Road Conditions and Safety: In North Macedonia, road conditions differ significantly from those in the United States. Driving safely in North Macedonia requires excellent defensive driving skills.
- Most major highways are in good repair, but many secondary urban and rural roads are not maintained and are poorly lit. Secondary mountain roads may be narrow, poorly marked, and lack guardrails.
- Many vehicles are old and lack front or rear lights.
- Horse-drawn carts, livestock, dead animals, rocks, or other objects are sometimes in the roadway.
- Roadside emergency services are limited.
- In case of emergency, drivers may call the police at 192, the Ambulance Service at 194, and Roadside Assistance at 196.
- Pedestrians should be very cautious when crossing streets, even when using crosswalks, as local drivers often do not slow down or stop for pedestrians.
- Driving at night in rural mountainous areas is inadvisable due to poor or nonexistent lighting.
Traffic Laws: U.S. citizens need a valid U.S. driver?s license and an International Driving Permit (available in the United States only) to drive in North Macedonia.
- Drivers and passengers should always wear seat belts.
- Many local drivers routinely ignore speed limits and other traffic rules, such as stopping for red lights and stop signs.
- Drivers often make illegal left turns from the far right lane, or drive into oncoming lanes of traffic.
- Using a cell phone while driving is illegal.
Public Transportation: Public transportation in North Macedonia is dilapidated. Taxis are generally safe.
See our Road Safety page for more information.
Aviation Safety Oversight: As there is no direct commercial air service to the United States by carriers registered in North Macedonia, the U.S. Federal Aviation Administration (FAA) has not assessed the government of North Macedonia?s Civil Aviation Authority for compliance with International Civil Aviation Organization (ICAO) aviation safety standards. Further information may be found on the FAA’s safety assessment page.
For emergency services in North Macedonia, dial 194.
Ambulance services are available in Skopje and major tourist areas, such as Ohrid, though response times, equipment and staff training may be below US standards. In other regions of the country, especially rural areas and small towns, ambulances are staged regionally and may be more than an hour away or unavailable when needed.
Medical care in North Macedonia varies in quality by location and provider. Skopje has four private hospitals that offer services ranging from cardiovascular surgery to pediatric intensive care. Quality of care is not equal to U.S. health care. Outside Skopje, medical care is substandard, with the exception of trauma services in Ohrid.
- Rheumatology, endocrinology, burn, and psychiatric services are either substandard or unavailable to non-citizens throughout the country.
- A government formulary controls which prescription medications are available; the list does not include several medications available in most Western countries. Insulin is not available to non-citizens.
- Government-operated emergency services are substandard. Private emergency services in Skopje, operated by private institutions, meet high quality standards.
We do not pay medical bills. Be aware that U.S. Medicare/Medicaid does not apply overseas. Most hospitals and doctors overseas do not accept U.S. health insurance.
Medical Insurance: Make sure your health insurance plan provides coverage overseas. Most care providers overseas only accept cash payments. See our webpage for more information on insurance providers for overseas coverage. Visit the U.S. Centers for Disease Control and Prevention for more information on the type of insurance you should consider before you travel overseas.
We strongly recommend supplemental insurance to cover medical evacuation.
Always carry your prescription medicine in original packaging, along with your doctor?s prescription. Check with the Republic of North Macedonia Customs Administration to ensure the medication is legal in North Macedonia.
Vaccinations: Be up-to-date on all vaccinations recommended by the U.S. Centers for Disease Control and Prevention.
Further health information:
Air Quality: Visit AirNow Department of State for information on air quality at U.S. Embassies and Consulates.
- Air pollution is a significant problem in several major cities in North Macedonia. Consider the impact seasonal smog and heavy particulate pollution may have on you, and consult your doctor before traveling if necessary.
The U.S. Embassy maintains a list of doctors and hospitals. We do not endorse or recommend any specific medical provider or clinic.
Local laws and Special Circumstances
Criminal Penalties: You are subject to local laws. If you violate local laws, even unknowingly, you may be expelled, arrested, or imprisoned. Individuals establishing a business or practicing a profession that requires additional permits or licensing should seek information from the competent local authorities, prior to practicing or operating a business.
Arrest Notification: If you are arrested or detained, ask police or prison officials to notify the U.S. Embassy immediately. See our webpage for further information.
- North Macedonia?s customs authorities enforce strict regulations that require special licenses or permits for the exportation of items deemed to be of historical value or significance. Taking such items out of North Macedonia without the appropriate government-issued permit can result in arrest, monetary fines, and prison sentences. North Macedonia’s Customs Administration provides more information on customs regulations.
- Taking photographs of anything that could be perceived as having military or security interest may result in problems with authorities. Visitors should comply with ?no photography? signs. If you are in doubt, ask for permission before taking photographs.
- While larger stores and restaurants accept credit cards, it is recommend to have cash in local currency (denar) for purchases in small establishments.
- Failure to declare currency exceeding 10,000 euros, or the equivalent, may result in its confiscation and a court proceeding. Penalties typically include a fine and a percentage of the undeclared amount.
Faith-Based Travelers: See our following webpages for details:
- Faith-Based Travel Information
- International Religious Freedom Report ? see country reports
- Human Rights Report ? see country reports
- Hajj Fact Sheet for Travelers
- Best Practices for Volunteering Abroad
LGBTI Travelers: There are no legal restrictions on same-sex sexual relations or the organization of LGBTI events in North Macedonia. Vandals attacked an LGBTI center several times in the last five years, and in June 2019, a prominent activist for the rights of LGBTI people was chased, pulled from a car, and violently assaulted in Skopje. We advise exercising caution when attending LGBTI events.
