Author
Access to health care for beneficiaries of international protection is guaranteed in national legislation and is not limited to urgent medical health care. Legal provision regulating the health care for beneficiaries of international protection is set mainly in the:
- Act No. 580/2004 Coll. on Health Insurance and on Amendments and Supplements to Act No. 95/2002 Coll. on Insurance and on Amendments and Supplements to Certain Acts (Health Insurance Act),
- the Act No. 577/2004 Coll. on the Scope of Healthcare Covered by Public Health Insurance and on the Reimbursement of Healthcare-related Services (Act No. 577/2004 Coll.), and
- Act No. 576/2004 Coll. on Healthcare, Services Related to the Provision of Healthcare, and on Amendments and Supplements to Certain Acts (Act No. 576/2006 Coll.).
Asylum holders are subject to mandatory public health insurance in Slovakia.[1] They are required to register with a public health insurance company within eight days of granting of asylum. The application must be accompanied by the decision granting asylum.[2] Asylum holders may choose any of the three public health insurance companies operating in Slovakia (Union, Dôvera, or Všeobecná zdravotná poisťovňa). An asylum holder is issued a health insurance card and is required to present his or her insurance card when receiving healthcare services. The scope of healthcare services covered by public health insurance for an asylum holder is equal to that of a national. During the first six calendar months following the granting of asylum, the State pays the health insurance contributions on their behalf.[3] After this initial six-month period, asylum holders are required to pay health insurance contributions themselves, unless they fall within another category of persons whose contributions are covered by the State. In 2025, the minimum monthly advance payment for public health insurance amounted to €107.25.
Beneficiaries of subsidiary protection are not subject to mandatory public health insurance and are therefore not insured persons within the public health insurance system. However, they are entitled to reimbursement of health care costs by the State.[4] Health care is provided within the same scope as care covered under public health insurance, and the costs are reimbursed by the State through the public health insurance company with the largest number of insured persons (currently Všeobecná zdravotná poisťovňa). A subsidiary protection holder is issued a so-called entitlement certificate (nárokový preukaz) and is required to present his or her entitlement certificate when receiving healthcare services.
Following the major COVID-19 vaccine crisis, PCR tests are available for purchase in pharmacies. Vaccination against COVID-19 is covered not only for persons with public health insurance[5] (including asylum holders), but also for certain categories of uninsured individuals.[6] This includes, inter alia, holders of subsidiary protection. The MoH may also designate additional categories of foreigners eligible for coverage. The costs of vaccination for these persons are reimbursed by the health insurance company with the largest number of insured persons in Slovakia.
The main challenges faced by the beneficiaries of international protection when accessing the health care are a language barrier, a lack of medical stuff, especially specialists in psychiatry and child psychiatry, long waiting times for examinations, poor awareness of health care providers about the ways in which medical procedures administered to holders of subsidiary protection are reimbursed and on the level of coverage for the administered procedures and the related lower level of willingness to treat them. Additionally, access to specialised health care is subject to the standard referral system, which requires a prior examination by a general practitioner and subsequent appointment with a specialist.
[1] Article 3(3)(c) of the Health Insurance Act.
[2] Article 8(5) of the Health Insurance Act.
[3] Article 11(7)(q) of the Health Insurance Act.
[4] Article 9h(1)(a) of the Health Insurance Act.
[5] Article 29ba(1) of the Health Insurance Act.
[6] Article 29ba(1) of the Health Insurance Act.