Who are eligible for health insurance and healthcare services for free?
In Hungary, social insurance is a risk community and participation is compulsory for every citizen and permanent residence. The insurance relationship resulting from the obligation to participate is the basis for entitlement to certain benefits.
Eligibility for health care services can be acquired in several ways:
being insured (e.g. being an employee, full-time self-employed)
being entitled (e.g. full-time student, pensioner, socially deprived)
person liable to pay health service contributions (a resident individual who is neither insured nor entitled)
to receive health services on the basis of an agreement (e.g. foreigners who are not working and not entitled and are not permanent residence or refugees)
Social security, social policy, and health cooperation conventions
More information (in Hungarian): https://www.neak.gov.hu/felso_menu/lakossagnak/ellatas_magyarorszagon/jogosultsag_az_ellatasra/az_egsszsegbiztositas_szolgaltatasaira_jogosultak
When claiming health insurance benefits, we use a special identification number, called a social security number (hereinafter 'social security number'), to identify the person in health, social and social security records. The social security number can be verified by an official card, the so-called "social security card" (TAJ), issued by the government office.
When using the health service, it is compulsory to present the official identity card certifying the social security number and, in the case of patients over 14 years of age, a valid identity card.
At each doctor-patient appointment, health care providers check on-line whether the patient is registered with the health insurance company in the register of eligible persons. During the eligibility check, the system may give the following signals to the provider in relation to the eligibility:
"GREEN LIGHT" - social security card valid, relationship settled"
"RED light" - valid social security number, status not settled"
If the relationship is unresolved, the health care provider cannot refuse to provide the care, but must apply to the government office to have the relationship resolved.
More information (in Hungarian): https://www.neak.gov.hu/felso_menu/lakossagnak/ellatas_magyarorszagon/jogosultsag_az_ellatasra/ellatasra_jogosultsag_igazolasa
