Healthcare in Romania: from the CAK's S1 to the health fund and the family doctor whose list you must be on

Romania has one national health fund, the CNAS, with a health insurance house in every județ. For you the question isn't which insurer, but how you get into that fund, and then which family doctor. If you come with a Dutch statutory pension, that runs through the CAK's S1: Romania is on the list of treaty countries. If you work, you pay a 10 percent health contribution on your salary. The pitfall is for whoever has neither: anyone without income who wants into the Romanian system pays the contribution on six minimum wages, for twelve months.

Retired: the S1 route through the CAK

If you have a Dutch statutory pension or benefit, you register with the CAK. You can do that as soon as your departure or pension date is no more than five months in the future. Within four weeks you receive a letter, with the S1 document attached, and the name of the health fund where you must register in Romania. After that you no longer pay a Dutch premium but a treaty contribution to the CAK; Romania charges you no contribution of its own, because you fall under the Dutch insurance and Romania only provides the care.

Your Europe describes the rule: if you don't receive a pension from the country where you live, you receive care there as long as you would be entitled to it in the country that pays your pension. You request the S1 from that country's institution, and after arrival register it with the health fund of your new country of residence.

Apply for the form well before departure and only cancel your Dutch policy once it's settled. A gap between two systems is the most expensive thing that can happen to you in this journey.

The family doctor is compulsory, not convenient

According to the European Commission's guide, every insured person in Romania must be on the patient list of a medic de familie. That family doctor is the first point of contact for everything that isn't an emergency, and refers you to the specialist. Without registration with a family doctor your right exists on paper, but not in the consulting room. So choose one in your first weeks, right after registering your S1 and with your personal number in your pocket.

What	Deadline or rule
Registering with the CAK	up to 5 months before your departure or pension date
Answer from the CAK, with the S1	within 4 weeks
Registering the S1	at the health fund of your județ, after arrival
Family doctor	compulsory on the list of a medic de familie
Health contribution employee	10% of gross salary, withheld by the employer
Health contribution without income and without S1	10% on 6 minimum wages, for 12 months
Romanian pension up to 3,000 lei	insured without contribution
CAK route for new applicants	expected from 1 November 2026 only with AOW, Anw, WAO, WIA or Wajong

What do you get, and what do you pay on top?

The basic package comprises, according to the guide, emergency care, prevention, care for acute and chronic illnesses, laboratory tests, dentistry with one free check-up a year, day and inpatient admission, home care, medicines with or without a personal contribution and medical devices. Outside the hospital you pay for your medicines yourself, unless they are on the list of compensated medicines; for pensioners and some groups there are free or cheaper medicines. EURES adds that family doctors also help the uninsured, for payment, and that the private sector offers wide access to specialists through subscriptions and private policies.

Count on paying privately on top. Your right is a right to the care from the Romanian system, with the same waiting times as for Romanians. Many Romanians take a subscription at a private clinic for specialists, and whoever lives outside the big cities has less choice. An S1 gives you access, not speed; keep room in your budget for a private subscription.

If you work in Romania: the route through the employer

Whoever takes up employment pays, according to EURES, a 10 percent health contribution on gross salary, withheld by the employer, and is insured with that. Your Dutch insurance ends on the day your Romanian one begins, and the CAK doesn't come into it. A self-employed person pays the contribution through their own return; how that works is in working in Romania.

Children up to 18 are insured without contribution, and young people up to 26 if they study; that helps a family that comes down to one income.

Who falls in between?

Anyone who leaves before the AOW on savings or on an early pension, and doesn't work, has no S1 and no employer. The guide is honest about it: anyone without income who wants into the system pays the health contribution on six gross minimum wages, for twelve months. That is the price of access; a private policy is the alternative.

As expected, from 1 November 2026 only new applicants with AOW, Anw, WAO, WIA or Wajong will be admitted to the CAK route. The CAK reports that the European institutions have provisionally agreed to the amendment of Annex XI to Regulation 883/2004, and that nothing changes for anyone who already has insurance through the CAK on the basis of an early pension. Whoever is on the edge has an interest in being registered before that date. How healthcare fits into the rest of your move is in the step-by-step plan for Romania.

In Vertrekklaar this is phase 1 of 5 of the journey, step 1.2: the same steps, but for your situation — in your order, tickable, and with the deadlines watched. See the whole journey to Romania or go straight to step 1.2 in the open plan.