According to the Hungarian Health Act, beneficiaries of international protection fall under the same category as Hungarian nationals. Although for 6 months (before June 2016, this period was 1 year) after refugees and persons with subsidiary protection are granted 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 Menedék Association’s experience, in practice this is not accepted by the health care service provider, therefore the asylum authority in the reception centres files the request for the health insurance card on the basis of destitution. However, this takes quite a long time. Since 2018 the card (unlike earlier) is delivered by post which makes it even longer than receiving it in person 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 too long, it is not even requested immediately upon the granting of the status in Vámosszabadi but only after the person establishes a domicile out of the reception facility. Furthermore, the recent amendments of the Social Insurance Act has unfavourable effect on those beneficiaries of international protection who left the country and later on they are returned by another EU Member State. According to the 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 on billed to the patient.
In practice, similarly to asylum seekers, 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 to that. The obstacles furthermore, might be due to administrative difficulties or simply to the lack of law awareness. According to a research from 2017, which is based on interviews carried out with 18 refugees and 4 social workers, refugees generally feel marginalised regarding the healthcare system. 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.
Not only adult refugees but also unaccompanied children who were granted international protection face the same difficulties explained above. In case of children, Menedék Association has witnessed an incident in 2017 when the hospital raised serious doubts about the child’s age and attempted to get rid of the responsibility to treat the patient even though the children’s age had been established by a forensic medical examiner in the asylum procedure.
As to the issuance of health insurance card besides the cited research, SOS Children’s Villages noted in 2018 that it is extremely problematic since it takes long time until the beneficiary of international protection is provided with the card. As per the Evangelical Lutheran Church, there was a case in 2018 that a person with subsidiary protection requested to be registered as homeless and to be issued with a health insurance card but was not been provided with that up to more than a year. On the other hand, the experiences of the Baptist Aid showed the opposite so that beneficiaries were usually within one week provided with the health insurance card. However, they noted that it took longer if firstly the health insurance status of the person had to be clarified.
Section 3(s) Act CLIV of 1997 on Health Care.
Mangeni Akileo, Marginalization of refugees and asylum seekers in the healthcare system: A Hungarian case study, Central European University, 2017.