During the asylum process and until the asylum seeker leaves Sweden or is granted a residence permit, he or she is entitled to a free medical examination, emergency health care and urgent medical or dental care that cannot be “postponed” (“vård som inte kan anstå”). They are also entitled to gynaecological and prenatal care, including health care on the occasion of childbirth, as well as health care in accordance with the Swedish Communicable Diseases Act (smittskyddslagen).[1]
Children and teenage asylum seekers under the age of 18 are entitled to the same health care as all other children living in the county council area where they are seeking treatment.[2]
County councils are the authorities that are responsible for primary health care centres (vårdcentralen), hospitals and the National Dental Service (Folktandvården).
Should there be a need for health care beyond the free medical examination, mentioned above, patient fees (co-ays) may differ depending on the county council, region and type of care involved. But in general asylum seekers pay 50 SEK (€4.60) to see a doctor at the district health centre or to receive medical care after obtaining a referral. Other medical care, such as with a nurse or physical therapist, costs 25 SEK (€2.30) per visit. Medical transportation costs 40 SEK (€3,70). Gynaecological and prenatal care, including health care on the occasion of childbirth, as well as health care in accordance with the Swedish Communicable Diseases Act is free of charge. The fee for emergency care at a hospital varies from county to county. Asylum seekers pay no more than 50 SEK (€4.60) for prescription drugs. Children are in most cases entitled to health care free of charge until they turn 18 years old. Dental care is free of charge for children until they turn 23 years old. However, there may be a patient fee (co-ays) for emergency care for children in some of the regions. [3]
If an asylum seeker pays more than 400 SEK (€37.00) for visits to a doctor, medical transportation and prescription drugs within 6 months, they can apply for a special allowance. The Migration Agency can compensate for costs over 400 SEK. The “400 SEK rule” applies individually for adults and common for siblings under 18. The cost of emergency medical or dental care is not covered. .[4]
However, adults without children can be left without shelter and money if they refuse to leave Sweden voluntarily within 4 weeks of an expulsion order gaining legal force. Persons in that situation are entitled to the health care mentioned above, but the Migration Agency does not provide any financial assistance for health care or medicine.
A study conducted by the Swedish Red Cross revealed that although persons who stay in Sweden beyond 4 weeks after the date when their expulsion order gained legal force are entitled to (some) health care, there may be a number of practical obstacles on an individual basis. These might include the fear of authorities and a lack of knowledge about the duty of confidentiality these persons may have. The study also highlights the lack of knowledge on the part of healthcare staff about the laws on this matter as an obstacle for these persons to actually get the health care they are entitled to.[5]
A study conducted by the Karolinska Institute revealed that the suicide rate among asylum-seeking young people reached 51.2 out of 100,000 persons; while for the general population (but the same group of age) the suicide rate was as low as 5.2 out of 100,000 persons. The study further documented 43 suicides by 2017, an issue that persisted up until 2020 as six suicides and three suicide attempts were recorded during that year.[6] In another study from 2020, the Red Cross University College and the Swedish Public Health Agency looked at the prevalence of post-traumatic stress among young newcomers living at the municipalities between 2014-2018. The results indicated that 56% of asylum-seeking young people from Afghanistan suffered from post-traumatic stress.
As regards access to health care in 2021, it should be noted that medical assistance in the context of Covid-19 is considered as urgent care, meaning that asylum seekers and undocumented migrants have access to it. Covid-19 vaccines have been and will continue to be offered for free to everyone in Sweden, including asylum seekers and undocumented migrants.
[1] Section 6 of Law (2008:344) on health care for asylum seekers etc. (lag (2008:344) om hälso- och sjukvård åt asylsökande m.fl.) section 7 of Law (2013: 407) on health care for certain foreigners staying in Sweden without the necessary permits (Lag (2013:407) om hälso- och sjukvård till vissa utlänningar som vistas i Sverige utan nödvändiga tillstånd), chapter 7, section 3 of The Communicable Diseases Act (2004:168) (Smittskyddslagen (2004:168))
[2] 1177 Vårdguiden, ‘Healthcare in Sweden for asylum-seekers, people with no papers and people in hiding’, available at: http://bit.ly/2GoMC3k.
[3] Ibid
[4] Migration Agency, ‘Fees for medical care’, available at: https://bit.ly/37Y350F.
[5] Swedish Red Cross, Nedslag i verkligheten – tillgång till vård för papperslösa, 2018, available at: https://bit.ly/3Px1nnE.
[6] EvaMärta Granqvist och Joel Larsson. Find a humane solution for Sweden’s unaccompanied young people – now!, October 2020, available at: https://bit.ly/3ugPWpB.