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How to get Romanian health insurance if you’re not paying it mandatorily

Are you living in Romania and would like to get Romanian health insurance, so you can benefit of medical care in all public hospitals and clinics? Would you also like to make sure you won’t have any potential issues with the immigration authorities, and start paying the Romanian health insurance as soon as possible?

Even if you do not currently derive taxable income that may be subject to Romanian health insurance (for example, salary income from a Romanian employer), you can get health insurance voluntarily. This means you will have to pay a fixed amount of money to the state budget as health insurance contribution (CASS). For this, you will have to fulfil a few steps which include the preparation and submission of the annual tax return, and potentially do a short trip to the local Romanian National Health Insurance House.

We detail below all these steps, which will enable you to get insured in the Romanian public health system.

Completion and submission of the annual tax return solely for the purpose to get Romanian health insurance

If you didn’t know before, The Romanian annual tax return can be used, in addition to the purpose of reporting your taxable income generated during a year, also for getting insured in the Romanian public health system, and paying your contribution for this purpose.

This means that, if you are not already mandatorily insured in the Romanian public health system (e.g., through your Romanian employer or by declaring taxable income in Romania and paying the health insurance contribution on that income), you can insure yourself by completing and submitting the annual tax return (“Declarația Unică”) for the year you need to insure for.

For example, if you just relocated to Romania in January 2021 for the purpose of setting up a business here, or just as part of moving here together with your family, you may have been informed by the Romanian Immigration authorities that you must insure yourself in the public health system as part of benefitting from a long-term right of residence in Romania. But since you are not deriving salary income or any other income for which you are obliged to pay the health insurance, you will need to do that voluntarily, by yourself.

Thus, as first step, according to the Romanian Tax Code, those who do not obtain taxable income in Romania (and that may be subject to the health insurance contribution), but who still need to insure themselves in the public system must submit the annual tax return (“Declarația Unică”) in order to acquire the status of “insured person”, and pay the amount required by law.

Also, those who obtain and report taxable income in Romania, but the income is not high enough to be subject to the health insurance contribution as well (i.e., income is below 12 minimum gross wages), can voluntarily get insured and pay the contribution in the same way.

Submitting the tax form will allow you to get insured and pay the health fund contribution for the entire tax year (calendar year). For example, if you need to get the Romanian health insurance for 2021, you will have to complete and submit the tax form for year 2021, and will have to pay the contribution for the entire year, as one-off payment.

As individual that doesn’t derive income subject to taxation, you will have to complete only the Chapter II, Section 2.2 of the annual tax form. This Chapter of the form is related to income estimated to be obtained during the current year, which is declared in advance. In this section, you will have to select the special box for “taxpayer that doesn’t derive taxable income, but wants to ensure voluntarily”, or the one for “taxpayer that derives taxable income below the level of 12 minimum gross wages”, as the case may be for yourself.

Once you complete and submit the tax form, you will also have to pay the health insurance contribution amount into the tax authorities account. Payment can also be done through online bank transfer, or directly at the local tax office (ANAF office). The amount you will be due for an entire year is calculated as 10% of six minimum gross salaries. For year 2021 this will be approximately 1,380 Lei.

For more details regarding the preparation and filing of the Romanian annual tax return, you can also check our article: Romanian annual tax return – frequently asked questions.

Getting certificate of health insured person from the Romanian National Health Insurance House

The completion and submission of the annual tax return is only the first step as part of the entire procedure. The next, and final step, is to get a certificate of insured person from the Romanian National Health Insurance House. This will allow you to prove that you are insured and for which period. You will be able to use the certificate during the entire year, to get medical care in the Romanian public hospitals and clinics whenever you need it (if the case).

According to the instructions of the Romanian National Health Insurance House, those who want to get the certificate of insurance will need to request it from the local Health Insurance House (from where they live in Romania) by submitting the following documents:

  • the bank transfer receipt which proves the payment of the health insurance contribution,
  • a copy of the annual tax form that was submitted to the tax office (ANAF),
  • copy of their identity documents (in case of foreign citizens: passport and Romanian residency permit).

Once you fulfill the above step, you will be issued the health insurance certificate.

Validity of the health insurance

How long is the health insurance valid? It is valid for the entire year for which you paid the contribution. This means that you will have to fulfill the same procedure next year, as well.

As per the Romanian tax legislation, the insurance becomes effective from the moment of submitting the Romanian annual tax return, but if you need to validate and use it, you also need to pay the annual contribution, and obtain the certificate of health insured person from the Romanian National Health Insurance House.

You can get the Romanian health insurance at any time, there is no special period of the year in which the tax return must be submitted for this purpose.

Good to know:

Any insured person can request, after the end of each year, an annual list with the medical care services and the medications they have benefited for the entire year as part of the insurance, and their costs. The list can be requested from the local Health Insurance House. As per the law, the Health Insurance House will have to issue the list to you within maximum 45 days as of the date you submit the request.


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