Mandatory health insurance for refugees

The project is implemented by the Republic of Azerbaijan. It began in December 2019 and was completed in January 2020. 

Asylum-seekers, refugees, and persons under the protection of UNHCR are entitled and have access to emergency healthcare in the Republic of Azerbaijan.  With the introduction of a mandatory health insurance system there was a need to define the categories of population to be included in the medical insurance free of charge. Therefore, relevant amendments were made to the Law of the Republic of Azerbaijan on Medical Insurance. 

The key goal was to ensure access of refugees and persons under the protection of UNHCR to the mandatory health insurance system free of charge in the Republic of Azerbaijan. Taking into account the vulnerability of these persons, it was essential to provide free healthcare services.

Main activities of the Good Practice

Access to healthcare system is of the utmost importance for vulnerable groups. Therefore, the Republic of Azerbaijan attaches special importance to ensuring access of vulnerable population, including refugees and asylum seekers to healthcare. The current legislative framework, in general, allows refugees and asylum seekers, as well as persons under protection of UNHCR in Azerbaijan to have access to national healthcare without any discrimination. 

According to Article 6 of the Law of the Republic of "On the Status of Refugees and IDPs (Internally Displaced Persons)" persons who have been granted refugee status are entitled to receive medical assistance in the Republic of Azerbaijan. Furthermore, according to Article 11 of that Law, a person who has applied for asylum can get medical assistance, as well.

In 2017, the Government of Azerbaijan started pilot projects to apply mandatory health insurance in several districts of the country. It was planned to introduce mandatory health insurance in the whole territory of the country starting from 2020. Taking into account the vulnerability of refugees and persons under the protection of UNHCR, a voluntary pledge was made by the Government of Azerbaijan to include refugees, as well as persons under the protection of UNHCR into the health insurance system. 

In order to implement the pledge, it was required to make amendments to the Law on Medical insurance. Therefore, the issue was raised by the State Migration Service before the Government.  Focal points were appointed from relevant state agencies for swift coordination of the interagency activities. As a result of several meetings agreement was reached to make amendments to the legislation, as well as proposals were drafted and submitted  for consideration accordingly. After consideration the proposals were approved and amendments were made to the legislation. Thus, thanks to strong interagency cooperation and swift reaction by relevant state agencies, as well as relevant amendments made to the legislation, refugees and persons under the protection of UNHCR were covered by mandatory health insurance free of charge.

Elements which helped facilitate the implementation of the good practice

Article 6 of the Law of the Republic of Azerbaijan dated May 21, 1999 "On the Status of Refugees and IDPs (Internally Displaced Persons)" states that persons who have been granted refugee status are entitled to receive medical assistance in the Republic of Azerbaijan. Furthermore, Azerbaijan was among the first countries to support and  the Global Compact on Refugees, where paragraph 72 says that in line with national health care laws, policies and plans, and in support of host countries, States and relevant stakeholders will contribute resources and expertise to expand and enhance the quality of national health systems to facilitate access by refugees.

Though, in general the legislation guaranteed medical assistance to refugees, the launch of mandatory health insurance in the country created the necessity to make amendments to the legislation. Swift reaction of relevant state agencies and strong interagency cooperation contributed to making amendments to the legislation which facilitated implementation of the activity. 

Partners involved

• State Migration Service of the Republic of Azerbaijan.
• State Agency on Mandatory Health Insurance.

What challenges were encountered in delivering the project and how were they overcome?

Challenges

There was a debate with the relevant state agencies whether to include vulnerable groups, including refugees into the mandatory health insurance free of charge or not.

How they were overcome

The challenges were resolved thanks to strong interagency coordination, flexibility of focal points, as well as swift reaction of the relevant state agencies.

Results of the Good Practice

• Amendments were made to the legislation.
• Refugees, as well as persons under the protection of UNHCR were included into the national mandatory health insurance system.
• Refugees, as well as persons under the protection of UNHCR received access to free healthcare services.

In what way does the good practice meet one or more of the four objectives of the Global Compact on Refugees?

Objective 1: Ease the pressures on host countries

Objective 2: Enhance refugee self-reliance

Next steps

Currently, relevant category of persons already have access to healthcare services. The State Migration Service and State Agency on Mandatory Health Insurance coordinate their activities to solve any difficulties that may arise during the process.