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Navigating the Challenges of Healthcare Financing in Serbia: Expert Insights

In Serbia, the healthcare system relies on a combination of public finance and private contributions. The Republic Health Insurance Fund (RFZO) plays a major role in healthcare financing, with additional funding from budget sources, such as the Pension and Disability Insurance Fund, and the National Employment Service. Over 90% of public expenses are financed through RFZO, while around 69% of total current healthcare expenditures in Serbia are funded from public sources.

Health insurance in Serbia is closely linked to employment status. Employees receive basic health insurance based on their employment status, whether it is temporary or permanent. Employers are responsible for regularly paying contributions to the RFZO on behalf of their employees, which enables access to healthcare services. Retirees rely on health insurance based on their previous contributions during their working life, while unemployed individuals must register with the National Employment Service in order to qualify for health benefits.

Establishing and securing universal healthcare package represents a global challenge, and Serbia is no exception. Universal coverage would mean that health services must be accessible to most citizens, regardless of their income level. In Serbia, this is further complicated by factors such as aging population, global economic recession, migration patterns, and the issue of fiscal sustainability, which are challenges shared by other countries in the World Health Organization’s European region.

Silver Tsunami in Serbia

The main factor of health deprivation is the third demographic transition, also known as the aging of the population. Changes achieved in recent decades, especially at the end of the twentieth and beginning of the twenty-first century, indicate that Serbia has been exposed to very intense population aging. The process of demographic aging manifests itself through a low proportion of young people and a high and continuously increasing share of the elderly in the total population. According to data collected in the 2022 population census, the share of persons aged 65 and over amounts to 22.0%, while only 14.4% consists of the young population up to 15 years old. This type of demographic change represents unique challenges for healthcare financing and the provision of health services.


Expenditures for healthcare expressed in dollars per capita have grown and later fluctuated, particularly in the period 2000–2016. Compared to EU countries, some non-EU countries, and the average spending in EU countries, Serbia allocates a relatively modest absolute amount of funds for healthcare. According to data from the World Health Organization (WHO), the table shows the following data on health expenditures in the Republic of Serbia:

Trend or Necessity

Awareness of the benefits of contracting private health insurance both for employees and companies in Serbia has significantly increased. Besides large companies, especially developed ones, we can see a rise in awareness among the managerial structures of small and medium-sized enterprises, where this trend has gained momentum.

Although 2022 was a year of constant growth in participation in the total premium, the number of contracts, and the number of insured under private health insurance, according to data from the National Bank of Serbia, in the first three quarters of 2023 there was a significant increase compared to the same period of the previous year. More details and statistical data can be read in our previous article .

Contracting private health insurance for employees represents a step towards solving the complex challenges of financing healthcare in Serbia. As we face the need for comprehensive health system reforms, prioritizing population health, and modernizing information systems, companies must be ready to recognize the importance of providing additional security to their employees.