General information
A foreigner coming to Poland is obliged to have a health insurance. This is one of the documents required when applying for visa and the document needed to file the application for temporary residence.
Basic provisions setting forth the principles and scope of healthcare services provided and their financial are included in the Act of 27 August 2004 on healthcare services financed from public funds.
Provision of healthcare services and their financing, as well as drug reimbursement are the tasks of the National Health Fund (Narodowy Fundusz Zdrowia, NFZ).
A foreigner residing in Poland can benefit from service provided by the public healthcare services financed from public funds if he/she is insured in the National Health Fund or is entitled thereto based on regulations on the coordination.
A foreigner will be subject to obligatory health insurance if he/she satisfies conditions to be covered by such insurance, set in Article 66 of the Act. In other instances, he/she can get health insurance on a voluntary basis (Article 68 of the Act) by concluding the agreement with the National Health Fund.
Health insurance involves the duty to pay the premium, the amount of which differs depending on the health insurance type:
| Obligatory | Voluntary | |
|
Who can get insurance |
Person referred to in Article 66 of the Act |
Persons referred to in Article 68 of the Act, who are not subject to obligatory health insurance |
|
Premium amount |
9% of the premium base, which is usually income within the meaning of the Act on Personal Income Tax, e.g. if we have concluded an employment contract or a personal service contract with an employer. At the same time, a part of the premium (up to 7.75% of the base) reduces the amount of tax remitted by the employer on our employment contract. |
In Q2 2015, the premium amounted to PLN 364.83 (i.e. 9% of the base – average monthly remuneration in the remuneration in the enterprise sector for the previous quarter). The premium for voluntary health insurance is paid to the account of the Social Insurance Institution (ZUS): The premium is paid on a monthly basis and is indivisible; its amount changes every quarter. Information on the current amount of the premium is published on the MOW NFZ website or can be obtained by calling: 22 456 74 01. |
|
Payer of premiums |
For employees – their employer, for unemployed – labour office, for people on old-age and disability pension – usually Social Insurance Institution. |
Persons carrying out non-agricultural business activities or being voluntarily insured in the National Health Fund paid the premium on their own. |
Benefits under health insurance in the National Health Fund (unlike benefits under sickness insurance that are discussed below) do not include any cash benefits. A person insured in the National Health Fund can expect only the benefits involving healthcare, including inter alia medical examination and advice, treatment, medical rehabilitation, care for pregnant women and children, care for ill and disabled people, issuing decisions and opinions on health condition.
As a rule, treatment of a person insured in the National Health Fund is free. However, a patient sometimes has to cover costs of some services. The National Health Fund does not finance services that are not included in lists of guaranteed services, set in the Regulation of the Minister of Health. However, an individual request for treatment reimbursement can be submitted to the National Health Fund and it is possible that it would be approved.
The following can also involve bearing costs (in whole or in a part) by a patient:
- purchasing drugs recommended by a physician;
- accommodation and food in a sanatorium and a care and treatment facility;
- using some sanitary transport services;
- issuing some decisions or certificates, e.g. the decision on the ability to drive vehicles;
- providing healthcare services if the only and direct reason for providing these services was an event associated with alcohol intoxication of a patient.
When using healthcare services, every patient is allocated to a voivodeship branch of the National Health Fund. Allocation to the specific branch depends on the place of residence and registration.
In addition to services provided by the public healthcare services, a person insured in the National Health Fund can use free services of private entities (e.g. an outpatient clinic, hospital, dentist’s surgery), provided that such entity has signed the contract for these services with the National Health Fund. The National Health Fund is obliged to publish, on its website, the information on concluding every agreement for the provision of healthcare services, within 14 days.
Private medical facilities have usually signed with the National Health Fund agreements for the provision of some services (e.g. laryngological clinic). In such case, a person insured can obtained free laryngological advice at such facility, while other services would be provided against payment.
An information board is a sign that a patient can use services provided by a private facility, based on the insurance in the National Health Fund. This is because every private entity providing such services has to place outside a board with the logo of the National Health Fund and the name of the service provider.
In addition to the information board, the following information should be presented in a prominent place:
- information on the timing and place of visits and persons who treat the patients;
- information on locations and working hours of subcontractors, e.g. laboratories to which patients are referred;
- principles for scheduling visits and the information on making complaints and requests;
- list of patient's rights;
- address and telephone number of the Ombudsman for Patient’s Rights and telephone numbers for emergency medical service: 112 and 999.
A physician providing services under a contract with the National Health Fund cannot provide services against payment (commercial) during the hours set in his/her work schedule.