Health insurance in Montenegro: a comparison between statutory and private insurance companies

The healthcare system in Montenegro offers both statutory and private health insurance companies, which offer various services and tariffs. For many people, it is important to understand which type of health insurance best suits their needs. This article compares statutory and private health insurance companies in Montenegro, including the average premiums and the advantages and disadvantages of each option.

Statutory health insurance companies

Structure and financing

Statutory health insurance in Montenegro is compulsory for all employees and their families. It is financed by contributions from employees and employers, supplemented by state subsidies. The contribution rate for statutory health insurance is currently around 12.3% of gross wages, with 8.5% being paid by the employer and 3.8% by the employee.

Services

Statutory health insurance covers a wide range of healthcare services, including:

• Doctor visits and treatments
• Hospitalization
• Medication (with partially reduced co-payments)
• Preventive measures and check-ups
• Rehabilitation measures

Advantages of statutory health insurance

1. Comprehensive coverage:
   Statutory health insurance offers comprehensive medical care that covers most health needs.
2. Cost control:
   As the contributions are income-related, health insurance remains affordable for all citizens.
3. Principle of solidarity:
   Statutory insurance is based on the principle of solidarity, whereby the financial burden is distributed equally among all insured persons.

Disadvantages of statutory health insurance

1. Waiting times:
   Due to high demand, there may be waiting times for certain treatments and specialists.
2. Limited options:
   Insured persons often have less freedom in choosing their doctors and hospitals compared to private insurers.

Private health insurance

Structure and financing

Private health insurance in Montenegro offers an alternative or supplement to statutory health insurance. The premiums vary depending on the insurance provider, scope of benefits and individual risk factors such as the insured person’s age and state of health.

On average, the monthly premiums for private health insurance are between 50 and 200 euros per person, depending on the insurance packages selected and the scope of the benefits covered.

Services

Private health insurance plans often offer a wider range of services and amenities, including:

• Shorter waiting times and preferential access to specialists
• Access to private hospitals and clinics
• Extended screening and prevention programs
• Additional services such as alternative medicine and dental treatments

Advantages of private health insurance

1. Flexibility and freedom of choice:
   Insured persons are generally free to choose which doctor or hospital they wish to go to and have access to a wider network of medical service providers.
2. Shorter waiting times:
   Private insurance often offers faster access to treatment and specialized medical services.
3. Additional services:
   Private health insurance often covers services that are not included in statutory insurance, such as alternative healing methods or dental treatment.

Disadvantages of private health insurance

1. Higher costs:
   Private health insurance can be significantly more expensive than statutory insurance, especially for older people or those with health problems.
2. Risk-based premiums:
   The premiums can vary greatly depending on the individual risk, which can lead to financial burdens for people with health problems.
3. Limited solidarity:
   In contrast to statutory health insurance, private insurance is not based on the principle of solidarity, which can lead to an uneven distribution of costs.

Comparison of average contributions

Statutory health insurance companies

The statutory health insurance contributions in Montenegro are fixed and amount to around 12.3% of the gross salary. For an employee with a gross monthly salary of 1000 euros, this means a contribution of 123 euros, with the employer paying 85 euros and the employee 38 euros.

Private health insurance

The premiums for private health insurance vary greatly depending on the insurance provider and the scope of benefits. Here are some sample packages:

• Basic package:
  On average 50-70 euros per month. Covers basic medical services and emergency care.
• Comfort package:
  On average 100-150 euros per month. Includes extended benefits, faster access to specialists and private hospitalization.
• Premium package:
  On average 150-200 euros per month. Includes comprehensive medical care, including preventive check-ups, alternative healing methods and extensive dental services.

Advantages and disadvantages of private health insurance in detail

Advantages

1. Personalized services:
   Private health insurance companies often offer customized insurance packages that are tailored to the individual needs of the insured person.
2. Comfort and amenities:
   Insured persons often enjoy additional comfort, such as single rooms in hospitals and direct appointments with specialists.
3. Advanced prevention:
   Private insurers often place greater emphasis on preventative measures and health care, which can lead to better overall health.

Disadvantages

1. Cost intensity:
   The higher premiums can be a financial burden for many people, especially if they are dependent on comprehensive cover.
2. Inequality:
   As private insurance companies charge risk-based premiums, people with pre-existing conditions or older age groups may have to pay significantly higher premiums.
3. Possible gaps in coverage:
   Although private insurance policies offer a wide range of benefits, certain treatments or medications may be excluded, depending on the policy conditions.

Conclusion

The choice between statutory and private health insurance in Montenegro depends heavily on individual needs, financial means and health requirements. Statutory health insurance offers solid basic care and financial security, while private health insurance offers more flexibility, faster access to medical services and additional benefits.

For many citizens, a combination of both systems may be the best solution, with statutory health insurance providing basic coverage and private insurance serving as a supplement for specialized or preferred medical services. It is advisable to carefully examine the various options and, if necessary, seek professional advice in order to make the best decision for your own healthcare.