“Free healthcare” only on paper — 84% of Albanians pay out of pocket for medical visits and tests

Albania ranks among the countries with the highest burden of out-of-pocket health spending, also reflecting a lack of stability in the financial protection the state provides to families for basic services, according to the results of the “SecuriMeter 2025” survey by the Regional Cooperation Council.

According to the survey’s official figures, about 57% of Albanian households say they spend between 1% and 10% of their total income on medical visits and medicines. This group represents the vast majority of the population and marks the highest level in the Western Balkans for this category.

Meanwhile, in neighboring countries such as Bosnia and Serbia, a larger share of citizens manage to be covered by public schemes at minimal cost, whereas in Albania almost every interaction with the healthcare system appears to come with a bill that weighs on patients’ budgets.

Even more concerning is the fact that 27% of Albanian households are forced to allocate more than 10% of their income to health expenses. This threshold is considered critical by international organizations such as the WHO, as spending at this level often leads to further impoverishment of middle- and low-income groups.

Although countries such as Serbia (34%) and Kosovo (32%) have higher percentages in this extreme category, the structure of spending in Albania shows a broader distribution of the financial burden across society.

What makes Albania’s situation unique in the region is the very small number of those who pay nothing. Only 9% of households manage to keep health expenses below 1%. This is the lowest figure in the Balkans (where the regional average is 13%), suggesting that “free” coverage remains more of a promise than a tangible reality for most Albanians.

Analysts suggest that this trend reflects the urgent need to review the list of reimbursable medicines and improve the management of the primary healthcare system.

At a time when wages are facing high inflation, the fact that more than 84% of the population must pay significant amounts out of pocket for healthcare (the 1–10% and over-10% categories combined) places the country’s social security in a highly vulnerable position.

Healthcare costs are expected to remain one of the main obstacles to improving the well-being of Albanian families in the coming years.

“KORÇA BOOM”