Eligibility and Contribution Requriements for Long-Term Care
In Slovenia, compulsory LTC insurance applies to all individuals who meet the conditions set out in the Long-Term Care Act (ZDOsk-1). According to the Act, individuals insured for LTC include persons who are covered under the mandatory health insurance system, either by relevant health insurance regulations or other applicable legislation, provided they are at least 18 years old.
Minors (under the age of 18) are also considered insured for LTC if they are covered by mandatory health insurance due to an employment relationship, self-employment in a business or profession, agricultural activity, or the performance of a managerial function in a company or institution in which they hold ownership or founding rights.
In addition to the insured persons themselves, their family members are also considered insured for LTC, provided they are insured as family members under the regulations governing mandatory health insurance.
A person insured for LTC may exercise his or her right to LTC services if, due to illness, age-related frailty, injury, disability, or a loss or lack of intellectual abilities, such person is dependent on the assistance of others – either for an extended period or permanently – in performing basic and supportive daily activities.
In addition, the following conditions must be met to apply for the LTC:
- the person has been insured for LTC for at least 24 months within the last 36 months prior to claiming LTC rights;
- the person has permanent or temporary residence in Slovenia;
- the person falls into one of the categories of LTC;
- the person is not receiving comparable benefits, such as the allowance for assistance and care, institutional care under the Social Welfare Act, or personal assistance (unless provided otherwise by the Personal Assistance Act).
There are four basic rights to long-term care, which are mutually exclusive: receiving care from a family care-giver, LTC at home, LTC in an institution, or a cash benefit.
LTC is financed from two sources: a budgetary source of up to EUR 190 million annually and the compulsory contribution for LTC insurance.
Long-Term Care Contributions: Who Pays, How Much, and Where It Goes?
The provision on the mandatory LTC insurance contribution stipulates that, as of 1 July 2025, employees and employers each pay 1 percent of the gross salary, pensioners pay 1 percent of their net pension, and individuals (e.g., self-employed) who act as both employer and employee are required to pay 2 percent of their gross salary.
Companies considered as “payer of tax,” under the provisions of the Long-Term Care Act (ZDOsk-1), will be required to calculate a 1-percent LTC insurance contribution on employment income at the expense of the employee, and an additional 1 percent at the expense of the employer.2 For income arising from other contractual relationships, payers will be required to calculate a 1-percent LTC insurance contribution, which is generally borne by the recipient of the income.
The LTC contribution is paid into a fund managed by the Health Insurance Institute of Slovenia and is collected in the same manner as compulsory health insurance contributions. For employees, the contribution is automatically calculated and deducted with each salary payment, just like health and pension contributions. For self-employed individuals, farmers, and those engaged in supplementary activities, the contribution is assessed and paid similarly to health insurance contributions, with a monthly obligation managed by the Financial Administration of the Republic of Slovenia. For pensioners, the contribution is automatically deducted at the time of pension disbursement.
Long-term care in institutions will be funded through mandatory LTC insurance. This will cover LTC services such as assistance with daily activities and nursing care, the administration of the LTC system, and services provided by various care providers. In addition, mandatory health insurance will continue to cover nursing and rehabilitation services.
Participants will remain responsible for personal living costs, including accommodations and meals. As of 1 December 2025, institutional LTC services will be funded through LTC insurance instead of being paid directly by individuals.
If financial resources prove insufficient, co-payments for LTC services may be introduced after 2028. In such cases, participants would be required to pay 10 percent of the service's value.
Concerns have been raised regarding the availability and quality of day-care services provided by LTC providers. Family care-givers are entitled to partial compensation, amounting to 10 percent of lost income and substitute care costs. In addition, 20 percent of LTC funding is earmarked for activities aimed at promoting and maintaining participants' independence.
