--- name: healthcare-system-primer description: "Understand and enrol in a new country's healthcare system — how it works (public/private/insurance-based), what you're entitled to with your status, how to register with a doctor, get insurance if required, and what to do before you're covered. Use when someone says 'how does healthcare work in [country]', 'register with a doctor abroad', 'do I need health insurance in [country]', or 'I just moved and need to see a doctor'. Produces a system explainer, an enrolment checklist, a coverage-gap plan, and cost expectations. Orients and routes to official sources; not medical or insurance advice." --- # Healthcare System Primer Skill Healthcare systems are one of the most disorienting things about a new country because they work on completely different logics — tax-funded and universal, insurance-mandated, employer-tied, or pay-as-you-go — and getting it wrong means either an unexpected bill or being uncovered when you need care. Newcomers routinely don't register until they're sick, then discover a waitlist, a missing insurance requirement, or that they weren't eligible yet. This skill explains how *this* country's system works for someone with your status, gets you enrolled properly, and covers the gap before you're in the system. It orients and routes to official sources; it gives no medical or insurance-purchase advice. ## What This Skill Produces - A **system explainer**: how this country's healthcare actually works (funding model, public vs private, what's free vs paid, GP-gatekeeping or direct access) and what your status entitles you to - An **enrolment checklist**: the steps to get into the system — register with a doctor/ GP, obtain a health card/number, buy mandatory insurance if required — in order, with the documents each needs - A **coverage-gap plan**: what to do for healthcare *before* you're enrolled or during a waiting period (travel insurance, private options, emergency access — which is usually available regardless) - **Cost and access expectations**: typical costs, waiting times, prescription systems, and how to actually get an appointment — the practical reality, not just the theory ## Required Inputs Ask for (if not already provided): - The country (and status/visa — it determines eligibility) and where they'll live - Their situation: any ongoing condition/medication (so continuity-of-care and prescription-transfer are addressed), family members to cover - Whether they have interim coverage now (travel/private insurance) and a job (employer health cover changes things) - Urgency: a current health need vs setting up proactively ## Framework 1. **Explain the model, then their place in it.** Universal/tax-funded (register and you're covered), mandatory-insurance (you must buy a policy, often within a deadline), employer-tied, or mixed. State the model plainly, then what the user's specific status entitles them to and from when — eligibility often has a waiting period or a residency/registration prerequisite. 2. **Sequence enrolment with its prerequisites.** Registering usually needs the address and the tax/social number from [[arrival-setup]]; a health card/number may gate seeing a GP; mandatory insurance often has a signup deadline with penalties. Put the steps in dependency order with the documents each wants. 3. **Handle mandatory insurance without recommending a product.** Where insurance is required, explain that it's required, the deadline, and the *types* of plan and how to compare them — but the skill does not recommend a specific insurer or product; it routes to the official comparison/regulator and flags the penalty for going uninsured. 4. **Bridge the coverage gap.** Between arrival and enrolment there's often a gap. Options: keep travel/private insurance active, private pay-per-visit, and the key reassurance that emergency care is typically available regardless of enrolment (though it may be billed). For anyone with an ongoing condition, prioritise continuity — carrying prescriptions, a summary from the previous doctor, and finding a GP fast. 5. **Set practical expectations.** How to book (many systems require registering with one GP practice first; some gatekeep specialists via referral), typical waits, prescription and pharmacy mechanics, and costs. This is what turns "I have coverage" into "I can actually see a doctor," which are not the same thing. ## Output Format ``` ## How healthcare works here (and your place in it) [The model · public/private/insurance · GP-gatekeeping or not · what your status entitles you to, and from when] ## Enrolment checklist (in order) [Register with a doctor/GP · health card/number · mandatory insurance if required — prerequisites & documents for each · any signup deadline] ## Before you're covered (the gap) [Interim insurance · private pay · emergency access regardless · continuity for ongoing conditions/prescriptions] ## Getting an actual appointment [How to book · referral system · waits · prescriptions & pharmacies · typical costs] ⚠ Systems and eligibility are country- and status-specific and change — confirm at the official health-system source. Not medical or insurance-purchase advice. ``` ## Quality Checks - [ ] The system model is explained AND the user's specific entitlement/eligibility is stated with timing - [ ] Enrolment steps are sequenced with prerequisites (address, tax number, deadlines) - [ ] Mandatory insurance is explained without recommending a specific product, with the penalty flagged - [ ] The coverage gap is bridged, including continuity for ongoing conditions - [ ] Practical access (booking, referrals, waits, costs) is covered, not just coverage in theory ## Anti-Patterns - [ ] Do not assert a country's exact rules, costs, or eligibility as fact — orient and route to the official source - [ ] Do not recommend a specific insurer or plan, or give medical advice — explain types and route to comparison/regulator and to clinicians - [ ] Do not ignore the coverage gap or continuity for existing conditions — that's where real harm happens - [ ] Do not conflate "enrolled" with "can get an appointment" — cover the practical access - [ ] Do not skip the mandatory-insurance deadline where one exists — going uninsured is often penalized ## Related [[arrival-setup]] provides the prerequisites (address, tax number); [[tax-residency-primer]] and [[credit-from-scratch]] for the other systems; [[doctor-visit-prep]] once you're enrolled; [[perimenopause-navigator]]/[[diagnosis-limbo-kit]] for specific health navigation. ## Example Trigger Phrases - "How does healthcare work in [country]?" - "Do I need health insurance in [country]?" - "I just moved and need to see a doctor."