Travelers Who Require Accessibility Assistance: Individuals with disabilities may find accessibility and accommodation very different from the United States. North Macedonia?s law requires only that new buildings be accessible to persons with disabilities. Most public buildings are inaccessible and inconsistent inspection results in construction of new facilities that are not accessible. Public transportation for persons with disabilities is very limited.
Women Travelers: See our travel tips for Women Travelers.
Safety and Security
Terrorism: Terrorist groups and those inspired by such organizations are intent on attacking U.S. citizens abroad. Terrorists are increasingly using less sophisticated methods of attack ? including knives, firearms, vehicles, and rudimentary IEDs ? to more effectively target crowds. Frequently, their aim is unprotected or vulnerable targets, such as:
- High-profile public events (sporting contests, political rallies, demonstrations, holiday events, celebratory gatherings, etc.)
- Hotels, clubs, and restaurants frequented by tourists
- Places of worship
- Shopping malls and markets
- Public transportation systems (including subways, buses, trains, and scheduled commercial flights)
For more information, see our Terrorism page.
Crime: Violent crime against U.S. citizens is rare. Theft and other petty street crimes do occur, particularly in areas where tourists and foreigners congregate.
- Do not leave anything of value in plain view in unattended vehicles.
- Securely lock the windows and doors of your residence when not at home.
- Organized crime is present in North Macedonia, and violent confrontations between rival organizations occasionally results.
- ATM use is generally safe; however, take standard safety precautions and be aware of your surroundings.
- Pickpockets are a problem in crowded areas of Skopje. You should:
- Be aware of your belongings and surroundings at all times.
- Know that pickpockets use various diversionary tactics to distract victims, including groups of children swarming the victim.
- If pickpocketed, report the crime to the police.
- Cancel your credit cards as quickly as possible
- Taxis are generally safe. Use metered taxis to avoid conflicts about the fare.
Demonstrations occur sporadically and often result in traffic disruptions, particularly near the center of Skopje. They may take place in response to political or economic issues, on politically significant holidays, and during international events.
- Even demonstrations intended to be peaceful can turn confrontational and possibly become violent.
- Avoid areas around protests and demonstrations.
- Check local media for updates and traffic advisories.
- Be aware of your surroundings at all times.
- Follow the instructions of North Macedonia?s authorities.
Information about demonstrations in North Macedonia can be found on the Embassy?s Security and Emergency Messages for U.S. citizens webpage.
Victims of Crime: U.S. citizen victims of sexual assault are encouraged to contact the U.S. Embassy for assistance. Report crimes to the local police at 192 (ambulance: 194) and contact the U.S. Embassy at (389) (2) 310-2000. Remember that local authorities are responsible for investigating and prosecuting crime.
See our webpage on help for U.S. victims of crime overseas.
- Help you find appropriate medical care.
- Assist you in reporting a crime to the police.
- Contact relatives or friends with your written consent.
- Provide general information regarding the victim?s role during the local investigation and following its conclusion.
- Provide a list of local attorneys.
- Provide our information on victim?s compensation programs in the United States.
- Provide an emergency loan for repatriation to the United States and/or limited medical support in cases of destitution.
- Help you find accommodation and arrange flights home.
- Replace a stolen or lost passport.
Domestic Violence: U.S. citizen victims of domestic violence are encouraged to contact the Embassy for assistance.
Tourism: The tourism industry is unevenly regulated, and safety inspections for equipment and facilities do not commonly occur. Hazardous areas/activities are not always identified with appropriate signage, and staff may not be trained or certified either by the host government or by recognized authorities in the field. In the event of an injury, appropriate medical treatment is typically available only in/near major cities. First responders are generally unable to access areas outside of major cities and to provide urgent medical treatment. U.S. citizens are encouraged to purchase medical evacuation insurance. See our webpage for more information on insurance providers for overseas coverage.
Entry exit Requirementsh
Visit the Embassy of North Macedonia website for the most current visa information.
- Valid U.S. passports are required for travel to North Macedonia.
- Visas are not required for tourist or business trips of less than 90 days within a six-month period. However, persons with illegal stays over 90 days may face delayed departure, a court hearing with a substantial fine, or a re-entry ban.
- Travelers planning to work, study, or stay longer than 90 days in North Macedonia must obtain the proper visa before traveling to North Macedonia; adjustment of status is not possible within North Macedonia.
- All foreign citizens must register with local police within 48 hours of arrival.
- Hotels register foreign guests.
- If not staying in a hotel, travelers should register in person (the owner or landlord of the residence should accompany registrants) at the police station nearest to current lodgings; changes of address should be re-registered with the police station nearest the new address.
- The government of North Macedonia requires all foreign citizens to provide proof of travel medical insurance when they enter the country.
- Unaccompanied U.S. citizen minors traveling in North Macedonia should have a notarized statement of consent from a parent or guardian certified by a competent authority in the country from which the child arrives, or by an embassy or consulate of North Macedonia.
- Travelers should carry a copy of passports, photo IDs, and/or residence permits at all times; local authorities can request your identification.
- U.S. citizens born in North Macedonia are advised to read the Greece Country Specific Information if they plan to travel to Greece.
- Dual citizens of the U.S. and North Macedonia who have stayed outside of North Macedonia for more than three months should either report to the nearest embassy or consulate of North Macedonia before returning to North Macedonia, or report to the nearest police station after entering North Macedonia. Failure to notify may delay departure from North Macedonia.
The U.S. Department of State is unaware of any HIV/AIDS entry restrictions for visitors to or foreign residents of North Macedonia.
See the Department of State?s Fact Sheet on North Macedonia for information on U.S. – North Macedonia relations.