries' citizens the right to certain health services while in Romania. However, it does not provide a patient from an affiliated European country, with all medical treatment free of charge. It is highly recommended that any foreign national visiting or residing in Romania obtains Romanian international health insurance to give them full medical coverage while in the country – as there are restrictions on the availability of public-run Romania healthcare provision for a foreign patient.
In the past, Romanian officials have confirmed cases of West Nile Virus in Bucharest, Alba, Cluj, Constanta, Dolj, Sibiu, Teleorman, Galati and Mures. There is no vaccination against West Nile Virus. To prevent contracting West Nile Virus, it is advised to take precautionary measures against bites from mosquitoes and protect your skin at all times.
Visitors to Romania are advised to ensure that they have had the appropriate vaccines for tetanus, hepatitis A and B, typhoid, rabies and diphtheria as these diseases pose a potential risk while in the country. Travelers planning to visit rural areas are at increased risk from contracting these diseases; although rabies is uncommon in the cities in Romania, it is strongly recommended to avoid contact with stray dogs. Before traveling to Romania, it is advisable to seek a doctor’s advice for up-to-date health information and details of current health issues affecting the country.
As a foreign national in Romania, you may find that healthcare provision, within the healthcare system in the country, differs considerably to your home nation. You should also bear-in-mind, the quality of healthcare services in Romania are not to the standards of most western European countries and some healthcare facilities in the country are limited in the medical treatment they can provide for a patient. As a visitor in Romania requiring medical attention, it is recommended to seek healthcare services from a privately run healthcare facility in a Bucharest or a major city as they are geared to offer better quality
healthcare services. When taking out Romanian international health insurance, it is recommended that it includes medical air ambulance and medical repatriation cover – as in cases of extreme medical emergency a patient may require this expensive healthcare option.
The Romanian healthcare system has been severely impacted by the 2007-2008 global financial crises. This has taken its toll on funding and progress with improvements to health services. The decline in the Romanian economy has lead to high levels of unemployment – which in turn has lead to a sharp fall in contributions to the NHIF – and austerity measures affecting investment and human resources available to the healthcare sector.
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Romania International Health Insurance |
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If you are looking for peace-of-mind knowing that medical costs will be covered in case of an accident or illness, to yourself and your family, while traveling to or residing in Romania, international health insurance plan will be the ideal solution. Policies can be tailor-made to ensure all your needs are met while in Romania. Should you require further information on Romania, international health insurance, or to receive a free international medical insurance quotation, please do not hesitate to call one of our expert advisers now. |
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