Dependants and universal health insurance in the EU

Discrimination against children is frowned upon in the European Union, which is respecting Convention on the Rights of the Child. Nevertheless Czech authorities fail to recognize the right of children from non-EU countries, whose parents are employed in the Czech Republic, to access financially available quality health care. The only health care plan available for those children for 5 long years has the scope of a travel insurance (no pre-existing conditions, oncology, HIV or mental health covered) with occasional pediatric visits. Managing conditions that private health insurance doesn’t cover out of pocket can’t be considered an available alternative even in case of minor problems, as foreigners from outside the EU are paying on average triple prices for every medical service.

The table below illustrates that the discriminating Czech approach towards children of publicly insured third-country nationals is a unique dishonorable practice among other European countries.

Health insurance market in different countries of the European union is very alike, with each country guaranteeing universal health care to its residents. Generally, universal health care is provided through a solidarity system of public health insurance funded by tax-payers (with the exception of the Netherlands where it is provided by a highly regulated market of private health insurance companies). Private health insurance is considered a complementary option offering premium services – wider provider network, shorter waiting times, co-payments reimbursement for public health insurance, extra coverage like massages or single hospital rooms.

EU country
Market specifics
Children
Unemployed spouses
Austria
Public health insurance, complementary private health insurance offers premium services.
Everyone who resides in the country for more than 6 months can enroll into public health insurance.
Co-insured at no extra cost if engaged in raising one or more children living in the same household.
Otherwise spouses pay the premiums themselves.
Belgium
Public health insurance with co-payments, private health insurance offers premium services and co-payments coverage.
Co-insured with the employed parent at no extra cost till age 25 unless they are fiscally independent
Bulgaria
Public health insurance (NHIF), private health insurance offers premium services.
Everyone who holds long-term residence permit is enrolled into NHI.
Enrolled into NHIF with state paying the premiums till 18 y.o
Enrolled into NHIF, fixed premium is payed.
Croatia
Public health insurance with fixed co-payments, private health insurance offers premium services and co-payments coverage.
Children have public health insurance.
Child of a foreigner outside of EU pays minimal premium.
Child of a EU resident has their premiums covered by the state.
Spouses of employed foreigners are automatically covered without additional cost.
Cyprus
Public health insurance (GHS) with fixed co-payments, private health insurance offers premium services and co-payments coverage.
Children (less than 26 y.o) of employed foreigners are enrolled into general healthcare system (GESY)
Enrolled into GESY
Czech Republic
Universal healthcare through public health insurance, private health insurance specifically for foreigners with limited coverage similar to travel insurance (no pre-existing conditions, cancer, mental health coverage). Public and private health insurances for foreigners are mutually exclusive – once a foreigner becomes eligible for public health insurance, their private health insurance is annulled.
Private health insurance for foreigners only
Private health insurance for foreigners only
Denmark
Public health insurance, private health insurance offers premium services.
All residents of Denmark are entitled to public health insurance.
Insured together with the employed parent at no extra cost till 15 y.o
Estonia
Insured together with the employed parent at no extra cost till 19 y.o
Enrolled into public health insurance with fixed premiums, for pregnant women or those raising kids premiums paid by the state
Finland
Enrolled into public health insurance at no extra cost.
Enrolled into public health insurance
France
Public health insurance, private health insurance offers premium services.
All residents get access to state healthcare after three months of residence.
Co-insured with an employed parent at no extra cost till 18 y.o.
Co-insured with the employed foreigner at a fixed percent of his salary
Germany
Public health insurance, private health insurance offers premium services.
All legal German residents get access to Government Health Insurance System.
Co-insured with an employed parent at no extra cost
Co-insured with the employed foreigner at no extra cost
Greece
Public health insurance with fixed co-payments, private health insurance offers premium services and co-payments coverage.
All legal residents are entitled to Social Health Insurance.
Co-insured with the employed parent
Co-insured with the employed foreigner
Hungary
Public health insurance, private health insurance offers premium services.
All long-term residence are entitled to public health care.
Enrolled into public health care, before permanent residence pay the monthly premium (~60% of the adult premium)
Enrolled into public healthcare, pay fixed monthly premium (around 230 euros in 2018)
Ireland
Public health insurance, widely utilized complementary private health insurance offers premium services and fees compensation.
Every ordinary resident (who is living or intending to live for at least 1 year in Ireland) is eligible for public health insurance (Health Service Executive or HSE)
Enjoy same entitlement to health services as their parents. Child care till age 6 is free of charge.
Enroll into HSE.
Maternity services are free of charge.
Italy
Public health insurance with occasional co-payments, private health insurance, though uncommon, offers premium services and fees compensation.
Every legal resident is entitled to public health care (Servizio sanitario nazionale or SSN).
Enroll into SSN.
Pregnant women are exempt from fees.
Latvia
Public health insurance, complementary private health insurance offers wider network and premium services.
Children of an employed parent can enroll into public health insurance system.
Can enroll into public health insurance system, if taking care of a child less than 7 y.o or at least 3 children less than 15 y.o.
Otherwise only private health insurance option is available.
Lithuania
Public health insurance, complementary private health insurance offers premium services.
State pays the premium for pregnant women up to 56 days after delivery.
Otherwise spouses need to get private health insurance.
Luxembourg
Public health insurance with fixed co-payments, private health insurance is a popular option of additional coverage providing premium services and co-payment reimbursement.
Malta
Public health insurance, private health insurance is uncommon.
Co-insured with the employed parent at no extra cost till 18 y.o.
Co-insured with the employed foreigner at no extra cost
The Netherlands
Social Health Insurance System is comprised of private entities – no public health insurance.
Everybody has private health insurance.
Private health insurance, children till 18 years don’t pay the premium
Private health insurance
Poland
Public health insurance (Public National Health Fund) insurance, complementary private health insurance providing premium services.
Co-insured with the employee at no extra cost
Portugal
Public National Health Service (Servico Nacional de Saude, SNS), complementary private health insurance offers over premium services and co-payment reimbursement.
Any legal resident of Portugal is eligible to enroll into public health system.
Co-insured with the employed parent at no extra cost.
Co-insured with the employee at no extra cost.
Romania
Public health insurance, complementary private health insurance offers premium services and co-payment reimbursement.
Any person who is legally resident in Romania can benefit from the national health insurance system from the date of starting the contribution payment to the fund.
Don’t pay the premium till 18 y.o or till 26 y.o in case of study
Enrolled into public health care, fixed premium is paid. Pregnant women or those who just recently gave birth don’t pay the premium.
Slovakia
Public health insurance, private health insurance uncommon.
Public insurance if a parent has public insurance, state pays the monthly premium
Public health insurance in case of contractor work, private health insurance otherwise
Slovenia
Public health insurance, complementary private health insurance.
Enrolled into public healthcare, free of charge till 15 y.o (or 26 y.o in case of study)
Enrolled into public healthcare
Spain
Public health insurance, private health insurance provides premium services and co-payment reimbursement.
Co-insured with the employed foreigner if residing in Spain.
Pregnant women or those who just recently gave birth are publicly insured with premiums paid by the state.
Sweden
Public health insurance, private health insurance offers premium services and co-payment reimbursement.
Everyone staying or intending to stay for over 12 months in Sweden is considered a resident and entitled to public healthcare.
Entitled to public health insurance, all services are free of charge till 18 y.o
Entitled to public health insurance