Health service contribution

What do you need to pay if you are not insured?

In Hungary the rules of social security also apply to uninsured people. Act LXXX of 1997 (Social Security Act) lists and regulates a number of circumstances which help professionals decide when an individual has to pay the health service contribution, and when you can claim exemption from it.

In this article we summarise the key information on health service contribution payments and highlight what a resident natural person needs to do to become eligible for health services, even if they are not insured.

Who qualifies as insured, who qualifies as resident?

If a private individual pays the health service contribution, he or she becomes fully eligible to use the services provided by the health insurance system. Insured Hungarian residents can become eligible for all (cash and in-kind) services. Firstly, you need to examine whether the person has insurance status or not.

The criteria for insured status are set out in Section 5 of the Social Security Act. Based on this, among other things, individuals are considered insured if they:

  • are in employment,
  • are students under a study contract,
  • receive job-seeking allowance,
  • work under an engagement contract and the prescribed salary conditions are met,
  • are registered as a full-time small taxpayer, or
  • are a pensioner drawing a direct pension.

Secondly, you need to check if the given individual qualifies as a resident in line with the above-mentioned act.

Based on Section 4 of the Social Security Act, persons are considered resident if they

  • are Hungarian citizens with a permanent registered address in Hungary, immigrants and persons with settled status, persons recognised as refugees and beneficiaries of subsidiary protection in accordance with Act LXVI of 1992 on Keeping Records on the Personal Data and Address of Citizens,
  • are subject to the provisions of the Act on Entry and Residence of Persons with the Right to Free Movement and Residence who exercise their right to free movement and residence for the duration of 3 months in the territory of Hungary, and have registered as a resident in Hungary according to the Act on Keeping Records on the Personal Data and Address of Citizens, and
  • are stateless.

One further prerequisite for the health service contribution payment is to have a permanent registered address for at least one year without interruption in the territory of Hungary.

What do you need to do to become insured?

The main rule is to pay the health service contribution from the first day after the termination of entitlement to health services, and to register this with the NAV within 15 days. However, there are insurance statuses where, upon termination and if the insured individual is a resident, the insurance does not need to start immediately by paying the health service contribution. According to Act LXXXIII of 1997 on the Services of the Compulsory Health Insurance System, such cases are the following:

  • if the entitlement was valid for at least 45 days before the termination of the status, the insured status remains unchanged for another 45 days,
  • if the entitlement lasted less than 45 days, then the insured status is lengthened with that given number of days,
  • the insured status is upheld for another 45 days, if the entitlement prior to the termination of the current status lasted longer than 45 days, and the entitlement terminated last did not last 45 days, but no more than 30 days elapsed between the two entitlement periods.

If a given individual ceases to be insured for any of the above reasons, they need to register with the tax authority by filling in the T1011 form. This form can be downloaded from the NAV website. In 2019 the contribution amount is set at HUF 7,500 (EUR 23) per month (HUF 250 – EUR 0.77 – per day). The payment is due by the 12th day of the month following the given month. The tax identification number of the payer always needs to be indicated on the transaction.

It is possible to transfer the payment of this amount to another person (e.g. a relative), but this needs to be approved by the tax authority first. This information too must be indicated on the form.

When does the health service contribution payment obligation cease?

When a new insurance status is established – for instance, if the individual starts a new job and the tax authority receives a new registration from the employer, i.e. the paying agent, or if the employee moves abroad and becomes insured there – the tax authority does not need to be informed about the termination of the contribution payment. The tax authority will automatically cancel the individual’s health service contribution payment obligation.

If someone incorrectly reports their payment obligation on the T1011 form, this needs to be cancelled at the authority. A change form must be filed within 15 days if the private individual acquires a new insurance status that the tax authority does not know about. This could be the case if the person becomes a pensioner drawing a direct pension or receives child care allowance. In such cases, entitlement to healthcare services needs to be proven to the authority with a relevant resolution.

It is important to know that the statute of limitation on assessing and paying the contribution is 5 years pursuant to the Act on Rules of Taxation.

The information given here about the health service contribution payment obligation covers only a fraction of the detail given in the legislation. The legal background of when to pay this contribution is in no way limited to these cases only. Please seek the help of a professional to get more information and to find out whether you need to pay the contribution or not. Feel free to contact the social security experts of WTS Klient Hungary if you have any specific questions about the topic.

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