Ukrainian cancer patients on the run

If Ukrainian refugees are ill upon entry or become ill during their stay in Germany, they will receive medical care in Germany.

For cancer patients, this usually means that the necessary oncological treatment will be continued or even started. For this, they have to go through a multi-step procedure in Germany

Procedure when Ukrainian cancer patients enter the country

Procedure when Ukrainian cancer patients are already there

People who have fled from Ukraine and enter the country by 4 March 2024 do not need a residence certificate (residence title) for the first 90 days.

Within these 90 days, however, the refugees must have received or at least applied for a residence title. If an application has been filed, the status of "permitted residence" will remain until a decision is made on the application. The so-called "fiction certificate" is issued.

The foreigners authority or municipality at the place of residence is responsible. The exact procedures may differ from region to region.

• In many cities, for example in Berlin, it is possible to carry out the procedure online.
• The competent local offices or the websites of the municipalities provide information on the respective procedure.
• Also at the Federal Office for Migration and Refugees.

This is how medical care with a residence permit continues

After the residence permit has been granted, refugees from Ukraine can work and apply for social benefits. To do so, they must register independently at the relevant JobCentre or social welfare office.

If people from Ukraine have a residence permit and are fit for work but unemployed, they receive money from the Job Centre ("Bürgergeld") and are supported in their job search. They become compulsory members of the statutory health insurance, receive an insurance card and are thus entitled to all benefits of the statutory health insurance.

If people from Ukraine have a residence permit and cannot work, for example because of their age or because they are incapacitated due to illness: Then they receive basic security ("social assistance"). Although they are then not compulsorily insured in the statutory health insurance scheme, they also receive a health insurance card from a statutory health insurance fund. If necessary, they can use this card to obtain health services that correspond to the scope of services provided by the statutory health insurance. To do so, they must present the insurance card at clinics and surgeries. In this way, the costs can be settled directly with the social welfare office.

Refugees who have not yet applied for basic benefits will initially continue to receive benefits under the Asylum Seekers' Benefits Act and only basic health insurance cover.

Refugees who accept a job in Germany usually become members of a statutory health insurance fund and receive the full benefits of the statutory health insurance. Spouses and children are then usually also insured (family insurance).

Refugees who have assets or a high income from self-employment cannot usually receive benefits under the Asylum Seekers' Benefits Act, from the JobCenter or from the Social Welfare Office. They must also pay the costs of their medical treatment themselves. The Cancer Information Service cannot provide information on when this is the case and what costs are incurred. In principle, private health insurance may also be an option for these people.

Further important information for cancer patients who have fled

Contact the clinic or doctor's office at an early stage: In this way, those affected can quickly discuss with doctors how cancer treatment can be continued or started. This is especially true in cases where the report to the authorities cannot be made immediately after arrival or cannot be finalised right away.

Clarify costs: Refugees should discuss with the doctors treating them whether and what costs will be incurred – especially if they are still receiving basic care under the Asylum Seekers' Benefits Act. Doctors must inform refugees whether they have to bear the costs of treatment themselves and how much.

• The Cancer Information Service cannot provide an assessment of which treatments are covered by basic care in individual cases.

Psychological and psycho-oncological support: The events related to the war in Ukraine can have a negative impact on the psyche of any cancer patient at any stage of the cancer disease. Although people react differently to war and trauma, it can be assumed that during or shortly after the flight, the psychological strain on those affected is very high. This can intensify cancer- or treatment-related complaints such as pain or severe exhaustion (fatigue). Some people therefore need additional psychological support.

• Those affected can get help from the Ukrainian Psycho-oncology Association (UPOA). Their psychologists are still available virtually for psychological support via Facebook.
• There are also other international psycho-oncology societies or associations that offer their help, such as in Poland.
• The information sheet Coping with Cancer in an Emergency or Catastrophic Situation (PDF) of the American Cancer Society offers initial orientation for those affected.

Further assistance for Ukrainian cancer patients

Transport of cancer patients from Ukraine: Policy actions

Regardless of this, German politics is working on uncomplicated solutions to ensure that the medical care of refugees is unbureaucratic and comprehensive. It is possible that the current procedure will change again because of this.

• We inform here promptly about any changes.

Are politicians organising ways to bring Ukrainian cancer patients to Germany? According to the Federal Ministry of Health (BMG), the federal and state governments have agreed to accept sick and injured people from Ukraine for treatment in Germany.

The Federal Office of Civil Protection and Disaster Assistance (BBK), the Joint Reporting and Situation Centre (GMLZ) of the Federation and the federal states and the Federal Foreign Office are working together to coordinate the transport of patients to Germany.

After arrival in Germany, the patients are distributed to hospitals in Germany according to a cloverleaf mechanism. The cloverleaf mechanism was developed during the Corona pandemic and organises the transfer of patients between federal states and individual regions in Germany.

How can cancer patients from Ukraine or their relatives organise patient transport? People who need help can try to contact the Ukrainian Ministry of the Interior or the government via their hospital. There, all cases are registered centrally and assistance is organised. If necessary, aid organisations that provide assistance in Ukraine can also organise transport to neighbouring countries. Examples are the Arbeiter-Samariter-Bund (ASB), the German Red Cross (DRK), the Johanniter or the Malteser. The Federal Foreign Office offers a list of aid organisations in the Humanitarian Aid Coordination Committee.