Health care coverage and access for displaced persons from Ukraine: Assessing the implementation of the Temporary Protection Directive across EU Member States.

Abstract Background: Since the beginning of the conflict in Ukraine, close to 4.3 million non-EU citizens have been granted temporary protection in the European Union (EU). Beneficiaries gain access to health care in their host countries. All EU countries must ensure coverage for and access to a minimum set of health care services, but they can arrange delivery and extend the services covered as they deem feasible, necessary, and appropriate. Objective: The aim is to assess the implementation of temporary protection across 27 EU countries, including legislative provisions and health care coverage foreseen. This study offers a comparative overview of health care entitlements and financial coverage, access to services and barriers encountered in host health systems. Methods: This study is based on three qualitative survey rounds conducted with members from the EU Health Security Committee and the Health Systems Policy Monitor network (European Observatory on Health Systems and Policies). Results: All Member States have made the necessary legal provisions. However, large variations in health care benefits and financial coverage exist. The main reported access barriers relate to language, pre-existing capacity limitations, and lacking awareness of provisions on both beneficiary and health care provider sides. Conclusion: As displaced persons from Ukraine transition into stable living conditions in host countries, data should be collected systematically to ensure health services can be tailored to meet their needs. Better aligning health care provision with other services, such as social care, may help unburden health systems and maximise the use of available resources.