Romania (RO)

Romania is the largest country in Southeastern Europe — a full Schengen EU member state blessed with the dramatic Carpathian mountains, medieval Saxon towns like Sibiu and Brasov, the legendary Transylvania region, a booming technology sector, and one of the lowest costs of living in the European Union.

Capital: Bucharest

Region: Europe

Language: Romanian

Currency: RON (lei)

Cost of living: Very affordable (index 38)

Emergency: 112

Healthcare in Romania

Romania operates a Bismarck-style social health insurance system funded through mandatory payroll contributions and administered by CNAS (Casa Națională de Asigurări de Sănătate). Public healthcare is free at the point of use for insured residents, but a rapidly expanding private sector now delivers much of everyday care in major cities. The gap between public and private quality is significant, and most expats combine mandatory public cover (CASS) with a private subscription for convenience.

Romania ranks around 27th in Europe on the Euro Health Consumer Index. Public infrastructure is uneven — world-class specialists in Bucharest university hospitals coexist with under-resourced rural clinics. Private clinics in Bucharest, Cluj-Napoca, Timișoara and Brașov deliver care on a par with Western European standards at a fraction of the price.

Public healthcare: CNAS — Casa Națională de Asigurări de Sănătate

National Health Insurance House

Eligibility:Mandatory for all Romanian residents with taxable income. Employees are enrolled automatically by their employer. Self-employed and freelancers (PFA, SRL administrators) pay directly through ANAF. Children, students under 26, pregnant women and registered unemployed persons are covered for free. EU citizens working in Romania are covered by CASS on the same terms as Romanians.

Monthly cost:Salaried employees: 10% of gross salary (CASS) withheld automatically by the employer. Self-employed: minimum annual CASS is 10% of six national minimum wages (the gross minimum for 2026 applied to a six-month base), paid through Declarația Unică. Students, children, pensioners on low pensions and registered unemployed persons are covered at no cost.

What's included:

Primary care via your family doctor (medic de familie) — free consultations
Specialist consultations with a referral (trimitere) from your GP
Emergency care at UPU (Unitate Primiri Urgențe) — always free regardless of insurance status
Hospital inpatient and surgical care
Pregnancy, birth and postnatal care
Prescription subsidies (categories A, B, C)
Chronic-disease programmes (diabetes, oncology, dialysis) fully funded

Not included (or co-pay required):

Most adult dental care beyond emergency extractions
Cosmetic and elective procedures
Branded medication when a generic is available (you pay the price difference)
Most glasses and contact lenses for adults
Private hospital rooms and non-emergency private specialist visits

Co-payments:Public care is free at the point of use for the insured. No copayment for GP visits, referred specialist visits, emergency care, or hospital stays. Prescriptions carry partial costs — category A drugs are reimbursed 100%, category B 90%, category C by condition-specific lists. Informal gratuities to hospital staff, once widespread, are now illegal but occasionally still expected in older public hospitals.

How to enrol:Employees: automatic enrolment via employer payroll — no action needed. Self-employed: register and pay CASS monthly via the SPV (Spațiul Privat Virtual) portal on ANAF. EU residents: present your EHIC or S1 form when registering with your medic de familie. Once covered, register with a medic de familie in your area — this is the single most important onboarding step and unlocks the rest of the system.

Waiting period:Coverage generally begins from the month you start contributing. EU nationals moving with an S1 form are covered from the day of registration.

Private healthcare: Abonamente medicale private (Private medical subscriptions)

Who can use it:Open to anyone — no medical underwriting required for standard subscription plans. Most Romanian middle-class professionals take a private subscription in parallel with CASS for faster access, English-speaking doctors, and modern facilities. Employers often cover private subscriptions as a benefit.

When it makes sense:Strongly recommended for: working professionals in Bucharest/Cluj/Timișoara who value speed and English-language service; parents with young children; expats who want a familiar clinic environment. Less essential for: retirees in rural areas where the nearest private clinic is distant; anyone whose employer already provides a gold-tier plan.

Monthly cost:€20–80/month for individual plans (approximately 100–400 RON). Family plans: €40–150/month. Higher-tier plans include dental, physiotherapy, MRI, and international second opinions.

Major providers:

Regina MariaMedLifeMedicoverSanadorEnayati Medical CityPuls

Accessing care

GP system

Your medic de familie (family doctor) is the gatekeeper to the public system. Each insured person registers with one GP who issues referrals (trimiteri), manages chronic prescriptions and coordinates specialist care. Register by turning up with your ID, CNP and — if employed — your employer contribution certificate (adeverință de asigurat). Switching GPs is free but only once per six months under standard rules.

Specialist referral

Public specialists require a written referral (trimitere) from your medic de familie, except for gynaecology, dermatology and psychiatry which are direct-access. Waiting times in the public system range from 1–6 weeks in cities and significantly longer for scarce specialties (neurology, endocrinology). Private clinics typically offer next-day appointments in any specialty for an out-of-pocket fee of 200–400 RON.

Emergency care

Call 112 for any life-threatening emergency — the number is free, works on any phone without a SIM, and connects ambulance, police and fire services. For less urgent acute issues go directly to the nearest UPU (Unitate Primiri Urgențe) in a public hospital. UPU care is free for everyone, insured or not. Private hospital emergency visits cost 400–800 RON if uninsured.

Out of hours

Out-of-hours primary care is provided by "permanențe" — rota-based GP surgeries open outside normal hours, and by urgent-care clinics. Public hospital UPU departments are always open. Larger private clinics (Regina Maria, MedLife) have their own out-of-hours emergency desks, normally 08:00–22:00 with 24/7 hotlines.

