Health in Macedonia

The Health Insurance Fund, known as FZO, is the main public purchaser of healthcare and contracts certified public and private providers. More than 90% of the population was covered in 2024, although gaps remain for people with irregular employment and some Roma communities. Primary-care practices are mainly private solo practices with FZO contracts, while secondary and tertiary care is provided mainly by public hospitals, clinics and institutes. A chosen or family doctor usually provides prevention, examinations, prescriptions, chronic-disease management and initial triage. Planned specialist, diagnostic and hospital care normally follows the pathway from the chosen doctor to an e-referral and an appointment through Мој Термин. Emergency care bypasses this referral pathway. Regional health centres provide local access, but rural and remote areas can face transport, workforce and technology constraints. The Ministry of Health maintains provider information through its official registers. Emergency medical help can be requested by calling 112 from any operator. The Crisis Management Center coordinates calls around the clock, while emergency teams connected to health centres can provide treatment at home. Give the exact location and a short description of the condition. Routine care, transport by family or community members and informal home support do not replace clinical assessment or emergency services. Health services include diagnosis, treatment, hospital care, dental and mental-health services, rehabilitation, maternity and child care, and chronic-disease programmes. The Ministry of Health publishes clinical guidance and annual prevention programmes. Current programmes include Health for All, maternal and child health and brucellosis prevention. The programme archive also covers mandatory immunization, systematic examinations for children and students, early detection of cancer, HIV and tuberculosis control, cardiovascular disease, diabetes, mental health, dialysis and haemophilia support. Active immunization is mandatory from birth to age 18 under the national calendar; the current schedule and vaccine products should be confirmed with the provider or Ministry notice. The Institute of Public Health and ten regional Centers of Public Health handle epidemiological surveillance, infectious-disease records, microbiology, sanitary hygiene and parts of screening and prevention. They also monitor population health and environmental factors such as water, air and sanitation. In 2023, circulatory diseases accounted for 43.8% of recorded deaths, neoplasms for 18.6% and endocrine or metabolic diseases for 7.2%. FZO e-prescriptions, contracted pharmacies and the Positive List support access to reimbursed medicines, but reimbursement and availability depend on the product, contract and programme. MALMED regulates medicines and medical devices, maintains relevant registers and receives adverse-reaction reports through pharmacovigilance. Shortages and medicine affordability remain practical concerns, so the current Positive List and duty-pharmacy information should be checked before relying on a specific product. Follow-up normally continues through the chosen doctor or specialist. Electronic records, e-prescriptions and e-referrals support continuity. Rehabilitation is available through contracted providers. Orthopaedic and other aids generally require specialist confirmation, processing through the relevant FZO regional service and supply by a contracted provider. Mental-health follow-up can involve psychiatric hospitals or clinics together with primary care. Long-term personal care remains fragmented; North Macedonia has no unified nationwide health-care equivalent to a Pflege pathway. Insured people use FZO rights through the contracted network, subject to insurance status, referral and benefit rules. Primary-care examinations and emergency medical calls are listed as exempt from participation on the FZO information page. Participation is generally capped at 20% of the average service or medicine cost, while aids can involve participation of up to 50%; exemptions depend on the person, programme and applicable vulnerable-group rules. Exact tariffs, contracts, reimbursement lists and appointment availability can change. An FZO rights decision normally takes 30 days, or 45 days when a medical-commission opinion is required. An appeal normally has a 15-day deadline; after a missed deadline, a request may be possible within three days under the applicable procedure. Keep valid insurance information, referral or appointment codes and medical documents, follow clinical instructions, pay applicable participation and report suspected medicine reactions. The FZO rights line is 080033222 on weekdays from 8:30 to 20:00, with a mobile number, 076/339-180, listed for 16:30 to 20:00. North Macedonia had 6,326 physicians and 8,578 hospital beds in the latest 2022 statistical table, equal to about 3.5 physicians and 4.7 beds per 1,000 inhabitants. Workforce migration, shortages and uneven access to medicines, diagnostics, transport and modern technology affect the practical experience. Out-of-pocket spending represented 40.2% of total health expenditure in 2022, with medicines a major burden. Exact provider availability, duty pharmacies, fees, phone operation, appointment slots, reimbursement lists and immunization details should be confirmed from current Ministry of Health, FZO, MALMED or provider information.