Here’s what you need to know to remain insured in the Romanian public healthcare system
 
As of 2025, individuals in Romania who earn income exclusively from passive sources — such as rental income, dividends, or other non-salary streams — must pay close attention to changes regarding their health insurance status. Even though some reporting obligations have been simplified, access to public healthcare services requires a few key steps.

 
What changed in 2025?
  • You are no longer required to submit an estimated tax return during the year for rental, dividend, or other passive income;
     
  • Income earned in 2025 will be declared and taxed in 2026, by the standard May deadline;
     
  • However, if you want access to public healthcare services in 2025, you must take proactive steps and opt to pay the health insurance contribution (CASS) voluntarily.
Important: If you don’t have an employment contract, are not self-employed (PFA), and have no other form of insured income, you are not automatically covered by the national health system. You need to take action to become insured and gain access to services like doctor visits, hospitalization, prescriptions, or reimbursed treatments.
 
How to stay insured in 2025?
 
Even though you are not legally required to file a tax return during the year, you can still file a voluntary health insurance contribution through the annual tax return. Here’s how:
  1. Complete the 2025 Single Tax Return, checking Chapter II – “Option for paying the health insurance contribution (CASS)”;
     
  2. Choose to pay voluntarily at the 6-month minimum salary threshold;
     
  3. The amount due is 2,430 RON (10% of 6 × 3,300 RON – the gross monthly minimum wage in 2025);
     
  4. Once submitted, this contribution becomes mandatory, even if your actual income later falls below the legal threshold.
     
How is the health contribution (CASS) calculated?
  • If your total annual income (rent + dividends + other sources) is below 24,300 RON → there is no legal obligation to pay CASS, but you can choose to pay voluntarily to be insured;
     
  • If income is between 48,600 RON and 97,200 RON → you must pay 2,430 RON in 2026 (equivalent to 6 minimum wages);
     
  • If income exceeds 97,200 RON → you owe 7,290 RON (corresponding to 3 × 6 minimum wages).
Practical example:
 
Andrei earns only rental income in 2025, totaling 36,000 RON. He does not have a job, a PFA, or any other insured income.
To gain access to medical services in 2025, Andrei:
  • Files the Single Tax Return during 2025 (ideally early in the year);
     
  • Selects the option for voluntary CASS payment at the 6-salary threshold;
     
  • Pays 2,430 RON;
     
  • Is considered insured for the entire year;
     
Later, in 2026, since his 2025 income was below 48,600 RON, he has no additional payment obligations.
 
Key takeaways:
  • Opting to pay CASS is voluntary, but it’s the only way to access healthcare if you don’t have insured income from other sources;
     
  • Once you file the return and choose to pay, the contribution becomes mandatory, even if your actual income later drops below the threshold or ceases entirely;
     
  • If you’re uninsured and don’t make this payment, you’ll only have access to emergency medical care — without coverage for other essential health services;
     
  • If you were insured through the 2024 declaration and still meet the same conditions in 2025, you’ll need to repeat the process to maintain your coverage.
Tip: If your 2025 income comes only from passive sources like rent, dividends, interest, or platforms like YouTube or Fiverr — and you don’t have a job or another insured activity — make sure you file your declaration and voluntarily pay the CASS contribution to stay covered under Romania’s public healthcare system.
 
☎️ Need help completing the Single Tax Return or clarifying your fiscal status? Reach out to the Financess team for tailored support:
📞 (+40) 749 097 969
📧 contact@financess.ro