Important change to the payment of health insurance, from January 1. Which patients are no longer exempt and what amounts they have to pay

From January 1, 2026, three categories of patients who suffer from serious chronic diseases included in the national health programs – cancer, HIV/AIDS and tuberculosis – and have no income are no longer exempt from paying health insurance, the National House of Health Insurance says, in a response to HotNews. Only these three categories of patients will continue to have access to all medical services settled by the CNAS, including outside the respective health program, without paying the health insurance contribution.

Patients included in the other national health programs, who suffer from chronic conditions other than the three, will benefit, in the absence of payment of the contribution, only from medical services offered within the respective health program.

These patients were exempted from paying the contribution until December 31, 2025. Before January 1, they became fully insured in the health system with inclusion in the national health program in which they are treated.

These are patients receiving treatment in the following 12 health programs:

• National program of cardiovascular diseases;
• National program of endocrine diseases;
• National diabetes program;
• National Orthopedics Program;
• National Mental Health Program;
• The national program for replacement of renal function (dialysis);
• The national program for intensive therapy of liver failure;
• The national program for transplantation of organs, tissues and cells of human origin;
• The national program for the treatment of neurological diseases;
• The national treatment program for hemophilia and thalassemia;
• The national deafness treatment program;
• National treatment program for rare diseases.

The amount that people with no income must pay to be insured

In order to continue to be fully insured in the health system and to benefit from all the medical services settled by CNAS, outside the program in which they were included, patients must pay health insurance – a fixed amount of 2,430 lei per year, established for people who do not generate income.

In July 2025, the National Health Insurance House officially announced that only uninsured cancer patients would be exempted, from September 1, 2025, from paying the contribution and remain insured in the health system as a whole. The measure would have been part of the first package of austerity laws assumed by the Bolojan Government.

However, the CNAS changed its mind then and finally decided that, until December 31, all patients included in the national health programs would remain exempt from paying the health contribution.

“A transition period is granted for patients included in the national health programs, who do not generate income. They will benefit, until December 31, 2025, in addition to the medicines and services provided within the health programs of which they are beneficiaries, and the entire package of basic services supported by the FNUASS budget, under the same conditions as the insured persons. During this transitional period, the uninsured patients included in the national health programs have the possibility to take the necessary steps to ensure it”, said then the Minister of Health, Alexandru Rogobete, in a dialogue with HotNews.

6.6 million health insurance payers

In July 2025, the Government decided to eliminate, from September 1, 7 categories exempted until then from the payment of health insurance, but which benefited from settled services:

• co-insured persons – dependents of an insured person, respectively husband/wife/parents without their own income;
• persons persecuted during the communist period;
• unemployment benefit beneficiaries;
• persons on parental leave;
• persons with the minimum inclusion income;
• the monastic staff;
• pensioners whose pension exceeds the threshold of 3,000 lei, who pay a 10% contribution only for what exceeds 3,000 lei.

Romania had, at that time, over 10 million non-paying insured persons – representing social categories exempt from paying the contribution – and 6.6 million contributors.

The President of the National Health Insurance House, Horațiu Moldovan, declared then, in an interview for Hotnews, that, following the reduction of categories exempted from the payment of the contribution, the impact will be 7 billion lei, given that the budget of the Single National Health Insurance Fund (FNUASS) had a deficit of 11 billion lei in 2025.