30
May
2016

Healthcare entitlements of migrants in an irregular situation in the EU-28

This table reviews the entitlements of migrants in an irregular situation to access healthcare across the EU. The following definitions of emergency, primary and secondary healthcare apply.
  • Emergency care includes life-saving measures as well as medical treatment necessary to prevent serious damage to a person’s health.
  • Primary care includes essential treatment of relatively common minor illnesses provided on an outpatient or community basis (e.g. services by general practitioners).
  • Secondary care comprises medical treatment provided by specialists and, in part, inpatient care.
Healthcare entitlements of migrants in an irregular situation in the 28 EU Member States
EU
Member
State		 Emergency
healthcare*
(for free/
against payment)		 Primary
healthcare
(provided/
not provided;
for free/
against payment)		 Secondary
healthcare
(for free/
against payment)		 Legal references
AT Yes, against payment Yes, against payment Yes, against payment Law on Doctors (Ärztegesetz 1998), BGBl. I. Nr. 169/1998 last amended by BGBl. I. Nr. 56/2015; Austria, Hospital Act (Bundesgesetz über Krankenanstalten und Kuranstalten, KaKuG), BGBl Nr. 27/1958 last amended by BGBl I Nr. 32/2014; Austria, General Social Insurance Act (Allgemeines Sozialversicherungsgesetz, ASVG), BGBl Nr. 189/1955 last amended by BGBl I Nr. 118/2015.
BE Yes, for free Yes, for free Yes, for free Law regarding the Public Centres for Social Welfare (Loi organique des centres publics d’action sociale/Organieke wet betreffende de openbare centra voor maatschappelijk welzijn), 8 July 1976; Belgium, Royal Decree on urgent medical aid provided by public social welfare centres to foreigners staying illegally in the Kingdom (Arrêté royal relatif à l’aide médicale urgente octroyée par les centres publics d’aide sociale aux étrangers qui séjournent illégalement dans le Royaume/Koninklijk besluit betreffende de dringende medische hulp die door de openbare centra voor maatschappelijk welzijn wordt verstrekt aan de vreemdelingen die onwettig in het Rijk verblijven), 12 December 1996, Art. 57, para. 2; Belgium, Chancery of the Prime Minister (Chancellerie du Premier Ministre/Kanselarij van de Eerste Minister), Accord de Gouvernement/Regeerakkoord, 9 October 2014.
BG Yes, for free, but only in centres for emergency medical care Yes, against payment Yes, against payment Regulation No. 25 of 4 November 1999 on Emergency Medical Assistance (Наредба № 25 от 4 ноември 1999 г. за оказване на спешна медицинска помощ), 4 November 1999, Art. 3 ; Bulgaria, Health Act (Закон за здравето), 10 August 2004, Art. 85; Bulgaria, Regulation No. 2 of 1 July 2005 on the terms and procedure of rendering medical assistance to foreigners who do not enjoy the rights of Bulgarian citizens (Наредба № 2 от 1 юли 2005 г. за условията и реда за оказване на медицинска помощ на чужденците, които не се ползват с правата на българските граждани), 1 July 2005, Art. 22; Bulgaria, Regulation No. 40 of 24 November 2004 setting up the basic package of healthcare services guaranteed by the budget of the National Health Insurance Fund budget (Наредба № 40 от 24.11.2004 г. за определяне на основния пакет от здравни дейности, гарантиран от бюджета на НЗОК), 1 January 2005.
CY Yes, against payment, but low fee Yes, against payment, but with exceptions Yes, against payment The state medical institutions and services general (Amending) Regulations of 2013 [Οι περί κυβερνητικών ιατρικών ιδρυμάτων και υπηρεσιών Γενικοί (Τροποποιητικοί) Κανονισμοί του 2013], No. 4666, 30 April 2013, Art. 8; Cyprus, General regulations on state medical institutions and services (Οι περί κυβερνητικών ιατρικών ιδρυμάτων και υπηρεσιών Γενικοί Κανονισμοί), Ref. 225/2000, 660/2002, 455/2004, 364/2005 and 629/2007, Art. 8(1).
CZ Yes, against payment Yes, against payment Yes, against payment Health Services and Conditions of Their Provision Act (Zákon o zdravotních službách a podmínkách jejich poskytování), 6 November 2011, Act No. 372/2011; Czech Republic, Residence of Foreign Nationals in the Czech Republic Act (Zákon o pobytu cizinců v České republice), 30 November 1999, Act No. 326/1999 paras 180i and 180j.
