Presenting a valid and undamaged insurance card is not a precondition for providing healthcare in a prison

The complainant came to the prison’s healthcare centre with flu-like symptoms. The insurance card which he submitted was partially damaged and had an illegible expiry date. The physician refused to treat him because he had failed to comply with the duty to present a health insurance card as required by the head of the given department, and at the same time, the physician had concluded that his medical condition did not require urgent treatment.

The Ombudsman agreed that as a general rule, anyone who wants to access healthcare must first present his/her insurance card. However, the Prison Service as a healthcare provider may not refuse care to a convict if the convict does not have this card in his/her possession or if the card is damaged. With the exception of uninsured foreigners, a convict serving imprisonment is automatically insured within the system of public health insurance and the Prison Service is the only provider of healthcare available to the convict. In a prison, it is not necessary to present an insurance card to identify the patient and it is also irrelevant whether or not the expiry date is legible on the card because the insured person continues to be insured with the same insurance company even after expiry of the card.

After an initial attempt to defend the existing approach (including assurance that if the complainant had shown acute symptoms of a disease, the physician would have treated him), the prison director ultimately agreed that presenting a valid and undamaged insurance card was not a precondition for providing healthcare in a prison.