Author
Access to health care for asylum seekers covers the right to receive free primary care and appropriate treatment, emergency hospital care and free health care and treatment in cases of acute or chronic illnesses considered imminently life threatening, through the national emergency health care system and qualified first aid. These services shall be provided, as the case may be, through the medical service of the Regional Centres and/or other health care facilities accredited and authorised by law.[1]
In addition, asylum seekers have the right to be included in national public health programs aimed at preventing, monitoring and controlling contagious diseases in epidemiological risk situations.[2]
Asylum seekers are assigned a personal identification number which figures on their temporary identity documents in order for them to enjoy all the rights provided by the law.[3] After receiving the personal identification number, asylum seekers may register in the public health insurance system and, if they pay healthcare contributions and register at a general practitioner’s office, they have the status of an insured person with the same rights and benefits as nationals.
Asylum seekers benefit from free medical care through the medical network of the MoI – IGI and the costs are covered by the same structure and, for these services, do not have the obligation to pay the contribution for the public health insurance. In specific cases, medical insurance could be covered through projects financed through AMIF. However, medical services are mainly related to health checks upon accommodation in a Regional Centre and emergencies. Certain medical services are not included by the National Medical Insurance System (e.g. rehabilitation services, certain medicines and medical materials).
In 2022, not all the regional centres had a medical doctor employed.
In 2023, according to IGI-DAI[4], the situation in each centre was as follows:
- Bucharest: 1 doctor and 3 nurses were employed; the position of psychologist is vacant.
- Giurgiu: 1 psychologist and 1 medical assistant were employed; the position of doctor is vacant.
- Rădăuţi: the positions of psychologist and doctor are vacant.
- Şomcuta Mare: there are a psychologist and a doctor employed. Timisoara: there are a psychologist and a doctor employed. Galati: there is a psychologist employed, and an external doctor has a collaboration contract with IGI-DAI.
Regarding vulnerable persons (e.g. pregnant women, persons with disabilities, victims of human trafficking, etc.), IGI-DAI specifies that, in accordance with internal procedures, medical assistance is given with priority, periodic monitoring is carried out, information is provided concerning the administration of the medicines, people are accompanied to the hospital. Also, through projects implemented with funding from European funds, vulnerable people benefit from complementary medical and psychological assistance (e.g. from NGOs). No other details were provided, including from other actors than IGI-DAI.
According to CNRR, in 2024, asylum seekers in Romania had access to healthcare services provided by the medical staff of the Regional Centres. In general, applicants did not face significant obstacles in accessing medical assistance. Medical services within the Centres were provided by family doctors who collaborated with the Reception Centres, and when necessary, asylum seekers were referred for specialized medical checks, such as in psychiatry, funded through IGI resources. This ensured that their healthcare needs were not limited to the medical office within the Centre.[5]
Additionally, with the start of the AMIF project in December 2024, asylum seekers began benefiting from Integrated Health Services for Asylum Seekers. This project aimed to provide more comprehensive health services to asylum seekers throughout their stay.[6]
For medical emergencies, asylum seekers were referred to local hospitals and could be hospitalized if required. In such cases, language barriers were a significant challenge, especially when seeking emergency care at hospitals. However, interpreters were called to assist asylum seekers and ensure they received the necessary medical attention. [7]
In some instances, gender differences between asylum seekers and medical staff or interpreters were reported as obstacles. However, efforts were made to minimize these issues, ensuring that asylum seekers had access to medical assistance, regardless of gender. [8]
The language barrier was a major obstacle in accessing healthcare services, particularly in interactions with medical professionals outside of the Regional Centres. Many asylum seekers faced difficulties when trying to communicate with healthcare providers, which could impact the quality and timeliness of the medical care they received. [9]
Moreover, bureaucratic obstacles posed challenges in navigating public health services. According to the CNRR, procedures for accessing national public health programs, health insurance, and social benefits (such as unemployment or child allowances) were often complex and difficult to navigate without assistance. Additionally, public institutions’ services were not always adapted to the specific needs of asylum seekers. Many public servants lacked awareness of the relevant legislation, which sometimes led to the denial of rights, requiring direct intervention from NGOs to ensure asylum seekers could access the care and services they were entitled to. [10]
Save the Children played an essential role in assisting asylum seekers by covering the costs of medications during the transitional period in the AMIF projects for vulnerable individuals, ensuring they were not left without necessary treatments.[11]
In Galati, asylum seekers could also access health insurance under the same conditions as Romanian citizens. Minors were insured free of charge, while adults could obtain insurance if they had a job or were included in national health programs. However, finding a family doctor who would accept asylum seekers was often difficult due to the language barrier and the uncertain nature of their status in Romania (e.g., uncertainty about whether they would remain in the country or keep their job).[12]
Specialised treatment
The Asylum Act provides for the right of asylum seekers with special needs to receive adequate health care.[13] In practice, the ICAR Foundation is the only organisation with the necessary experience in providing psychological assistance to torture survivors and traumatised asylum seekers in all the reception centres.
In 2024, according to CNRR, each applicant’s file contained an observation sheet indicating the information declared by the applicant regarding age, gender, family situation (single-parent family, could risk gender violence, elderly person alone, etc.), pregnancy, physical or mental health problems/already diagnosed diseases, disabilities, substance abuse, whether the applicant was a victim of torture (there are indications/statements of the applicant in this regard) or human trafficking (there are indications/statements in this regard) as well as other concerns (if the applicant has difficulty concentrating, is emotional, agitated, cries, etc.). This information is collected at the different stages of the procedure (at the time of submitting the asylum application, during accommodation in the Centre, during the preliminary questionnaire, during the interview or during the court phase). The caseworker assesses whether it is necessary to inform the integration officer about the case in order to take special assistance measures. If a vulnerability arises later in the asylum procedure, the Reception Centre takes all measures to ensure adequate conditions for asylum seekers in need (of course, taking into account the reception conditions in each Centre). Medical staff in each centre conduct regular check-ups of people identified as having a special need.[14]
In 2022 in Rădăuţi an asylum seeker who was HIV positive was treated through the state scheme. This project was not implemented between October 2023 until December 2024.[15]
In Timișoara, as of 2022 ICAR personnel conduct the medical screening. IGI-DAI is notified if there are asylum seekers suffering from mental health issues and they are referred to specialised hospitals, if necessary. The ICAR Foundation doctor is present in the centre once a week. According to the JRS representative, AIDRom representatives carry out a more detailed screening.
[1] Article 17(1)(m) Asylum Act.
[2] ibid. Article 17(1) (m^1).
[3] ibid. Article 17(1^1).
[4] Information provided by IGI-DAI, 18 January 2024.
[5] Information provided by CNRR in February 2025.
[6] ibid.
[7] Information provided by CNRR and JRS Romania representatives in Galati in February 2025.
[8] Information provided by CNRR in February 2025.
[9] CNRR, Input by civil society organisations to the Asylum Report 2024, 2023, available here. Information provided by CNRR also in February 2025.
[10] ibid.
[11] Information provided by CNRR in February 2025. Also ICAR Foundation in Galati provided medical services, according to JRS Romania representatives in Galati.
[12] Information provided by JRS Romania (Galati) in February 2025.
[13] Article 17(1)(n) Asylum Act.
[14] Information provided by CNRR in February 2025.