Moving to Romania as a student, remote worker, or permanent resident? Understanding your health insurance options is essential—not just for compliance, but for real-world peace of mind. Unlike some EU countries where public coverage is automatic upon registration, Romania's system requires proactive steps—and the rules differ significantly depending on your residency status, income source, and nationality. Here's what you need to know, clearly broken down.
First, the public health insurance system (CAS—Casa de Asigurări de Sănătate) is mandatory for employed residents and EU citizens working under Romanian contracts. Contributions are payroll-deducted (10% from salary, matched by employer), granting full access to state hospitals, clinics, and subsidized prescriptions. Coverage includes GP visits, emergency care, maternity services, and chronic disease management—no co-pays for most primary care. However, wait times for non-urgent specialist appointments can stretch 4–8 weeks, and equipment or medication availability varies by region, especially outside Bucharest or Cluj.
Second, self-employed foreigners—including digital nomads on the temporary residence permit (Type D visa)—must register voluntarily with CAS and pay monthly contributions (around €65–€85 in 2026, based on declared income). This grants near-identical rights as employed contributors, but enrollment isn't automatic: you'll need a Romanian tax code (CUI), proof of address, and certified translation of your passport. Many newcomers miss this step and assume "EU membership = automatic coverage"—a costly misconception.
Third, private health insurance fills critical gaps—but it's not a standalone replacement for CAS if you're legally required to enroll. Most reputable local providers (e.g., Groupama, Omniasig, or Globality Health for expats) offer supplemental plans starting at €30/month. These cover faster specialist access, private hospital rooms, dental and optical care, and repatriation—none of which CAS provides. Crucially, private insurance does not replace CAS for legal residency purposes. For example, students on long-stay visas must show either CAS enrollment or valid private coverage meeting Romanian Ministry of Health minimum standards (including €30,000+ inpatient coverage and no pre-existing condition exclusions).
Fourth, EU citizens using the European Health Insurance Card (EHIC) or its successor, the UK Global Health Insurance Card (GHIC), enjoy limited, short-term access—only during temporary stays (e.g., tourism or short courses under 90 days). EHIC does not cover planned treatment, routine check-ups, or long-term residency. Once you register for Romanian residency—even as an EU national—you must join CAS or prove equivalent private coverage. Relying solely on EHIC after obtaining a residence permit risks denied care and potential visa complications.
Fifth, non-EU nationals face stricter requirements. Those applying for permanent residence or long-term visas must submit proof of comprehensive health insurance before entry—or enroll in CAS within 30 days of arrival. Visa denials commonly occur due to incomplete or non-compliant insurance documentation. Always verify that your policy lists "Romania" explicitly as the country of coverage and includes direct billing with local providers.
Finally, practical tips: Register for CAS in person at your county CAS office—online portals remain unreliable for foreigners. Bring notarized translations of all documents. If choosing private insurance, prioritize insurers with Romanian-licensed operations and 24/7 multilingual support. And never skip the mandatory annual CAS declaration—even retirees receiving pensions abroad must file Form 112 to maintain coverage.
Understanding these layers helps you avoid delays, fines, or unexpected bills—and ensures you get timely, high-quality care while building your life in Romania.