Croatian Health Insurance Fund

The Croatian Health Insurance Fund (Croatian: Hrvatski zavod za zdravstveno osiguranje or HZZO) is a quasi-public body that administers the universal health care system in Croatia. Established in 1993, the HZZO is the country's national social health insurance fund and its primary source of health financing. In 2019, 4.18 million people received health insurance coverage through HZZO.[1]

Croatian Health Insurance Fund
Hrvatski zavod za zdravstveno osiguranje
Hzzo logo.png
Agency overview
Formed21 August 1993 (1993-08-21)
Headquarters3 Margaretska Street,
Zagreb, Croatia
Employees2,285 (31 Dec 2019)[1]
Annual budgetHRK 25.0 billion (c. €3.3 billion) (2019)[1]
Minister responsible
Agency executive
  • Lucian Vukelić, Director


The HZZO is overseen by a director and a board of directors, appointed by the Croatian government on the recommendation of the Minister of Health.[2] These directors represent the insured population, the Ministry of Health, the Ministry of Finance and independent general practitioners.[3] A central office located in the Croatian capital of Zagreb, sets policies that are implemented by branch offices in each of the country's 21 counties.[3]

All health care providers that receive public funds are required to negotiate annual contracts with the HZZO that set prices and payment plans.[4]


Compulsory health insurance contributions form 76% of the fund's income. About a third of the population - those in employment - are liable to pay full contributions.[5]


The Constitution of Croatia, adopted in December 1990, declared that health care is a human right.[6]

In 1993, the HZZO was created by the Croatian Parliament in order to consolidate the fragmented and decentralized health care system which had been inherited from the Socialist Federal Republic of Yugoslavia.[7][8] The 1993 law recognized patient choice as a principle through a mandatory payroll tax of 15%[4] and allowing the use of private supplementary plans.[9] The Health Care Law of 1993 also guaranteed patients rights which includes access to information about their health, and the ability to refuse examination and treatment.[10]

In July 2001, the Ministry of Health under Ana Stavljenić-Rukavina issued a policy statement entitled "The Strategy and Plan for the Reform of the Health Care System and Health Insurance of the Republic of Croatia." Noting that such factors as the country's aging and the generous benefits established since 1993 threatened the fund's sustainability,[11] the paper proposed reducing the amount of basic services that are free at the point of use, which would result in the HZZO becoming less dependent on payroll contributions.[12] In order to increase revenue, the 2002 Health Insurance Law introduced higher copayments for hospital and specialist services. These services include diagnostic tests and prescription drugs. It also created a voluntary insurance policy that would complement the mandatory coverage each citizen received.[13] After 2002, citizens were no longer allowed to opt out of the public insurance system.[14]


  1. ^ a b c Izvješće o poslovanju Hrvatskog zavoda za zdravstveno osiguranje za 2019. godinu (PDF) (in Croatian). Croatian Health Insurance Fund. February 2020. Retrieved 20 July 2020.
  2. ^ Vončina, Luca; Džakula, Aleksandar; Mastilica, Miroslav (2007). "Health care funding reforms in Croatia: a case of mistaken priorities" (PDF). Health Policy. 80 (1): 144–157. doi:10.1016/j.healthpol.2006.02.016. Retrieved 12 June 2013. p. 4.
  3. ^ a b Vončina, Jemiai, Merkur et al. (2006). p. 19.
  4. ^ a b Vončina, L.; Strizrep, T.; Bagat, M.; Pezelj-Duliba, D.; Pavić, N.; Polašek, O. (2012). "Croatian 2008–2010 health insurance reform: Hard choices toward financial sustainability and efficiency". Croatian Medical Journal. 53 (1): 66–76. doi:10.3325/cmj.2012.53.66. PMC 3284176. PMID 22351581. p. 3.
  5. ^ "The Health Systems and Policy Monitor". Croatia (Vol 16 no 3). European Observatory on Health Systems and Policies. 2014. Retrieved 10 February 2016.
  6. ^ Vulic, Spaso; Healy, Judith (1999). "Health Care Systems in Transition: Croatia" (PDF). European Observatory on Health Systems. Retrieved 12 June 2013. Cite journal requires |journal= (help) p. 6.
  7. ^ Vončina, Jemiai, Merkur et al. (2006). p. 13.
  8. ^ Vončina, Džakula, Mastilica (2007). p. 2.
  9. ^ Letica, Gordana; Račić, Tatjana (2002). "Model for private health insurance in Croatia" (PDF). 27th International Congress of Actuaries. Archived from the original (PDF) on 31 March 2014. Retrieved 16 June 2013.
  10. ^ Bosanac, Sanja Babić; Borovečki, Ana; Fišter, Kristina (2008). "Patients' rights in the Republic of Croatia – between the law and reality" (PDF). Medicinski Glasnik. Medical Association of Zenica-Doboj Canton. 5 (1): 37–43. Retrieved 12 June 2013. p. 38.
  11. ^ Vončina, Jemiai, Merkur et al. (2006). p. 14.
  12. ^ Vončina, Džakula, Mastilica (2007). pp. 7–8.
  13. ^ Vončina, Jemiai, Merkur et al. (2006). p. 89.
  14. ^ Vončina, Luca; Jemiai, Nadia; Merkur, Sherry; Golna, Christina; Maeda, Akiko; Chao, Shiyan; Džakula, Aleksandar (2006). "Croatia: Health System Review" (PDF). Health Systems in Transition. European Observatory on Health Systems and Policies. 8 (7): 1–108. Retrieved 12 June 2013. p. 33.

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