The initial medical examination of asylum seekers after their initial admission to a reception centre (EAST or VQ) is usually conducted within 24 hours. A general examination is conducted through a physical examination including vital signs, skin lesion, injuries, including Tuberculosis (TBC) X-ray and questions on their state of health by means of a standardised medical history. If, within the scope of the medical examination, circumstances indicate that further investigations are required, asylum seekers are transferred to specialist doctors or a hospital.
Every asylum seeker who receives Basic Care has health insurance. Treatment that is not covered by health insurance may be paid, upon request, by the federal provinces’ departments for Basic Care or the Ministry of Interior. If Basic Care is withdrawn, asylum seekers are still entitled to emergency care and essential treatment.
In practice, this provision is not always easy to apply, however. If an asylum seeker has lost basic care due to violent behaviour or absence from the EAST for more than three days, he or he will not receive medical assistance, because it is assumed that they have had the opportunity to visit the medical station in the EAST. However, as those asylum seekers are no longer registered in the EAST, they will not be allowed to enter and receive medical treatment there. Without health insurance or access to the medical station of the EAST, asylum seekers may face severe difficulties in receiving necessary medical treatment. Some of them come to the NGO-run health project AMBER MED with doctors providing treatment on a voluntary basis.
In some federal provinces such as Vienna, asylum seekers receive an insurance card in the same way as other insured persons and can thus access health care with their insurance contracts without complications. In all other provinces, asylum seekers do not receive an ecard, instead of the ecard they receive a replacement document (c-card Ersatzbeleg), except Tyrol where people in basic care have their insurance number written on the back side of their white ID card, which is working well when going to a doctor’s office. Caritas Salzburg reports that it is also working without replacement document, and doctor’s appointments could also be made this way because of the plug-in card system, it is only necessary to tell the insurance number..
After the asylum seeker has submitted the asylum application, he or she must undergo a mandatory medical examination, including a tuberculosis examination. The Ministry of the Interior has commissioned the BBU GmbH to carry out the medical examination, which is part of the admission procedure. The company has contracts with general practitioners and nurses to provide health care in the federal reception centres.
Asylum seekers are obliged to submit medical findings and expert opinions, if those help to assess the presence of a mental disorder or other special needs (§ 2 Abs. 1 GVG-B).
Since September 2018, hospitals have the obligation to inform the BFA of the upcoming release of a foreigner against whom a deportation procedure is pending. This is not mandatory but happens upon requests of the BFA. However, once such a request has been issued, hospitals are obliged to keep the BFA updated of relevant developments (e.g. if there a change in the release date for example). The police may further also be informed on the matter by the BFA upon explicit request. 
The Austrian Integration Fonds (Integrationsfonds) took some time before providing information on the Covid-19-pandemic to refugees and asylum seekers. In April 2020, the Integrationsfonds sent short messages via mobile phones to inform refugees and asylum seekers about the Corona pandemic and the legal situation. Critics were raised as the information was at times incorrect and incomplete; e.g. he Integrationsfonds did not inform the concerned persons about their right to go for a walk during the lockdown. It took the Integrationsfonds up until January 2021 to establish Online Counselling for persons with low German skills. Through this counselling service, the Integrationsfonds aims to inform interested persons about the possibility to get tested and/or vaccinated. In the Austrian vaccination strategy, asylum seekers accommodated in larger facilities are categorised as Priority group number 3 together with person over 70 years old.
In Vienna, in 2021, there were regular translations about information related to COVID, but it still took some time for this to work in a timely manner. The possibility to call and ask questions into the national language was also provided by the Magistrate’s department 17 on integration and diversity. Despite these efforts, the written information material about COVID-19 regulations and access to vaccination was not sufficient to reach all people in basic care, which is partly due to the fact that not all people are literate or that written translations were not available in all relevant first languages. There is also the possibility that infected persons are brought into quarantine quarters, as well as regular screenings (once or twice per month) in the facilities themselves, especially if there are positive cases in a facility. In Vienna there is ‘Alles Gurgelt’- PCR tests that can be done independently at home, where asylum seekers also have access. In Burgenland, for example, NGOs would like to see more COVID-19 screenings in the facilities, not only on an occasion-related basis.
In all federal states there were vaccination campaigns for asylum seekers and refugees with extra appointments or extra vaccination routes in the facilities themselves, which started in April 2021 until June 2021. However, there were limited information sessions before the vaccination appointments. In certain communities there is a high level of vaccination skepticism (e.g. Chechnya) and there is a lot of fake news circulating on the internet. Due to the low resources in basic care facilities, the staff cannot adequately respond to all questions about COVID-19 or vaccination, and furthermore, it is mainly medical staff that is required for providing such information, not social workers.
One concern that has been raised by NGOs is the compulsory vaccination that will be introduced in Austria in 2022 and to what extent this will be sanctioned by police. Some NGOs would like vaccinations to take place in the initial reception centres and only be assigned once two partial vaccinations have been carried out.
In each federal province, one NGO part of the Network for Intercultural Psychotherapy and Extreme Trauma provides treatment to victims of torture and traumatised asylum seekers. This is partly covered by AMIF funding, partly by the Ministry of Interior and regional medical insurance. However, the capacity of these services is not sufficient. Victims often have to wait for more than 6 months in Vienna, Styria and Tyriol for psychotherapy, while in other federal states they wait approximately 3 months.
The Basic Care system – and thus the health care provided – varies from one federal province to another and is regulated in many different laws on state level. In some federal provinces, asylum seekers will be provided care in regular special care facilities (see Special Reception Needs). “Increased care” for special needs must however be requested by the asylum seeker. A prerequisite for receiving additional care is the submission of up-to-date specialist medical findings and assessments demonstrating a need for care, as well as social reports not older than 3 months. These requirements contribute to the asylum seeker’s obligation to cooperate throughout the procedure. Reports from NGOs are also taken into account when examining the additional need for care.
 Article 2(4) GVG-B.
 asylkoordination österreich, Nationwide NGO survey on basic services, Dec 21/Jan 22, unpublished
 Article 15 (1)3 Asylum Law.
 § 46 (7) Aliens police Law 2005.
 Integrationsfonds, “Informationen zu Impfungen und Testungen: mehrmals täglich COVID-19-Onlineberatungen für Migrant/innen und Flüchtlinge”, 14 January 2021, available in German at: https://bit.ly/3ttXRii.
 asylkoordination österreich, Nationwide NGO survey on basic services Dec 21/Jan 22, unpublished.