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According to the Hungarian Health Act,[1] beneficiaries of international protection fall under the same category as Hungarian nationals. However, for the first 6 months after granting of status, they are entitled to health services under the same conditions as asylum seekers. Therefore, the asylum authority funds the health care expenses of the beneficiaries for 6 months, if they are in need and cannot establish other health insurance format. However, as per the Menedék Association’s experience, in practice this is not always accepted by the health care service providers. Menedék Association points out that the fact that beneficiaries of international protection cannot obtain their social security cards within 6 months after receiving their statuses still posed a difficulty in accessing health care services as providers were not aware of the relating legislation and of the fact that these beneficiaries are entitled to be provided.[2] The Evangelical Lutheran Church (Diakonia) also reported of such difficulties occurring in 2023.[3]
Since 2018 the card (unlike earlier) is delivered by post which makes it longer than receiving it in person and thus extends the duration of the procedure and delays the start of the employment. As per the Evangelical Lutheran Church, since the issuance of the health insurance card lasts so long, it is not requested immediately upon the granting of the status in Vámosszabadi, but only after the person establishes their domicile out of the reception facility. The possibility to obtain the health insurance card is further hindered by the difficulties arising with regard to the issuance of the identification and address card (see section above on Residence permit), as without those the application for the health insurance card cannot be initiated. The Evangelical Lutheran Church is aware of one person with international protection who requested a health insurance card in June 2020, three months after the recognition of his status, and finally received his card only in November 2021.
The recent amendments of the Social Insurance Act have unfavourable effects on beneficiaries of international protection who left the country and were later returned by another EU Member State. According to the Evangelical Lutheran Church, the health insurance eligibility of these people is terminated upon their departure. Consequently, if they are returned with poor health conditions necessitating immediate medical intervention, the costs of that are later billed to the patient. For instance, in 2020, even though a returned person with subsidiary protection managed to arrange his health insurance in December, the system officially still denied him access to health care services. Thanks to the generosity of the health care staff, he was provided with the necessary chemotherapy treatment. The Evangelical Lutheran Church is aware of a person whose subsidiary protection status had been withdrawn by the time they returned to Hungary in a very poor health condition in 2021. They were granted a temporary residence permit, thereby they were not eligible for health care services. The Evangelical Lutheran Church also reported for 2021 that the tax authority mailed a check about the debt stemming from the non-payment of health insurance contribution to several beneficiaries who had meanwhile left the country. The Evangelical Lutheran Church submitted no such reports concerning 2022.
In practice, similarly to asylum seekers (see Health Care), beneficiaries of international protection face significant barriers regarding access to health care. Barriers mainly stem from language difficulties, i.e. the lack of interpreters or the lack of basic English spoken by the doctor. NGOs’ assistance is the only available solution for that. The obstacles, furthermore, might stem from administrative difficulties or simply from lack of awareness of the law.[4] According to research from 2017, based on interviews carried out with 18 refugees and 4 social workers, refugees generally feel marginalised regarding the healthcare system.[5] The research highlights the importance of social workers and volunteers who ‘act as links between health care system and refugees’ helping with interpretation and as an information point for the health care institute’s personnel.. The overburdening of the Hungarian health care system due to the COVID-19 pandemic resulted in general that access got more burdensome. This certainly posed further obstacles for the already disadvantageous social groups such as beneficiaries of international protection.
According to the Evangelical Lutheran Church and the Menedék Association, health care for people living in one of the homeless shelters of the Baptist Integration Centre was arbitrarily denied by the competent practitioner in 2020. As a consequence, a refugee resident was not provided health care despite of having serious symptoms. Due to his sickness, he could not work which led to the loss of his job. Meanwhile, lacking the medical proof of being sick he could not benefit from the state aid either. The Baptist Integration Centre reported a similar incident from 2021: a homeless person tried to validate his health insurance before the competent authority but his request was rejected by the case officer and was told to go to work.
Menedék Association furthermore reports that the provision of health care to unaccompanied minors accommodated in the Fót children reception facility was still problematic in 2022 and 2023. These minors, should they be asylum-seekers, become entitled to health- are provision if they submit their statement of intent declaration at the Hungarian embassies of Kyiv or Belgrade and are accepted as asylum-seekers later on. Although Article 22 of Act CXXII of 2019 on social security asserts that children accommodated temporarily by the state become immediately entitled to health care provision, health care facilities do not know of this legal provision and thereby refuse to treat the minors accordingly, unless the competent child protection authority undertakes to reimburse the costs.[6]
The Cordelia Foundation is the only organisation that specifically focuses on bio-psycho-social support provision among people with international status (see above under Reception Conditions). Next Step reported in 2021 that people with international protection status and other vulnerable migrants with traumatic experiences might have more significant difficulties concentrating on and fully committing to long-term and more complex courses organised by the NGO. Therefore, Next Step offered mental health assistance to its community members throughout 2022 too.[7] No similar activity was reported for 2023.
There was no beneficiary of international protection residing in reception facilities infected by the SARS-CoV-2 virus in 2021.[8] At the outset of the vaccination campaign,[9] Hungarian citizens (above the age of 18) in the possession of a valid health insurance card were eligible for the vaccine. Since beneficiaries of international protection fall under the same category as Hungarian nationals regarding health care provisions (as indicated above), the priority order applied to them in the same manner as to Hungarian citizens. It can be note, however, that the website for the registration to get vaccinated was initially only available in Hungarian and only later was it translated to English.[10]
In 2021, the vaccine was made available for everyone, without a priority order and also for persons without a health insurance. Nevertheless, information provision from the Government’s side was poor, therefore many beneficiaries of international protection were not aware of the changes and of their eligibility for the vaccine. Among others, the Lutheran Church and the Menedék Association helped to transmit the official information to refugees and assisted them with interpretation, registration for a vaccination appointment and the delivery of the vaccination certificate. Menedék Association reports that the lack of information on beneficiaries’ eligibility to the vaccine was still a prevalent issue in 2022.[11] Regarding 2023, Menedék Association did not re-iterate this finding.
[1] Section 3(s) Act CLIV of 1997 on Health Care.
[2] Information received from Menedék Association by the HHC on 28 February 2023.
[3] Information received from the Evangelical Lutheran Diakonia by the HHC on 24 February 2024.
[4] Practice-informed observation by the HHC, January 2024.
[5] Mangeni Akileo, Marginalization of refugees and asylum seekers in the healthcare system: A Hungarian case study, Central European University, 2017.
[6] Information received from the Menedék Association by the HHC on 28 February 2023 and 1 February 2024.
[7] Information received from Next Step Hungary Association by the HHC on 6 February 2023.
[8] Information provided by the NDGAP on 7 February 2022.
[9] Available only in Hungarian: https://bit.ly/3n8Dsi4.
[10] See: https://bit.ly/3JWoVjl.
[11] Information received from the Menedék Association by the HHC on 28 February 2023.