Key Changes in Romanian Health Insurance Laws Romania is undergoing a significant reform of its public health insurance system starting August and September 2025, through Law 141/2025 and Emergency Ordinance (OUG) 8/2025. These changes aim to reduce the national fiscal deficit and improve the financial sustainability of the healthcare system. Health Contributions (CASS) – Starting August 1, 2025 Retirees who receive a monthly pension exceeding 3,000 lei will have to pay 10% CASS on the amount exceeding that threshold. This measure will apply from August 2025 until the end of 2027. Elimination of Automatic Exemptions for Some Categories – Starting September 1, 2025 Spouses, parents, or family members without income will no longer be automatically insured as dependents (“co-insured”). They will have to pay their own contributions to remain covered. Exemptions remain only for limited groups, including: Cancer patients with low income Legally recognized people with disabilities Children, emergency volunteers, stem cell donors, inmates, and other specific cases Health Insurance via the “Declarația Unică” Paying CASS through this declaration grants the individual the status of “insured in the public health system” for one year, renewable annually. To receive sick leave benefits (concediu medical), a separate contract must be signed and an additional 1% of the insured income paid (between 1x and 3x the minimum wage).If existing contracts are not updated within the legal deadline, coverage may be suspended, or the contract may be canceled. Changes to Sick Leave Compensation – From August 1, 2025 Sick leave payments will now vary based on the duration of the medical certificate: Up to 7 days: 55% 8–14 days: 65% Over 15 days: 75% of the calculation base For cardiovascular conditions, the benefit remains at 75% regardless of duration. Certificates issued before August 1 will be subject to previous laws. Who Is Affected and What Does It Mean? Retirees with higher income: 10% of the excess over 3,000 lei/month will be deducted automatically. In Romania, individuals without income or who are no longer co-insured can obtain the status of “insured” in the public health system by paying the health insurance contribution (CASS).The cost of this insurance for the year 2025 is fixed: 2,430 lei, covering 12 months of medical insurance. Dependents without income: They must pay CASS through the Single Declaration to remain insured after September 1, 2025. Self-employed individuals (PFA, freelancers, dividend earners, etc.): Must update their status and sign an additional insurance contract if they want sick leave benefits. Economic & Political Context These measures are part of a broader fiscal consolidation plan, aiming to reduce Romania’s budget deficit, which has exceeded 9% of GDP. In July 2025, the Romanian Constitutional Court ruled the new laws constitutional, despite opposition criticism regarding their impact on vulnerable populations. What Should You Do Now? ✅ Check if your income or family situation requires you to enroll in the new system. ✅ If you’re a retiree earning over 3,000 lei/month, expect automatic deductions starting August. ✅ If you’re a dependent without income, you’ll need to pay your own CASS to remain insured from September. ✅ If you’re self-employed, ensure your contract complies with OUG 8/2025 and includes coverage for sick leave if needed.
