Healthcare in Macedonia
Macedonia has an improving standard of compulsory state funded healthcare, which is available free to all citizens and registered long-term residents. Private healthcare is also available in the country. The Ministry of Health oversees the health service and the Health Insurance Fund (HIF) collects the contributions, allocate funds, supervise and contract healthcare providers. All citizens are entitled by law to equal access to healthcare.
There are the following types:
The basic state fund provides most medical services free of charge, including treatment by specialists, hospitalisation and emergency treatment including ambulance transportation, medicines included on the positive list, home visits by doctors, dental treatment of oral disease, surgical appliances, pregnancy and childbirth and rehabilitation.
Citizens can take out additional private insurance to cover services not provided by the state system. You are not allowed to opt out of the compulsory state system. Few people in Macedonia have the means to take out private healthcare.
Doctors and Health Centres
Doctors are the first point of contact with the state health system. Citizens can register with the doctor of their choice; however, people seeking state medical care must make sure that their doctor is contracted into the HIF scheme. If you are treated by anyone other than a state funded doctor, you will have to pay the fees yourself. Doctors are allowed to work in both sectors (private and public) at the same time and can use state facilities for their treatment. It is important to note that not all doctors are trained in general practice.
GPs prescribe drugs
Treat acute and chronic illnesses, provide medical examinations, preventive care, and health education and are responsible for referrals to specialist doctors and hospitals. They also issue sickness certificates for the employed (up to a period of 15 days) and provide directions to the HIF for employees who need a longer period away from work. Health centres are staffed by qualified doctors and nurses. If you need a doctor out of the normal practice hours, you will have to visit a duty doctor. Waiting times to see doctors vary and it is recommended that you make an appointment in advance. If you need urgent help, you may go to the doctors surgery on speculation, but be prepared for a long wait
Consultants are senior doctors who have completed a higher level of specialised training. GPs refer patients to a Consultant if he believes that a patient may need specialist help and diagnosis.
Hospitals and clinics exist in all major towns and cities of Macedonia. Patients are admitted to hospital either through the emergency department or through a referral by their doctor. Once a patient is admitted treatment is controlled by one of the hospital doctors. The quality of hospital rooms varies according to the quality of a person’s health insurance scheme. Privately insured patients will get a single or double room. State insured patients may have to share with two or three other people. There may be a waiting list for some non-emergency treatments and services.
Emergency care is available free for everyone including those without state health insurance. Emergency treatment is provided at the emergency room of all general hospitals and it is open non-stop all year. You may use their services if you need immediate attention, or if your GP refers you to them, or if there is no GP service available.
Private practice has been increasing over recent years. The premises, equipment and personnel are funded by the doctors themselves and through private insurance contributions, but it is used only by a limited percentage of people, often as a top up to the basic state healthcare and to cover them for the services deemed non-essential.