Healthcare Access for Asylum Seekers: Rules by Country

Last updated: 5 October 2026

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Healthcare access for asylum seekers is very different from country to country. In some countries, you get full access from your first day. In others, you can only get emergency care. This guide explains the rules in the UK, the US, Canada, and the main EU countries. It covers how to register with a doctor, what mental health support is available, and how medical evidence can support your asylum case.[1]

Many asylum seekers arrive with serious health problems. Some have been tortured. Some have chronic illnesses. Many have mental health needs from the trauma of fleeing their country. Knowing your rights to healthcare is one of the most important steps when you start your new life. This asylum guide walks you through the rules and how to use them.

UK: NHS Access for Asylum Seekers

In the UK, asylum seekers have wide access to the National Health Service (NHS). The basic principle is that asylum seekers receive free care that is similar to UK residents. There are some limits for refused asylum seekers, but most healthcare is free at the point of use.[2]

What Is Free

• GP services: Free for everyone, including refused asylum seekers
• Accident and Emergency (A&E): Free for all
• Family planning and contraception: Free
• Maternity care: Free for asylum seekers (charges may apply for refused asylum seekers, but treatment is never refused)
• Treatment for infectious diseases: Free (such as TB, HIV)
• Treatment for victims of torture: Free
• Mental health services: Free, including IAPT (Improving Access to Psychological Therapies)

HC2 Certificate

Asylum seekers can apply for an HC2 certificate. This is free and gives you full help with NHS costs, such as:

• Free prescriptions
• Free dental treatment
• Free eye tests and help with glasses
• Free travel to hospital appointments

To get an HC2 certificate, fill in form HC1. You can get this at a GP, pharmacy, or hospital. Full details on UK rules are at GOV.UK.

Mental Health and Torture Survivors

The NHS provides mental health support, including counselling and therapy. For survivors of torture, specialist services exist. Freedom from Torture and the Helen Bamber Foundation are charities that offer specialist therapy and medical assessments. Their reports can also support your asylum case.

US: Limited Healthcare Access

The US has the strictest rules. Most asylum seekers cannot get full health insurance until they receive asylum status. The main options are emergency care and community health centres.[3]

Emergency Medicaid

All asylum seekers can get Emergency Medicaid for life-threatening conditions. This includes labour and delivery for pregnant women. You must apply through your state Medicaid office. Coverage is limited to the emergency itself.

Federally Qualified Health Centres (FQHCs)

FQHCs are community health centres that serve people regardless of immigration status. They charge fees on a sliding scale based on income. Many asylum seekers use FQHCs for primary care, dental care, and mental health support. There are over 1,400 FQHC organisations across the US.

State Programs

Some states offer extra coverage:

• California: Medi-Cal covers most low-income people regardless of status
• New York: Emergency Medicaid plus some state programs
• Massachusetts: MassHealth limited coverage available
• Illinois: Health Benefits for Immigrant Adults program

Marketplace insurance under the Affordable Care Act is generally not available until you have asylum status. Once you get asylum, you can buy marketplace plans and may qualify for subsidies. For details, see the USCIS asylum resources.

Canada: Interim Federal Health Program (IFHP)

Canada has one of the strongest systems for asylum seekers. The Interim Federal Health Program (IFHP) gives asylum claimants access to:[4]

• Basic medical care, including doctor visits and hospital care
• Prescription drugs
• Dental care (limited)
• Vision care
• Mental health services, including counselling
• Maternity care

IFHP starts when you make your refugee claim and continues until your case is decided. If you win, you switch to provincial health insurance. If you lose, IFHP ends.

For details, see Immigration, Refugees and Citizenship Canada. To use IFHP, you need to find a doctor or pharmacy that accepts it. Most major cities have many providers.

EU Overview: Different Rules in Each Country

EU member states must provide at least emergency care under the EU Reception Conditions Directive. However, the level of care varies a lot by country.[5]

Germany

Asylum seekers in Germany have access to medical care from day one through the Asylbewerberleistungsgesetz (Asylum Seekers' Benefits Act). For the first 36 months, care is limited to acute and emergency conditions, plus pregnancy. After 36 months, asylum seekers get the same coverage as people on regular social benefits.

France

Asylum seekers in France can use Couverture Maladie Universelle Complementaire (CMU-C) and the Aide Medicale d'Etat (AME). After three months in France, asylum seekers can use the State Medical Aid (AME) for full healthcare access.

Sweden

Sweden gives asylum seekers full healthcare access from arrival. Adults pay small fees similar to citizens. Children get free healthcare. Mental health support is widely available.

Italy and Spain

Italy and Spain provide free emergency care and primary care to asylum seekers. Registration with the regional health system is needed.

Healthcare Comparison Table

Mental Health Support

Mental health is a major issue for asylum seekers. Many have lived through war, torture, or violence. Studies show that around 30% of asylum seekers have post-traumatic stress disorder (PTSD), much higher than the general population. Depression and anxiety are also common.[6]

Common Mental Health Conditions

• PTSD: flashbacks, nightmares, fear, avoidance
• Depression: low mood, loss of interest, sleep problems
• Anxiety: worry, panic attacks, trouble breathing
• Adjustment disorder: stress reactions to new life
• Suicidal thoughts: need urgent help

Where to Get Help

In the UK, ask your GP for a referral to NHS Talking Therapies (IAPT) or specialist services. Charities like Freedom from Torture, the Helen Bamber Foundation, and Refugee Council offer free counselling.

In the US, FQHCs sometimes have mental health staff. Refugee resettlement agencies, even if they do not serve asylum seekers, can sometimes refer you. Universities and graduate schools may offer free counselling clinics.

In Canada, IFHP covers psychological counselling and psychiatric care. CCVT (Canadian Centre for Victims of Torture) and similar organisations offer specialist services.

Medical Evidence and Your Asylum Case

Medical evidence can be very important for your asylum case. If you have scars from torture, mental health symptoms, or chronic conditions caused by what you fled, a medical report can support your claim. The most important type of report is the Medico-Legal Report (MLR).[7]

Medico-Legal Reports (MLRs)

An MLR is a detailed document by a doctor or psychologist. It examines:

• Your physical injuries and scars
• Your mental health symptoms
• Whether your injuries are consistent with the torture or harm you describe
• Your general health and any treatment needs

MLRs follow international standards, especially the Istanbul Protocol of 1999. The Istanbul Protocol explains how to document torture in a medical report. Reports following this protocol carry weight in court.

Medical and psychological evaluations following the Istanbul Protocol are an essential element of the international fight against torture and a key element in the protection of victims.
UN Office of the High Commissioner for Human Rights, Istanbul Protocol Guidelines (Updated 2022)

If you need a medical expert for your case, search the expert witness directory for qualified medical professionals. For background on country conditions affecting your healthcare needs, see our country reports and human rights resources.

Conclusion

Healthcare access varies a lot between countries. The UK and Canada offer wide access from day one. The US has very limited public coverage but FQHCs and emergency care provide some support. EU countries vary, with Germany and Sweden offering strong systems. Wherever you are, register with a doctor early. Mental health support is a basic right and many asylum seekers benefit from counselling. Finally, medical evidence can be a powerful part of your asylum case. Do not be afraid to ask for help. The healthcare system is there to support you in your most vulnerable time.