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.

How Foreigners Can Register

The Slovak system is based on your residency status and employment activity, not your nationality. However, your pathway differs slightly depending on where you are from.

EU/EEA Citizens

  • Temporary Stays: You can use your European Health Insurance Card (EHIC) for emergency and medically necessary care on the same terms as a Slovak resident.
  • Employed in Slovakia: If you move to work, you are mandated to join the public health insurance system. Your employer will register you and deduct contributions from your salary. You can choose between VšZP, Dôvera, or Union (VšZP is currently best for PrEP).
  • Not Employed: If you are studying or residing without employment, you generally cannot join the public system unless specific conditions apply, but your EHIC or private health insurance will cover you.

Non-EU Citizens

  • Residence Permit & Visas: To obtain or extend a temporary residence permit, you typically must provide proof of commercial (private) health insurance if you do not yet qualify for public insurance.
  • Employed in Slovakia: Once you are legally employed by a Slovak entity, you have the same rights and obligations as Slovak citizens. Your employer must register you with a public health insurer (VšZP, Dôvera, or Union).
  • Not Employed: If you hold a residence permit but are not employed (e.g., self-employed or specific student visas), you may have to arrange commercial health insurance out-of-pocket, as you might not qualify for the public system.

Once insured in the public system, 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 without paying out-of-pocket. Finding an LGBTQ+-affirming GP can be challenging; Dom Svetla can offer informal guidance on navigating the system.

National Health Hotline

Slovakia does not have a 24/7 centralized clinical health hotline for the general public like some other countries. For administrative questions and general health system information, you can contact the National Health Information Center (NCZI):

  • NCZI Call Center (International Format): +421 2 3235 3030

This number is for administrative queries, not medical emergencies. For a medical emergency, immediately call the universal European emergency number 112, or the direct ambulance number 155 (can only be dialed from within Slovakia).

Related: