In Hungary, healthcare providers check the validity of social security numbers before treating patients. This online check reveals whether the patient is included in the list of those entitled to treatment, as kept by the health insurer. The system can show “green”, “red”, “blue”, “brown” or “yellow” lights during the online check.
In the course of health insurance status checks, the feedback from the IT system at the National Institute of Health Insurance Fund Management can be as follows:
Green light: the social security number is valid, the legal status of the patient is in order and they are entitled to healthcare. This can be because they are insured and pay the 4 percent in-kind health insurance contribution, or because they pay the monthly health service contribution of HUF 7,110 (approx. EUR 23). In this case the patient gets a green light, and so the healthcare provider must treat them as part of the social security system.
Red light: the social security number is valid, and although the legal status of the patient is unresolved, the healthcare provider may not refuse to provide care and may not make the patient pay for the costs of the care. The healthcare provider must notify the patient that their legal status is unresolved.
Blue light: the patient is insured abroad, so the social security number is temporarily invalid. The patient has notified the health insurer that they have social security abroad. In this instance, the care cannot be claimed with a social security card, the patient may only receive medical care in Hungary with an EU card issued by the foreign insurer or with an equivalent form.
Brown light: health insurance status checks revealing this light show the social security number is invalid for some other reason. In such cases, the healthcare service may only be used in Hungary if the patient pays. This happens for example if the patient lives in a different country and has discontinued their Hungarian address, so their social security number has been invalidated.
Yellow light: the social security number is valid, but the patient only has limited entitlement to healthcare services for 24 months based on an agreement with the health insurer. The agreed unlimited entitlement to healthcare services – with the exception of emergency treatment – may be provided from the first day of the 24th month after the agreement is concluded, unless the prescribed contributions were paid retrospectively for 24 months when the agreement was concluded.
If the health insurance status checks do not reveal a “green” or a “yellow” light, the healthcare providers inform the patient about this. Problems with the validity of social security numbers can be resolved electronically through the government portal, or in person at the government offices for the county capitals (in the case of Pest county and Budapest, the government office in District 13 is the place to go).
After registering, the health insurance body sends notification about the result of the procedure to resolve the legal status.