DE Yes, for free Yes, against payment Yes, against payment Asylum Seeker Benefit Act (Asylbewerberleistungsgesetz), 1 November 1993, Sections 1, 4 and 6; Germany, Residence Act (Aufenthaltsgesetz), 1 January 2005, Sections 87 (2) and 88 (2). 
DK Yes, for free Yes, against payment Yes, against payment, but exceptions possible Administrative Act on Hospital Treatment, administrative act no. 958 of 28 August 2014 as amended by administrative act no. 570 of 29 April 2015 (Bekendtgørelse om ret til sygehusbehandling m.v.);  Denmark, Danish Aliens Act, Consolidated act No. 1021 of 19 September 2014 (Lovbekendtgørelse Udlændingelov); Denmark, Health Act, Consolidated act no. 1202 of 14 November 2014 (Bekendtgørelse af sundhedsloven).
EE Yes, for free Yes, against payment Yes, against payment Emergency, primary and secondary healthcare: Health Services Organisation Act (Tervishoiuteenuste korraldamiseseadus), 9 May 2001; Estonia, Regulation of the Minister of Social Affairs (Sotsiaalministri määrus), The Arrangements and Scope of the Health Check Procedures and the Provided Health Services for Asylum Seekers and Deportees (unofficial translation) (Varjupaigataotleja ja väljasaadetava tervisekontrolli ja neile osutatavate tervishoiuteenuste riigieelarvest rahastamise ulatus ja kord), 6 December 2013; Estonia, Regulation of the Minister of Internal Affairs (Siseministri määrus), Internal rules of the Detention Centre (unofficial translation) (Kinnipidamiskeskuse sisekorraeeskiri), 16 October 2014.
EL Yes, unclear in law whether for free Yes, against payment Yes, against payment Law 4251/2014, Immigration and Social Integration Code and other provisions (Government Gaz 80A, 1 April 2014), Article 26(2)(a).
ES Yes, for free Yes, against payment Yes, against payment Spain, Royal Decree 16/2012 on urgent measures to guarantee the sustainability of the National Health System (Real Decreto Ley16/2012, medidas urgentes para garantizar la sostenibilidad del Sistema Nacional de Salud y mejorar la calidad y seguridad de sus prestaciones); Spain, Royal Decree 1192/2012 regulating the condition of the insured and the beneficiary in relation to health assistance (Real Decreto 1192/2012, de 3 de agosto, por el que se regula la condición de asegurado y de beneficiario a efectos de la asistencia sanitaria en España, con cargo a fondos públicos, a través del Sistema Nacional de Salud).
FI Yes, against payment Yes, against payment Yes, against payment Health Care Act (Terveydenhuoltolaki/Hälso- och sjukvårdslag, 1326/2010), Chapter 6, Section 50; Finland, Act on Specialised Medical Care (Erikoissairaanhoitolaki/Lagen om specialiserad sjukvård, 1062/1989), Section 3; Finland, Act on Client Fees for Social Welfare and Health Care (Laki sosiaali- ja terveydenhuollon asiakasmaksuista/Lag om klientavgifter inom social- och hälsovården, 3.8.1992/734).
FR Yes, for free Yes, for free Yes, for free AME (State Medical Aid): France, Code of social action and families (Code de l’action sociale et des familles), art. L. 251-1; France, Decree No. 2015-120 of 3 February 2015 relating to payment for healthcare by the State Medical Aid (Décret n° 2015-120 du 3 février 2015 relatif à la prise en charge des frais de santé par l’aide médicale de l’Etat).
HR Yes, against payment Yes, against payment Yes, against payment Law on Compulsory Health Insurance and Health Care for Foreigners in the Republic of Croatia (Zakon o obveznom zdravstvenom osiguranju i zdravstvenoj zaštiti stranaca u Republici Hrvatskoj) (2013), Official Gazette (Narodne novine) No. 80/13.
HU Yes, against payment Yes, against payment Yes, against payment Decree 87/2004 (X. 4.) of the Ministry of Social, Health and Family Affairs on health care of people staying in Hungary, and not having entitlements to health care services under obligatory insurance (87/2004. (X. 4.) ESzCsM rendelet a Magyar Köztársaság területén tartózkodó, egészségügyi szolgáltatásra a társadalombiztosítás keretében nem jogosult személyek egészségügyi ellátásának egyes szabályairól); Hungary Governmental Decree 114/2007 (V. 24.). Governmental decree on the implementation of the Act II of 2007 on the Admission and Right of Residence of Third-Country Nationals. (A 114/2007. (V. 24.) Korm. rendelet a harmadik országbeli állampolgárok beutazásáról és tartózkodásáról szóló 2007. évi II. törvény végrehajtásáról).