Prescriptions

Prescriptions are issued electronically (rețetă electronică) and linked to your CNP. Take your ID to any pharmacy — the pharmacist retrieves the prescription from the national CNAS system. Subsidy levels: category A is 100% reimbursed, category B is 90%, category C is limited to specific conditions. Brand-name drugs cost the full price difference versus the subsidised generic.

Dental

Adult dental care is almost entirely private. Only emergency extractions and basic care for children and pensioners are covered publicly. A private check-up costs 150–300 RON; a filling 200–500 RON; a crown 1,500–3,500 RON; an implant 3,000–6,000 RON. Dental clinics in Bucharest and Cluj attract significant medical tourism from Western Europe for their quality-to-price ratio.

Mental health

Public mental-health capacity is limited — waiting lists for a psihiatru are often 4–8 weeks and therapy sessions via CNAS are rare. The Asociația Română de Psihiatrie (ARP) maintains a practitioner directory at romjpsychiat.ro. Private therapy costs 200–500 RON per session with Romanian-speaking therapists and 300–600 RON with English-speaking ones. Digital options: Hilio (hilio.com) and PsyHelp offer online therapy in Romanian and English.

Maternity

Public maternity care is free for insured mothers and covers prenatal visits, ultrasounds, birth and postnatal follow-up. Choose between state maternity hospitals (spitale de obstetrică-ginecologie) and private clinics. Private all-inclusive birth packages range from 3,000 EUR (standard) to 15,000 EUR (premium with a private room and dedicated doctor). Home births are legal but uncommon and not publicly funded.

Expat-specific advice

First steps on arrival:

Obtain your CNP (personal numeric code) or NIF (tax identification number for non-residents) — without this you cannot register for CASS
Activate your SPV-CNAS account on spv.cnas.ro to view and print your insurance certificate (adeverință de asigurat)
Register with a medic de familie in your neighbourhood — bring ID, CNP/NIF and proof of contribution
If EU/EEA: request your Romanian EHIC through the CNAS portal for travel coverage
Choose a private subscription (Regina Maria, MedLife or Medicover) for faster access and English-language service
Save 112 as an emergency contact; download the DSU 112 app for silent emergencies

Finding English-speaking doctors:English-speaking doctors are common in private clinics in Bucharest, Cluj-Napoca, Timișoara and Brașov — ask the clinic reception to book with an English-speaking practitioner. University hospitals often have younger doctors with excellent English. French is spoken by many older doctors; German by some specialists in Transylvania. For non-English languages, private clinics can arrange interpreters at an extra charge.

International insurance:International policies (Cigna Global, Allianz Care, Bupa Global) are popular among expat executives and digital nomads who travel frequently. They do NOT replace CASS if you are a Romanian resident — CASS is legally mandatory for residents. The practical combination is mandatory CASS + a Romanian private subscription or an international policy as a premium top-up.

Emergency card info:Carry your adeverință de asigurat (proof of insurance, printable from SPV-CNAS), your ID or residence card, and a note with your blood type and any allergies. Memorise 112 for emergencies. If you hold a private subscription, keep the provider's card or app on your phone for fast triage at their clinics.

EHIC notes:EU/EEA citizens: your home-country EHIC covers short visits to Romania before you become a resident. Once you register as a resident and start contributing to CASS, request your Romanian EHIC via the CNAS portal — it is issued free and valid for 2 years. S1 form holders keep their home-country health entitlements and are reimbursed through the Romanian system.

Pharmacies (Farmacie)

Hours:Standard hours Monday–Saturday 08:00–22:00, Sunday 09:00–18:00. Major cities have 24-hour farmacii — notable chains are Catena (the largest), Help Net, Sensiblu and Dona. Rural pharmacies typically close by 19:00 and on Sundays.

After-hours / emergency:Every city operates a rotating "farmacie de gardă" (duty pharmacy) open overnight. The duty roster is posted on the door of every pharmacy and on farmaciadegarda.ro. A small out-of-hours surcharge may apply.

Prescription rules:Prescription-only drugs (rețetă simplă or rețetă compensată) require an electronic prescription linked to your CNP — the pharmacist pulls it up from the national system. Over-the-counter (OTC) medication is freely sold but must be requested at the counter; Romanian pharmacies are not self-service. Antibiotics, strong painkillers and psychotropics are always prescription-only.

Available over-the-counter:

Pain relief: Paracetamol (Panadol), Ibuprofen (Nurofen, Advil), Aspirin
Cold & flu: Theraflu, Coldrex, Faringosept lozenges
Allergy: Cetirizine (Zyrtec), Loratadine (Claritine)
Digestive: Smecta, Mezym, Nexium 10mg
Vitamins and supplements (large selection, often cheaper than Western Europe)
Basic first aid: betadine, bandages, antiseptic sprays
Sore throat sprays: Bioparox alternatives, Hexoral, Strepsils

Typical costs

GP visit (with insurance)	0 RON (public) / included in private subscription
GP visit (private pay)	150–250 RON (private clinic consultation)
Specialist visit	0 RON (public with referral) / 200–400 RON (private pay)
Emergency visit	0 RON (public UPU) / 400–800 RON (private)
MRI scan	600–1,500 RON (private pay); free in public system with referral
Prescription average	~50 RON for the average subsidised prescription; full-price brand drugs can cost 100–400 RON
Dental check-up	150–300 RON (private); basic extractions free in public system
Baby delivery	0 RON (public, insured) / 8,000–25,000 RON (private clinic package)

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