Author
Asylum seekers are entitled to emergency healthcare during the asylum procedure. Emergency healthcare covers situations involving a threat to life or a serious deterioration of the applicant’s health condition. In certain individual cases, healthcare beyond emergency treatment may also be provided where justified by the applicant’s medical condition. The necessity of such treatment is assessed by the physician working in the reception facility or by a medical specialist. Asylum seekers’ health insurance contributions are not paid by the State.[1]
Asylum seekers do not have the right to freely choose their doctor or healthcare provider.[2] Primary healthcare is provided through medical staff operating within the asylum reception system, including doctors and nurses working in reception facilities. Where specialised medical treatment is required, the healthcare personnel of the facility arrange appointments with external specialists.
Applicants residing outside reception facilities remain entitled to the same scope of healthcare. However, they are generally required to travel to the designated reception facility in order to access medical services and referrals. Entitlement to healthcare is documented through a certificate issued by the MO, commonly referred to as the “yellow card”, which asylum seekers are required to carry and protect against loss or damage.
Unlike asylum seekers, persons held in immigration detention are covered by health insurance contributions paid by the State. Asylum seekers accommodated in immigration detention facilities also have access to healthcare services. A nurse is available in the facility, while a physician visits on a regular basis. Where specialised medical examinations or treatment are required, applicants are transported to external healthcare providers under police escort.
Specialised treatment for asylum seekers with mental health problems, including survivors of torture, trafficking in human beings, gender-based violence or other forms of serious psychological and physical violence, is not regulated through a dedicated specialised reception framework. While Slovak legislation requires the authorities to take into account the special needs of vulnerable applicants and to provide appropriate reception conditions following an individual assessment, it does not establish a specific system of specialised rehabilitation or treatment services for these categories of applicants.
In practice, asylum seekers may be referred to psychologists, psychiatrists or other medical specialists where such needs are identified. However, specialised programmes specifically designed for torture survivors, victims of trafficking or gender-based violence are not generally available within the reception system. Access to mental health support therefore depends largely on the availability of local healthcare providers and, in some cases, on support provided by non-governmental organisations operating in reception facilities.
Similarly, there is no specific framework guaranteeing gender-sensitive healthcare services for vulnerable asylum seekers. Female applicants may access gynaecological care, prenatal healthcare and paediatric services through the general healthcare system where required. However, asylum seekers do not have the right to choose their healthcare provider and cannot generally request treatment by a medical professional of a particular gender. Access to psychosocial support is available only to a limited extent and depends on local capacities and available services.
Practical barriers include the absence of interpretation during medical examinations, which may significantly affect communication between patients and healthcare providers. Language barriers therefore remain one of the most important obstacles to effective healthcare access. Additional challenges may arise from limited availability of specialised services, geographical distance to healthcare providers and the dependency of asylum seekers on the reception system for arranging medical appointments and referrals.
[1] Article 11(7) of the Health Insurance Act.
[2] Article 11(6) of the Act on Healthcare.