The End of Free Healthcare in the EU? What Will Ukrainians Now Have to Pay for Out of Pocket

The rules for access to medicine for Ukrainians are gradually changing in EU countries. Find out which medical services remain free for refugees in Europe, and which ones you increasingly have to pay for yourself

An insurance policy is a guarantee of your safety and peaceful stay outside Ukraine

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After the start of the full-scale war, millions of Ukrainians obtained temporary protection status in the countries of the European Union. Along with the right to residence, work and social support, people also gained access to the healthcare system.

In the first years after the start of the war, a significant part of medical services for Ukrainians was free or almost completely covered by the state. However, in 2025–2026, the rules for access to medicine began to gradually change in some European countries. In particular, part of the costs are increasingly being shifted to the patients themselves - especially when it comes to private consultations with doctors, dentistry, medications or treatment of injuries sustained during active recreation.

That is why the question is increasingly arising: is the era of completely free medicine for Ukrainians in Europe coming to an end? We find out further.

Poland has limited free medicine for Ukrainians since March 5, 2026. Read here who can be treated for free after March 5, 2026 and who will have to take out health insurance.

What medical care does temporary protection status cover?

Ukrainians staying in EU countries with temporary protection status usually have access to basic medical care. It may vary depending on the country, but in most cases it includes:

- emergency medical care;

- treatment of acute illnesses;

- hospitalization in case of a life-threatening condition;

- consultations with a family doctor;

- basic medical diagnostics.

That is, in case of a serious illness or injury, a person will not be left without help. However, this list is usually limited to basic care. Many other medical services – even quite common ones – in EU countries are partially or fully paid for by the patient.

Read about what insurance is required to enter the Schengen area and how to avoid visa refusal at the link.

What medical services in the EU do Ukrainians pay for themselves?

In addition to treatment at the expense of the insurance company, there is a certain list of services that are fully financed by the patient, including:

Private doctor consultations

In most European countries, there are both public medical institutions and private clinics. If a patient consults a doctor in the public system with a referral, the consultation may be free or partially paid for by insurance. However, an appointment with a private doctor is usually paid in full by the patient.

In particular, this rule applies to consultations with specialized specialists, quick appointments without a long wait, and diagnostics in private medical centers.

The cost of such consultations in European countries can range from 50 to 200 euros per appointment, depending on the country and the specialist.

Dental services

Dental treatment in Europe is traditionally considered one of the most expensive medical services. In many countries, the public system covers only basic procedures, such as an examination or standard treatment.

More complex procedures, modern materials or aesthetic dentistry are paid for by the patient themselves.

Approximate prices in Western European countries may be as follows:

- Dental examination – 50–80 euros;

- Filling – 70–150 euros;

- Root canal treatment – ​​300–700 euros;

- Crowns or implants – from 800 euros and more.

That is why many Ukrainians in Europe take out additional health insurance or plan dental treatment during trips home.

Medicines

Another item of expenditure is medicines. In many European countries, health insurance does not always fully cover the cost of medicines. A co-payment system is often used: part of the cost of the drug is covered by insurance or a state program, and the rest is paid by the patient.

As a result, even with insurance, people can pay 10–30 euros for prescription drugs, and some drugs are not reimbursed at all.

Injuries during active recreation

A separate category are injuries sustained during active recreation or sports. In some cases, emergency care may be free if treatment is provided in a public hospital. However, further treatment, rehabilitation, or visits to private clinics are often paid for independently.

Additional costs may arise, for example, in the case of injuries while skiing, mountain hiking, cycling, or extreme sports.

That is why travel insurance policies often contain separate conditions for active recreation.

We told you more about how to choose the right insurance policy for traveling abroad in a previous article.

Why is there no completely free medicine in the EU?

It is important to understand that there is no unified medical system in the European Union. Each country has its own healthcare financing model, and in most cases it is based on the health insurance system.

For example, in Germany, access to medicine is provided through the state health insurance system. In Poland, medical services are provided through the National Health Fund. The Czech Republic has mandatory health insurance, and in France there is a state social insurance system.

Because of this, even for citizens of these countries, medicine is not always completely free: patients pay for some services or medicines themselves.

Read here where in Europe the best education and healthcare is.

Why are EU countries gradually changing the rules for medical care for refugees from Ukraine?

After the war, European Union countries accepted millions of Ukrainians, which created an additional burden on social systems, including healthcare.

Experts note that many support programs were initially introduced as temporary humanitarian measures. Over time, countries began to gradually transfer Ukrainians to the regular social security system. As a result, instead of completely free care, the standard European model is increasingly being used, where medicine is financed through insurance premiums and partial payment for services.

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What changes after a Ukrainian gets a job in the EU?

Most European countries emphasize that in order to maintain access to free medicine, it is necessary to get a job. When a Ukrainian starts working in an EU country, he usually switches to the standard health insurance system.

His salary pays contributions to the state health care system, in return for which the person gains access to a wider range of medical services.

In effect, the system moves from humanitarian support to a regular social insurance model that operates for the country's citizens.

Does the change in the rules mean the end of free medicine?

Despite the changes, it is still too early to talk about the complete end of free medicine for Ukrainians in Europe.

The temporary protection status introduced in the EU on the basis of the Temporary Protection Directive guarantees access to basic medical services. At the same time, countries are gradually integrating Ukrainians into their own health insurance systems. This means that medicine is not disappearing, but the model is changing: from emergency humanitarian aid to the standard European system, where patients pay part of the costs themselves.

That is why Ukrainians living in Europe are advised to carefully study the rules of the medical system in their country and, if possible, take out health insurance - because in the EU, treatment without insurance can be very expensive.

Health insurance is an important tool for financial protection. The policy can cover the costs of treatment, medicines, transportation to the hospital and other medical services.

Take out insurance before your trip to be prepared for any situations abroad.

Reminder! Health insurance is mandatory for all residents of Germany, but the system provides an important advantage for families - the ability to insure family members for free through one insured person. We have already told you how family health insurance in Germany (Familienversicherung) works, who can be included in the policy, up to what age children are insured, what income restrictions apply and how to apply for insurance in 2026.

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