Health insurance and care

Stomatology, Medical University of Lodz, author: Promotion Department

The healthcare system in Poland is based on the principles of equal treatment and access to medical services. It relies on a number of general rules which are applicable unless a specific legislation or international agreement provides otherwise.

The main institution responsible for the management of public funds for healthcare, and the pillar of the entire health insurance system, is the National Health Fund (Narodowy Fundusz Zdrowia, NFZ).

The national health policy is the responsibility of the Ministry of Health.

Foreign researchers and their families visitting and living in Poland can access the Polish state-funded healthcare services:

as employees when healthcare contributions are paid by the employer,
as doctoral students with the health insurance covered by the university/institute,
having a voluntary insurance in NFZ or from a private insurance provider,
during temporary stays/visits based on the European Health Insurance Card,
registering the S1 document issued by another EU country (e.g. posted workers, family members),
when insured as family members of employees in Poland.

Health insurance

In Poland having health insurance is obligatory. When applying for a visa to Poland and legalising your stay in Poland, you always need to present an insurance coverage document.

Persons insured inthe National Health Fund (NFZ) can use state-funded healthcare services are mostly free-of-charge, with rare exceptions for example in case of some of dentistry services.

Insurance of employees

As a general rule, persons working in Poland on the basis of an employment contract (pl. umowa o pracę) and free-for-task contract (pl. umowa zlecenia), regardless of their nationality, are subject to compulsory health insurance. This means that the monthly insurance contributions are paid by the employer in the rate of 9% of the salary basis, subtracted each month.

In case of persons having a specific-task contract (pl. umowa o dzieło) the employer is not obliged to cover their insurance so they have to buy their insuranceindividually either in NFZ or in a private insurance company (more information below).

Insurance of doctoral students

All PhD candidates in Poland, regardless of nationality, are subject to the health insurance to be covered bythe higher education institution unless they are insured on another basis, for instance as employees or family members.

This means that the doctoral candidates have access the public heathcare services free-of-charge. The right to use the services ends only after 4 months following the graduation or termination of the education.

Insurance of family members

In Poland, an insured employee has an obligation to report his/her family membersto be covered by the health insurance under their employment contract. The family members are children and spouses, as well as parents and grandparents on condition that they live in a common household with the employee. In order to report the family members, their personal data have to be given to the employer. If you change employers, you have to report your family members to the new employer. Adding family members does not result in paying additional or higher contributions.

Voluntary insurance

In case you are not covered by the compulsory health insurance, you have to sign an individual insurance agreement either with the National Health Fund or with a private insurance company/medical service provider.It should be stressed though that the NFZ option is the most beneficial as it covers all state-funded medical services and any related hospital treatment.

However, only certain groups of foreigners can sign the voluntary NFZ agreement and these are among others:

European Union, Iceland, Norway, Liechtenstein and Switzerland nationals,
third country nationals who have: visa for the purpose of work (D-6 visa), temporary residence permit, permanent residence permit, EU long-term residence permit,
students and doctoral candidates.

This means that foreigners who have a visa for the purpose of conducting scientific research (D-13) cannot sign the voluntary NFZ agreement so they have to buy insurance at a private insurance provider.

In case of NFZ the payment (for last quarter of 2022) amounts to PLN 606,55 monthly. The ratemay change each quarter as it is related to the average salary in Poland.

Students and doctoral students pay a lower amount of PLN 55.80monthly. The contributions should be paid up to 15^th day each month to a given bank account.

Note: when signing the contract, NFZ will check your previous insurance period in Poland and/or other EU countries. In case of a gap between the previous insurance and the planned NFZ insurance, which lasted at least 3 months, you will have to pay an initial feewhose amount depends on the length of this gap. This means that the fee has to be paid in case of foreigners who come to Poland for the first time from third countries.

Students, incl. doctoral students, are exempted from the fee.

Evidence of insurance, which can be useful in some circumstances (e.g. when visitting a doctor), is a copy of the signed agreement between you and the NFZ together with the proof of payment of the last month’s contribution.

Private insurance providers

Numerous private insurance companies or medical centres offer various customised policies. You need to know that private insurance policies do not provide the same general and equal access to medical services as the public NFZ scheme.

The scope of the private services and the resulting payments depend on the policy you buy and on the contract you sign. The cheapest options only include basic services, for instance visits at general practitioners' or certain specialist doctors. More advanced services, e.g. more complicated dentistry treatment, giving birth, operations or hospitalisation, require more expensive policy.

Also note that private policies often set delay periods meaning that you cannot benefit from certain services, usually the most expensive ones, before a certain period of time passes, e.g. you only can use rehabilitation or small surgery treatment after 60 or 120 days of paying the insurance contributions.

Some employers in Poland do offer private healthcare package to their employees in addition to the public coverage. Sometimes also individual citizens decide to buy the private insurance in order to have faster access to medical services.

Medical services

Medical Biology Centre, Poznan University of Medical Sciences

In Poland a medical doctor providing primary health care (general practitioner, GP) is commonly called “a first-contact doctor” or a "family doctor". This is because you need to obtain a referral from your general practitioner in order to have access to more specialised medical services, e.g. to neurologists, eye specialists, to hospital treatment or medical rehabilitation.

The referral is not required in the event of emergency or for services provided by the following medical doctors: oncologist, gynecologist, psychiatrist, venereologist and dentist, which means that you can register for the visit whenever necessary.

