Insurance
1Automatic Health Insurance
- Anyone legally employed in Romania with the CASS contribution deducted from their salary is automatically covered by the public health insurance system (Casa Națională de Asigurări de Sănătate / CNAS).
- The National Health Insurance Card (Cardul Național de Asigurări de Sănătate) is used to access medical services at contracted facilities.
2Pension Insurance
- The CAS contribution deducted from the salary is deposited into the National Public Pension House (Casa Națională de Pensii Publice / CNPP), building the individual's pension history.
- This must be verified based on current regulations and individual circumstances.
3Status of Non-Employees
- Non-employees can also voluntarily enroll in the health insurance system by submitting the Single Declaration (Declarația Unică / Form D212).
- This must be verified based on current regulations and individual circumstances.
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🏥Private Supplemental Insurance — Real Options
State CNAS insurance covers basic and emergency care, but long wait times in the public system are common. Many employees (and some employers, as a job perk) also subscribe to one of the private clinic/insurance networks below for faster appointments and choice of doctor:
🩺The Reported Reality of Getting Your Health Card as a Foreigner
On paper, CASS insurance is automatic for any employee with a formal contract. But on migrant forums (like Expat.com), some foreigners have reported that when they went in person for the physical National Health Insurance Card, their local CNAS office told them "no cards have been issued to foreign citizens at present" — one user reported being on a waitlist since 2015. The common workaround is a renewable 3-month "Adeverință" (insurance certificate) that must be re-collected from the office repeatedly; some pharmacies and doctors accept this certificate in place of the physical card, others don't. These are forum reports, not official statistics — but they suggest getting this temporary certificate from your local CNAS office from your first day of work, and keeping it on hand, rather than waiting for the physical card.
Sources: Expat.com forum (user reports, not official statistics), official CNPP bilateral agreements list (cnpp.ro).
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Frequently Asked Questions
Are medical services free with employee health insurance?
In public hospitals and private clinics contracted with CNAS, basic and emergency services are generally free or highly subsidized.
Can I get state insurance if I am not an employee?
Yes, non-employees can voluntarily enroll in the health insurance system by submitting the Single Declaration (Declarația Unică) and paying the equivalent premium.
Does private insurance replace mandatory state CASS insurance?
No. Private insurance is always supplemental, never a substitute; the CASS contribution is still deducted from your salary by law regardless of whether you also hold a private subscription.
What if my CNAS office tells me physical cards aren't being issued?
Some foreigners have reported this experience on migrant forums. In that case, request the temporary insurance certificate (Adeverință), valid for a renewable 3 months, from the same office and keep it on hand until the physical card is issued.
Do my Romanian pension contributions transfer to an Iranian pension?
No. Romania has no pension "totalization" agreement with Iran (per the official CNPP list); your CAS contributions only count within the Romanian pension system.
This guide is part of the "Work & Employment" collection.
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