Skopje, 3 July 2025 (MIA) - The total number of health insurance beneficiaries is over 1,820,000, which is more than the number of residents according to the latest population census. The Health Insurance Fund has taken activities on setting up an intersectoral working group to determine the exact number of health insurance beneficiaries.

According to Health Insurance Fund director Sasho Klekovski, the total number most likely includes Macedonian nationals living abroad who have not deregistered from the country and continue to use health insurance, but he neither rules out the possibility of fake beneficiaries.

"Over half of the health insurance beneficiaries are on other grounds than on the basis of salary and insured children. We have launched an initiative before the Government to review the criteria. This is an intersectoral work that will take time because we have fewer residents than we currently have health insurance beneficiaries," Klekovski said in a statement to the media.

The Health Insurance Fund will also initiate amendments to the Law on Health Care in order to improve the control system for issuing sick leave, so as to grant sick leave to those patients who really need it. 

"Basically, we have about 17,000 sick leave due to illness and about 10,000 maternity leave. The increased number of control requests arises from the fact that in public sector institutions, there is a significant number of employees who are on sick leave. In healthcare, we have clinics where 20 percent of employees are on sick leave, and we have a special problem with sick leave in the police, customs and defence, and basically we can no longer physically respond to all sick leave applications, so we are considering how to propose changes to improve the sick leave control system," said Klekovski. 

He notes it is often the case that when workload increases, staff take sick leave to avoid work obligations.

An additional reason for taking sick leave, according to Klekovski, are collective agreements that provide for 90 to 100 percent payment of salary during sick leave, which in terms of income means that employees are not affected whether they are at work or not. Another point is the low salaries in some institutions in the public sector, which is why people take sick leave, so that they can work a second job.

Health Insurance Fund directors presented on Thursday the work done in the past year since taking office, noting among the most significant achievements the expansion of the health insurance-covered drugs list, which was done after a 10-year break, increased wages in healthcare, improved health services, better financing of primary healthcare, as well as greater efficiency and digital transformation of the Fund.

Photo: MIA archive