One can become eligible for social security covered services with valid social security coverage. This social security coverage also includes a health-insurance coverage as a so-called “collateral” legal relationship. The social security-covered legal relationship is usually established by an employment or working status.
In Hungary, if an individual does not have an employment or any other status (e.g. daytime student status) that qualifies them to become eligible for the social security covered services: the individual has to pay a compulsory, individual contribution fee. The individual contribution fee payment makes the individual eligible for social security-covered material services.
Individual health care service contribution fee payment
Individuals for whom the Hungarian social security regulations apply and neither have social-security coverage, and who are nor eligible for health care services based on the “risk population theory”, are obliged to pay an individual health care service contribution fee (individual contribution fee) in order to become eligible for these services.
One has to pay an individual, health-care-service contribution fee if they are otherwise not eligible for healthcare services.
Individuals paying the individual contribution fee become eligible for all the social security covered health care services.
Application for the payment
The National Tax and Customs Administration (Nemzeti Adó és Vámhivatal, NAV) informs the individual of the payment obligation within 8 days after the announcement of the termination of the social security covered legal relationship or the end of the eligibility for the social security covered health care services. NAV sends a notification about the payment obligation to the uncovered individuals (individuals who do not obtain a social security covered legal relationship) and automatically requests the payment of the individual contribution fee.
If NAV does not request the payment for any reason (e.g. if the uncovered individual who is supposed to pay the individual contribution fee has not been a citizen previously or the employer has not announced the termination of the employment status), the individual has to announce their payment obligation to NAV. At the same time, they have to make a declaration about neither bearing a valid social security insurance in other countries of the European Economic Area (EEA), nor in other social convention countries. Therefore, individuals with individual contribution fee payment obligations have to register at NAV.
The following documents are required for registration:
- 21T1011U form (available at any NAV offices, or can be downloaded from the official website);
- documents for personal identification: identity card (or temporary identity cards), valid passport or driving licence;
- residence card;
- tax identification card;
- TAJ card/Social Security Code card (Társadalombiztosítási Azonosító Jel, TAJ) a unified identification number of welfare systems;
- authorization, if someone else registers on behalf of the applicant.
A consultation procedure can be initiated if the individual doubts the legal basis of their payment obligation. For example, the individual had an insurance or was otherwise eligible for health care services or other EU directive or international agreement applied to them in the period specified by NAV.
During the consultation procedure, until the clarification of the individual’s legal relationship, the government office lists the individual in the register of the people eligible for healthcare services. If the individual was social security covered during the disputable period, NAV will conduct the consultation procedure.
Individual health care service contribution fee
From 1 January, 2021 the amount of the individual health care service contribution fee is 8 000 HUF (270 HUF/day). This fee must be paid until the 12th of each month following the reference month after the announcement of the termination of the social security covered legal relationship.
The contribution fee can be paid by another person with the authorization of the obliged individual (e.g. a family member with regular, monthly income can pay it for the obliged individual with no regular income) or an organization. The obliged individual has to declare the payment takeover within 15 days to NAV, because the takeover and the contribution fee payment are accepted only if approved previously by the abovementioned authority. If the person who takes over the payment obligation does not pay the contribution fee, the individual with the payment obligation is obliged automatically for the payment of the contribution fee, regardless of the previous takeover declaration.
If the individual with payment obligation does not pay the contribution fee, and the total arrear exceeds the six-fold amount of the contribution fee (i.e. 48 000 HUF), the obliged individual’s TAJ number can be invalidated, making the individual non-eligible for social security covered health care services. In this case, the individual cannot avail of healthcare services free of charge. The TAJ number validity can be restored after the payment of the total arrear or after the approval of a payment discount of the total arrear requested from NAV.
Termination of individual health care service contribution fee payment obligation
The individual contribution fee payment obligation can be terminated in the following situations:
- if it terminates by the establishment of a legal relationship that provides social security coverage (e.g. employment status);
- announcement of eligibility for health care services (e.g. daytime student status establishment in public education or in higher education);
- if NAV is officially notified about that the individual with payment obligation stays abroad and is not considered as a citizen in respect to social security coverage;
- if the individual with payment obligation dies.
Changes in legal regulations
The act about eligibility for social security covered services and their funds, which was enacted in 1 July 2020, regulates the special issues of eligibility for health care services subsidized by the Health Insurance Fund. The legislator’s aim with the new act is to ensure that a greater proportion of citizens pay the individual healthcare service contribution fee.
This act does not apply to most citizens, who are law-abiding, and bear arranged legal relationships including the payment of the individual health care contribution fee.
The most important changes are the followings:
Combined contribution fee: every social security covered individual is expected to pay universally a 18.5% of their salary as social security coverage fee.
If there is a social security contribution fee arrear, the TAJ number becomes invalidated. The amount of the arrear that invalidates the TAJ: six month absence of social security contribution fee payment.
The contribution fee does not apply to pensioners, regardless of their previous employment status.
Definition of the lower limit for the contribution fee payment: individuals who earn at least 30% of the national minimum wage are expected to pay the social security contribution fee.