IE Yes, for free Yes, against payment Yes, against payment Health Act 1970, Sections 45(1) and 47A.
IT Yes, for free Only in some regions, for free Yes, for free Legislative Decree No. 286 of 25 July 1998, Consolidated text of provisions governing immigration and the status of aliens, Article 1, paragraph 6 and Article 35; Italy, Decree of the President of the Republic No. 394 of 31 August 1999, Regulation containing norms on the implementation of the consolidated text of provisions governing immigration and the status of aliens, Article 43; Italy, Circular of the Ministry of Health No. 5 of 24 March 2000; Italy, Agreement between the Central Government–Regional Administrations Conference and the Public Administration of 20 December 2012, Guidelines for the correct implementation by the Italian Regions and Autonomous Provinces of the legislation on healthcare for the foreign population.
LT Yes, for free Yes, against payment Yes, against payment Order of the Minister of Health on the Approval of the Order and Scope of Providing Basic Health Care and Basic Health Care Services (Sveikatos apsaugos ministro įsakymas dėl būtinosios medicinos pagalbos ir būtinosios medicinos pagalbos paslaugų teikimo tvarkos bei masto patvirtinimo) of 8 April 2004, para. 4; Lithuania, Law on Health Insurance of the Republic of Lithuania (Lietuvos Respublikos sveikatos draudimo įstatymas) of 21 May 1996 (new version of 3 December 2002), Art. 6(5); Lithuania, Order of the Minister of Health No. V-794 on Amendment to the Order of the Minister of Health No. 357 on Approval of the List of Paid Health Care Services, Determination of Prices and the Order for their Indexation, Provision and Payment of these Services (Įsakymas dėl Lietuvos Respublikos sveikatos apsaugos ministro 1999 m. liepos 30 d. įsakymo nr. 357 „dėl mokamų asmens sveikatos priežiūros paslaugų sąrašo, kainų nustatymo ir jų indeksavimo tvarkos bei šių paslaugų teikimo ir apmokėjimo tvarkos” pakeitimo) of 11 July 2014, para. 5.
LU Yes, against payment Yes, against payment Yes, against payment Informal agreement between the Ministry of Health (Ministère de la Santé) and the Ministry of Foreign and European Affairs (Ministère des Affaires étrangères et européennes).
LV Yes, against payment Yes, against payment Yes, against payment Law on the Rights of Patients (Pacientu tiesību likums), 17 December 2009; Latvia, Medical Treatment Law (Ārstniecības likums), 12 June 1997. 
MT Yes, unclear in law whether for free** Unclear in law Unclear in law  
NL Yes, for free Yes, for free Yes, for free Netherlands, Criminal Code (Wetboek van Strafrecht), Articles 255, 455, 307, 308 and 309; Netherlands, Aliens Act 2000 (Vreemdelingenwety 2000); Netherlands, Health Insurance Act (Zorgverzekeringswet).
PL Yes, for free when provided by ambulance teams*** Yes, against payment Yes, against payment Act on Healthcare Services Financed from Public Funds (Ustawa z dnia 27 sierpnia 2004 r. o świadczeniach opieki zdrowotnej finansowanych ze środków publicznych), 27 August 2004; Poland, Act on the National Medical Emergency Services (Ustawa z dnia 8 września 2006 r. o Państwowym Ratownictwie Medycznym), 8 September 2006; Poland, Act on Preventing Infections and Infectious Diseases among People (Ustawa z dnia 5 grudnia 2008 r. o zapobieganiu zakażeń i chorób zakaźnych u ludzi), 5 December 2008.
PT Yes, for free Yes, for free Yes, for free Dispatch 25.360/2001 of the Cabinet of the Minister of Health, enlightening possible doubts regarding the relationship between foreign citizens and the National Health System (Despacho n.º 25.360/2001 do Gabinete do Ministro da Saúde, que esclarece eventuais dúvidas que se colocam no relacionamento entre cidadãos de países estrangeiros e o Serviço Nacional de Saúde), 12 December 2001. Portugal, Information Circular 12/DQS/DMD of the Directorate-General for Health, clarifying the contents of Dispatch 25.360/2001 of the Cabinet of the Minister of Health (Circular informativa n.º 12/DQS/DMD, que clarifica os conteúdos do Despacho 25.360/2001 do Gabinete do Ministro da Saúde), 7 May 2009.
