Author
Beneficiaries of international protection have the right to benefit from health insurance under the conditions provided by the law for the Romanian citizens.[1] Persons suffering from mental health problems, including torture survivors and traumatised persons also have access to treatment in the same conditions as Romanian nationals.
Challenges in practice include lack of awareness of how the National Health Insurance House (Casa Națională de Asigurări de Sănatate, CNAS) works and what it entails. Therefore, NGOs play a key role in assisting beneficiaries of international protection to overcome all the practical obstacles, which would be insurmountable without this type of support.
Although Romanian law grants refugees the same access to healthcare as Romanian citizens, in practice, they often face significant barriers that prevent them from effectively accessing medical services.
Challenges faced by beneficiaries of international protection in the healthcare system[2]
Limited understanding and financial barriers:
- Many beneficiaries struggle to understand how the health insurance system works;
- Lack of financial resources to pay for social health insurance;
- Even if insured, certain treatments and investigations are not covered and must be paid for by beneficiaries.
Bureaucratic and administrative challenges:
- Complex and lengthy procedure to obtain health insurance, register with CNAS, find a family doctor, and get specialist appointments;
- More complicated for unemployed refugees who must pay for their own insurance.
Limited access to healthcare providers:
- High waiting times for certain medical investigations;
- In big cities, family doctors often lack available slots or refuse refugee patients due to language barriers.
Language and cultural barriers:
- Most healthcare staff do not speak foreign languages, and hospitals/clinics do not provide interpreters;
- Difficulty navigating the healthcare system due to language barriers;
- CNRR provides support with interpretation services, medical accompaniment, assistance with forms, and communication with doctors.
Mental health challenges:
- Mental health is often overlooked for both refugees and host communities;
- There is a need for psycho-social support (PSS), psychological first aid (PFA), and trauma management, but Romanian healthcare and NGOs are not well-prepared.
According to CNRR, in practice, access to health care, particularly within the public healthcare system, remained difficult for beneficiaries of international protection in 2025. Although they are formally entitled to equal access to healthcare, persons granted international protection are not automatically insured after receiving status. During the first year of integration, beneficiaries may theoretically receive a monthly allowance of approximately EUR 150, intended to support their basic needs while learning Romanian and seeking employment. However, in order to access health services, they are required to pay contributions to the National Health Insurance House, which represents a significant financial burden for many of them. In addition, the procedure for obtaining health insurance is described as complex and cumbersome, requiring visits to several authorities before the final document proving insurance status can be obtained.[3]
CNRR noted that this situation worsened following legislative changes that entered into force on 1 August 2025 and removed the category of “co-insured person”. As a result, some beneficiaries of international protection who had previously been insured through an employed family member, including stay-at-home mothers insured through their husbands, are now required to pay health insurance contributions themselves.[4]
One of the main challenges remains the language barrier. The public healthcare system still does not provide interpreters within medical institutions, which makes even basic steps, such as scheduling consultations or medical procedures, extremely difficult. Communication problems also affect access to clear information on the costs of treatment and available services. In the absence of interpretation support, many beneficiaries rely on relatives or friends to communicate with doctors, despite the fact that these persons do not have professional medical interpretation training.[5]
CNRR further highlighted difficulties in accessing appropriate care for beneficiaries with highly specific medical conditions. In particular, women affected by female genital mutilation face serious obstacles in the public healthcare system, as medical personnel generally lack the specialised training and experience necessary to manage such cases, especially the most severe forms. CNRR referred to one case in which a patient in need of surgical intervention was assisted by a team of doctors from a private clinic who agreed to perform the operation pro bono. The medical team reportedly coordinated with specialised counterparts in other EU countries in order to prepare the intervention adequately. In that case, CNRR provided interpretation support between the patient and the medical staff.[6]
According to JRS Romania’s representatives in Galati, in 2024 most beneficiaries of international protection did not have health insurance. However, according to the Law,[7] certain groups are exempt from paying social health insurance contributions, including minors, young people up to 26 years old who are students or from the child protection system, dependents without their own income, persons with disabilities, patients under national health programs, and pregnant or lactating women, etc. Those who are unemployed and do not qualify for these exemptions can access emergency medical assistance at hospital Emergency Reception Units, while some medical costs, medications, psychological assistance, and health insurance may be subsidized through the integration programs run by NGOS, depending on funding. For insured beneficiaries, such as minors or those receiving minimum inclusion income, JRS has facilitated their registration with family doctors, assisting with language barriers by preparing written descriptions of symptoms. In cases requiring emergency unit visits, JRS has provided telephone mediation, and cultural mediators (Arabic and Ukrainian) are available to support communication. Non-urgent but acute medical issues occurring outside regular consultation hours are referred to Permanence Centers, which provide free primary healthcare in Galați between 3:00 PM and 8:00 AM on weekdays and operate 24 hours on weekends and public holidays. These centres offer medical assistance for acute conditions, referrals to specialists, emergency treatment administration, and the issuance of medical letters.[8]
As of 1 August 2025, co-insured persons (such as spouses or parents without income) are no longer entitled to free health insurance through an employed family member. This change has increased medical vulnerability among many families of beneficiaries of international protection, particularly in cases where only one spouse is employed. [9]
Furthermore, starting from 1 January 2026, patients enrolled in national health programmes are insured only for the specific condition covered by the respective programme (e.g. oncology or diabetes). For other conditions, including complications related to the primary illness, they are not covered. This has led to a decline in the quality of access to healthcare services and an increase in untreated serious medical conditions due to financial constraints among beneficiaries of international protection. [10]
Despite the legal provisions ensuring equal access to healthcare for beneficiaries of international protection, practical challenges such as bureaucratic hurdles, language barriers, and limited awareness of the healthcare system continue to hinder their ability to receive proper medical care. The role of NGOs in bridging these gaps is crucial, as they provide essential support in navigating the system, accessing medical services, and overcoming cultural and linguistic barriers.
Moving forward, a more coordinated approach involving authorities, healthcare institutions, and civil society is necessary to ensure that refugees and other vulnerable groups can fully exercise their right to healthcare. Strengthening integration programs, improving access to interpreters, and enhancing mental health support are key steps toward a more inclusive and efficient healthcare system. By addressing these challenges, Romania can foster a healthcare environment that is not only legally inclusive but also practically accessible to all.
In 2025, according to the Center for Comparative Migration Studies (CCMS), an increasing discrepancy was identified between the legal framework and its implementation in practice, particularly in the area of access to healthcare, alongside persistent structural discrimination in this field.[11]
[1] ibid.
[2] Information provided by IOM in February 2022 and by CNRR in February 2025.
[3] Information provided by CNRR, 03 February 2026.
[4] ibid.
[5] ibid.
[6] ibid.. Problem observed in a similar case in 2025 by JRS Romania in Galati.
[7] Article 224 Law 95/2006.
[8] Information provided by JRS Romania, January 2025.
[9] Information provided by JRS Romania, March 2026.
[10] ibid.
[11] Information provided by CCMS, April 2026.