That matters, because a job can also be the ticket into the country's public health insurance system. Contributions may start coming off the payslip in the first month. In return, the worker may be entitled to primary care, medical tests, specialist appointments or hospital treatment.

So the right may be there. Getting to it is another matter. Does the worker need to register with a doctor? Which document proves they're insured? Do they need a referral before seeing a specialist? What happens if they change employer? If you don't speak the local language, just working out the right question to ask can be hard enough.

Recruitment stops at the workplace door

In 2025, EU countries issued about 3.9 million first residence permits to people from outside the bloc. A third of them - 33.6% - were for work, according to Eurostat.

Workers from India, Nepal, Bangladesh, Sri Lanka, Pakistan and the Philippines are an increasingly familiar sight in construction, logistics, manufacturing, farming, hospitality, delivery and care work. European countries have built well-oiled systems to bring them in. Agencies set up the interviews , employers sort out work permits and immigration authorities process the residence papers.

Those systems are good at explaining how to get into the labour market. They are much worse at explaining how to get into a doctor's surgery.

Every country does it differently

There is no such thing as a single European health system. A worker in Romania may have to follow different procedures than one in Germany, Italy, Spain or Croatia. Whether you're covered can depend on your job, your residence status, whether you've registered and what kind of contract you're on.

The EU's revised Single Permit Directive guarantees equal treatment on social security for the workers it covers. But it's still national rules that decide how someone registers and gets care. So any blanket promise that healthcare in Europe is free would be misleading.

What workers need are practical answers for the country they're actually in:

1. Am I registered with the public health insurance system?

2. How can I check my insurance status?

3. Do I need to register with a family doctor?

4. What's covered, and what do I have to pay for?

5. What happens to my cover if I change or lose my job?

If nobody answers those questions, workers may put off getting treatment, pay privately for care that could have been covered, or wait until a manageable condition turns into an emergency.

Romania: a case in point

Romania is one example of a Europe-wide problem. By July 2026, more than 161,000 foreign nationals had the right to live there for work, according to Romania's General Inspectorate for Immigration. Nepal, Sri Lanka, India, Bangladesh and Pakistan were among the main countries they came from.

Foreign employees with the right residence and insurance status can use Romania's public health system. Once insured, they can register with a family doctor and get preventive, outpatient, hospital and emergency care under national rules. The Romanian National Health Insurance House sets out those rights in its guide for insured patients.

The official information is accurate. The problem is that it's mostly written for people who already know how the system works. Translating terms like family doctor, referral, contracted provider, and insured status doesn't necessarily make them any clearer. You can pay into the health system every month and still have no idea where to go when you get ill.

Healthcare should be part of the recruitment package

Everyone recruited to work abroad should get basic healthcare information before they leave, and again once they arrive. It should tell them how to check they're insured, how to register with a family doctor, how to get urgent care and what changes when their job ends.

It should work on a mobile phone and be translated into the languages workers actually use. Employers and recruitment agencies should hand it out as routinely as they do the employment and immigration paperwork. A long legal document won't do. A worker should be able to find the right answer in a few minutes.

One practical place to start is this English-language guide to healthcare in Romania. Europe needs the same thing for every country, adapted to local rules and checked by local institutions or medical organisations.

Europe has asked people from all over the world to help build its homes, deliver its food, staff its factories and look after its communities. Telling them how to see a doctor should be part of the deal. Otherwise, their health cover risks being a right that exists on paper but not one they can actually use.