OBJECTIVES: To analyze the health insurance cost of medial femoral neck fractures treated with arthroplasty, screw fixation and dynamic hip screw (DHS) methods on a 2 years follow up after primary treatment. METHODS: Data derive from the financial database of the National Health Insurance Fund Administration (OEP) and based on the S7200 ICD code and Diagnosis Related Groups 371A,B,C,H,K 374A,B,C and 375A,B,C. Patients with polytrauma or severe comorbidities were excluded from the study. Our retrospective analysis includes patients with femoral neck fracture identified with Social Security Identification number (TAJ) and discharged in 2000. We calculated the cost of acute and chronic hospital care, outpatient care and sick-pay. The following exchange rate was used: 1 Euro (EUR) = 253,23 Hungarian Forint (HUF). RESULTS: Altogether 518 patients were included into the study. The average cost per patient (for both with and without complications) was as follow. Acute inpatient care: arthroplasty 1357 EUR, screw fixation 1033 EUR, DHS: 925 EUR. Chronic inpatient care: arthroplasty 24 EUR, screw fixation 75 EUR, DHS: 52 EUR. Sick-pay: arthroplasty 896 EUR, screw fixation 994 EUR, DHS: 914 EUR. Outpatient care: arthroplasty 21 EUR, screw fixation 51 EUR, DHS: 39 EUR. Total health insurance expenditures were: arthroplasty 2299 EUR, screw fixation 2153 EUR, DHS: 1930 EUR. Total health insurance expenditures per patient with complications were: arthroplasty 3063 EUR, screw fixation 3971 EUR, DHS: 2481 EUR. Total health insurance expenditures per patient without complications were: arthroplasty 2215 EUR, screw fixation 1743 EUR, DHS: 1813 EUR. The rate of further treatment was arthroplasty 8.3 %, screw fixation 18.4 %, DHS: 14.7%. CONCLUSIONS: We found the highest cost in patients with complications in screw fixation, while patients without complications in arthroplasty. In both cases (with and without complications) dynamic hip screw had the lowest cost.