The Key Navigation Principle

Slovakia operates a public health insurance system with three main insurers: Všeobecná zdravotná poisťovňa (VšZP), Dôvera, and Union. For sexual health, the key navigation principle is that your insurer dictates your access route and costs.

The primary gatekeeper in the Slovak system is the obvodný lekár (general practitioner). For specialist care at public clinics, including infectious disease departments (infektológia) that manage HIV and PrEP, you typically need a referral (výmenný lístok) from your GP.

However, many gay and bisexual men bypass the public system for routine STI testing to maintain privacy, using Dom Svetla (free, anonymous rapid testing) or private labs (paid, no referral needed).

Insurance and Care Access

Public Insurance (VšZP, Dôvera, Union)

If you are employed in Slovakia, you will have public health insurance.

  • VšZP is the largest state insurer and currently the only one that fully reimburses PrEP (medication and monitoring).
  • Dôvera and Union do not routinely reimburse PrEP, meaning patients must pay out-of-pocket for generics (roughly €30–50/month).
  • All three insurers cover full STI diagnostics (including swabs) and HIV care at public hospital clinics, provided you have a GP referral.

European Health Insurance Card (EHIC)

EU/EEA visitors with an EHIC are entitled to medically necessary care on the same terms as a Slovak resident. This covers emergency PEP and acute STI treatment at public hospital clinics (like Kramáre). It does not cover routine screening or PrEP initiation.

Tourists and Uninsured

Without Slovak insurance or an EHIC, you must pay out-of-pocket for all care. Public hospitals will treat emergencies (like PEP) but will bill you. Private labs are the easiest route for routine STI testing if you are paying out-of-pocket, as they require no referral.

Registering as a New Resident

When you move to Slovakia and start working, your employer will register you for health insurance (often defaulting to VšZP unless you specify otherwise).

Once insured, your first step is to register with an obvodný lekár (GP). This doctor becomes your primary point of contact and issues the referrals needed to access specialists within the public system without paying out-of-pocket. Finding an LGBTQ+-affirming GP can be challenging; Dom Svetla can offer informal guidance on navigating the system.