Contemporary health insurance is based on the principled construction of social security instituted by the State in 1945. It is based on social contributions deducted from salaries (employment) and not on taxation. State regulation is fundamental and based on the idea of social redistribution for social justice. Wage contributions from those who work will provide access to health care for those who can't work for many reasons. As a result of inequalities in health care, the Universal Health Coverage (CMU) was created in 1999 for any individual on French soil, regardless of their administrative situation. Other complementary systems aim to cover everyone’s health needs.

"When a migrant woman can prove that she has legally resided in France for three months, she is entitled to free access to health care. They also have specialized associations that can assist them when they have not yet been granted access to medical care.

Language difficulties; lack of culturally competent and sensitive services; lack of psychological care; social and cultural stigmas.

Among the regulatory laws, it is possible to point out the Law 4368/2016 Measures to accelerate government work and other provisions and a Circular issued in 2019 revoked asylum seekers' access to the Social Security Number (AMKA). Article 55 of L. 4636/2019, introduced a new a Foreigner's Temporary Insurance and Health Coverage Number (PAAYPA) which activated in April 2020. If one applies for international protection in Greece, the Asylum Service will provide him/her with a Full Registration Card, on which PAAYPA is indicated. If one is granted refugee status, PAAYPA will be deactivated and will be turned to AMKA number, one month after he/she obtainsher residence permit. But in such a case, one can apply and turn PAAYPA into AMKA. Those who go through a pre-registration process in relation to their international protection application obtain a Temporary Social Security Number (PAMKA), is issued by the Greek authorities only for the purpose of COVID-19 vaccination. Persons who have never had a social security number (AMKA) or a temporary social security number for third country nationals (PAAYPA) can issue PAMKA by visiting their nearest Citizens' Service Centre (KEP).

Regarding the iIssuance of a Social Security Number one could submit an application at a Social Security Agency office, or at a Citizens’ Service Centre by presenting a valid applicant for international protection card or asylum seeker’s card and proof of address.The provisions of article 248 of law 4782/2021, as replaced by article 97 of law 4796/2021, provide for the issuance of a Temporary Social Security Registration Number (PAMKA) – to every person who does not have a Social Security Registration Number (AMKA) or a Temporary Insurance and Health Care Number of a Foreigner (PAAYPA) – exclusively for the purposes of the actions related to the protection of public health in the context of the COVID-19 pandemic.

Scarcity of resources, limited number ofhealth professionals,lack of cultural mediators, lack of training for health professionals, language barriers.

*Main legal reference in Italy: Law 40/1998, known as “Turco-Napolitano Law”, and the ensuing Consolidated Act on Immigration, i.e. Legislative decree 286/1998, especially the Article 35 (TUI).
In line with following regulations, esp. “Security Packages”, the conditions of access to national healthcare services (and other social rights) for immigrants and asylum seekers have been exacerbated since 2016, in particularly since 2018-19, up to 2020 – especially:
**Decree law 113/2018 on immigration and security, a “Security Set”, better known as “Salvini Security Decrees” or rather Migrant-and-Security Decrees (implemented by Law 132/2018, plus the following 2019 Security Decree).

Foreign citizens regularly residing in Italy, including asylum seekers and beneficiaries of international protection, are entitled to public healthcare.
Foreign nationals should have a regular domicile which allows them to renew their permit of stay, and finally health card. They are required to register with the National Health Service in order to obtain a health card and number which serve as a ticket for free visits to the chosen doctor. Once registered, they can enjoy public health benefits under the same conditions as Italian citizens. Medical assistance is extended to minors and newborn babies of parents registered with NHS.
*According to the Art. 35, 286/1998, irregular migrants have access to urgent services and essential treatments, and benefit from preventive medical treatment programmes aimed at safeguarding individual and public health.

Information on existing services should be more diffused and more correct; language barriers and communication difficulties; economic difficulties; specific measures in women’s health should be promoted and enhanced esp. for migrant women who arrive alone or live in difficult conditions; lack of specific training for medical workers on international protection and specific sanitary conditions.
**Law 113/2018 (2018-19) introduced far-reaching restrictions on the Italian migration policies by weakening the rights of migrants: among other things, this Law abolished civil registration (residence) of asylum seekers creating difficulties for access to health treatment and social coverage.

It is mainly regulated by the Portuguese Constitution and Law no. 95/2019 of 4 September, which approves the Basic Law on Health.

Access to health care under conditions of reciprocity. They must have a regularized situation in order to obtain the user number. However, people who do not have their situation regularized can receive health care in an emergency.

Slowness, difficulty of access and bureaucratic procedures

Most relevant are the general law Health Care and Health Insurance Act (1992) and International Protection Act which defines particularities pertaining to asylum seekers. Once awarded the status of international protection, refugees have formally the same rights as citizens. Migrants (foreign nationals) need to arrange basic and mandatory additional health insurance – as everybody else – to access the public health system.

A “personal physician” (GP) must be found

Difficulty finding a "personal physician", lack of information, discrimination in health care, language barrier

It is mainly regulated by Royal Decree-Law 7/2018, of July 27, on universal access to the National Health System

Provide identity documents; Prove they have effectively resided on Spanish territory over the last 90 days; Show that they are not able to export their right to healthcare from their country of origin to Spain; Prove that no third parties are obliged to pay.

The decentralization of the health management model sometimes implies a greater difficulty in certain autonomous communities. Also, the language barrier is one of the main problems