RO Yes, for free Yes, against payment Yes, against payment Law No. 95/2006 on the Health Care Reform (Legea nr. 95/2006 privind reforma in domeniul sănătății), published in the Official Gazette No. 372 of 28 April 2006.
SE Yes, against payment, but low fee Yes, against payment Yes, against payment Act on Health and Medical Care for Certain Foreigners Living in Sweden without Necessary Permits (Lag (2013:407) om hälso- och sjukvård till vissa utlänningar som vistas i Sverige utan nödvändiga tillstånd); Sweden, Ordinance on Health Care Fees etc. for Foreigners Living in Sweden without Necessary Permits (Förordning (2013:412) om vårdavgifter m.m. för utlänningar som vistas i Sverige utan nödvändiga tillstånd).
SI Yes, for free Yes, against payment Yes, against payment Health Care and Health Insurance Act (Zakon o zdravstvenem varstvu in zdravstvenem zavarovanju, ZZVZZ), Art. 7(1); Slovenia, Health Care and Health Insurance Act (Zakon o zdravstvenem varstvu in zdravstvenem zavarovanju, ZZVZZ), Article 2(1) and (2)
SK Yes, for free Yes, against payment Yes, against payment Act No. 576/2004 Coll. on Health Care and Health Care-Related Services, and Amending and Supplementing Certain Acts as Amended (Zákon č. 576/2004 Z.z. o zdravotnej starostlivosti, službách súvisiacich s poskytovaním zdravotnej starostlivosti a o zmene a doplnení niektorých zákonov v znení neskorších predpisov); Slovakia, Act No. 578/2004 Coll. on Health Care Providers, Health Professionals, Professional Organisations in Healthcare and on Amendments to Certain Acts, as Amended (Zákon č. 578/2004 Z.z. o poskytovateľoch zdravotnej starostlivosti, zdravotníckych pracovníkoch, stavovských organizáciách v zdravotníctve a o zmene a doplnení niektorých zákonov); Slovakia, Act No. 404/2011 Coll. on Residence of Foreigners and on Amendment and Supplementation of Certain Acts (Zákon č. 404/2011 Z.z. o pobyte cudzincov a o zmene a doplnení niektorých zákonov).
UK Yes, for free Yes, for free Yes, for free HM Government (1989), The National Health Service (Charges to Overseas Visitors) Regulations 1989 No. 306, Regulation 3, 3 March 1989; UK, HM Government (2015), National Health Service (Charges to Overseas Visitors) Regulations 2015 No. 238, Regulation 9, 5 February 2015; UK, HM Government (2015), Provision of Health Services to Persons Not Ordinarily Resident Regulations (Northern Ireland) 2015 No. 27, Regulation 4, 30 January 2015; UK, HM Government (2015), The Immigration (Health Charge) Order 2015 No. 792, 16 March 2015; UK, National Assembly for Wales (2004), The National Health Service (General Medical Services Contracts) (Wales) Regulations 2004 No. 478, (W.48) 26 February 2004; UK, HM Government (1989), The National Health Service (Charges to Overseas Visitors) (Scotland) Regulations 1989 No. 364, Regulation 3, 5 March 1989.

Source: FRA. Information up to date as of 31 December 2015.

Notes:
* Some Member States provide ‘healthcare that cannot be deferred’, which may be broader than emergency healthcare, and/or broader access to healthcare for specific groups of irregular migrants, such as children, pregnant women or foreigners staying in reception or detention facilities..
** In Malta there is no legislation regulating access to healthcare for migrants in an irregular situation. According to the Ministry of Health, third-country nationals in an irregular situation in Malta are entitled to core health services. There is no official definition of what ‘core health services’ constitute. However, according to the authorities, they include – but are not limited to – treatments that are necessary and lifesaving, that affect quality of life or that involve public health issues. An individual assessment is conducted by the visiting doctor and, when in doubt, the case is referred to the Director of Health Care Funding ( an authority in charge of healthcare entitlements, which falls under the Department for Policy in Health of the Ministry of Health).
*** In Poland, emergency healthcare provided by medical emergency teams (ambulance teams) is free of charge. However, other forms of medical treatment of migrants in an irregular situation, which have to be performed in a hospital, require payment.