In order to visit your family doctor, you first need to register at one of the out-patient clinics, preferably near the place of your stay. You should present your identity card or passport and a proof of insurance (e.g. a document called RMUA received from your employer or doctoral school).

When you are registered, you can sign up for an appointment with a doctor or visit him/her straight away, if he/she is not occupied.

Centre for Medical Simulation, Poznan University of Medical Sciences

Dentist

A range of free dental services provided to an insured person is limited. Children and young people of up to 18 years of age and pregnant women are covered by better arrangements. Moreover, you should remember that only basic dental materials are financed by public funds, and thus you need to pay for any more advanced products used in treatment. As a result, many Poles choose private dental services.

Pharmacy Training, Pharmacy Department of the Medical University of Warsaw, author: Dział Fotomedyczny WUM

Pharmacy

Medicines are available only in pharmacies, except for some painkillers. Some medicines can be obtained only on the basis of a prescription given by an authorised medical doctor. Most of precrptions are given in an electronic format (via text message - SMS with code or via an e-mail in pdf file). You can always ask the doctor for a printed version, if it is more convinient for you.

Note that most prescriptions are valid for 30 days.

The rates charged for medicines vary as some of them are reimbursed from public funds. In the case of reimbursed medicines, patients pay a flat-rate amount or only a specific portion of the price.

Some pharmacies are open 24 hours and during the night can charge an additional fee for selling medicines.

Source: Pixabay

Vaccines

In Poland the national vaccination programme includes the following obligatory vaccines free of charge:

Age	Vaccine against
within 24 hours after birth	tuberculosis, hepatitis B
month 2	hepatitis B, diphtheria/tetanus/pertussis, hib, pneumococci
month 3-4	diphtheria/tetanus/pertussis, polio IPV, hib, pneumococci
month 5-6	diphtheria/tetanus/pertussis, hib, polio IPV
month 7	hepatitis B
month 13-14	pneumococci, measles/mumps/rubella
month 16-18	diphtheria/tetanus/pertussis, hib, polio IPV
year 6	diphtheria/tetanus/pertussis (DTaP), polio IPV
year 14	diphtheria/tetanus/pertussis (dTap)
year 19	diphtheria/tetanus (dT)

Apart from the above mandatory vaccinations, there are recommended vaccines that are paid:

rotavirus infection - babies between month 2 and 6
meningococcal disease - children between month 2 and 18 years old;
human papillomavirus infection (HPV) - girsl after 12 years of age;
varicella - after month 13;
influenza - recommended for everyone (after month 6) before and during the flu season (autumn/winter) and especially for children (between month 6 until year 18) and adults after 65 years of age (for these 2 groups the vaccine may be free-of-charge), as well for high-risk groups e.g. people with weakened immune system or pregnant women;
tick-borne encephalitis - after month 13;
hepatitis A - after month 13.

In order to receive the additional vaccines you need to talk to your doctor in advance.

More about vaccination in Poland

See vaccination schedules in all EU countries

Emergency

Central Teaching Hospital of the Medical University of Lodz, author: Promotion Department

The National Medical Rescue System has been established in order to provide aid in the event of emergency – when any delay might result in health damage or loss of life. Insured persons have access to medical rescue services. If you are not insured, you will have to pay for the service. In order to call an ambulance, you should dial 999, accessible throughout the country, or a general emergency number 112. You can also go directly to the emergency department (SOR) in the nearest hospital.

Bialystok Clinical Hospital, author: Medical University of Bialystok (UMB)

At the reception desk, you will be asked to show your identification document (ID, driving license, passport or school ID in case of children) in order to confirm your right to free healthcare services. If it happens that the electronic system of patients doesn’t include your data, as a proof of having the health insurance you can present your employment contract, a monthly report issued by the employer (called ZUS RMUA) or your agreement with the National Health Fund, if you are insured on a voluntary basis. If you don’t have any of

the above-mentioned documents, you will be required to pay for the medical services. However, if you later prove your health insurance, your expenses will be reimbursed.

The Infant Jesus Teaching Hospital in Warsaw, author: Dział Fotomedyczny WUM

Unconditional right to free medical services

In some cases, a foreigner, regardless of the nationality and legal status, receives healthcare services unconditionally (even if he/she is not insured) and for free. It applies to urgent situations concerning the immediate risk to life and health, when emergency treatment is essential, e.g. after a car accident which results in a sudden deterioration of health leading to a serious health damage or the loss of life.

Traveling in the EU - European Health Insurance Card and S1 document

The European Health Insurance Card (EHIC) gives you access to necessary medical services for free when you travel temporarily in the European Union as well as to Iceland, Liechtenstein, Norway, Switzerland and the UK (until the end of 2020 due to Brexit) for tourist or work purpose.

It works both ways meaning that anyone covered in Poland by the state-funded NFZ insurance can obtain such a card - for free in the NFZ office competent for the place of residence.

It is important to know, however, that based on EHIC one can use the medical services on the same conditions as residents of a given country. This means that if a certain service is free-of-charge in Poland it may not be so abroad.

More about EHIC

When you move your habitual residence to another EU country, Iceland, Liechtenstein, Norway, Switzerland or the UK (before end of 2020) you should obtain a S1 documentinstead of using the EHIC to receive medical care in the new country of residence. S1 entitles you to healthcare if you don't live in the country where you are insured. It may be useful for posted workers, cross-border workers, pensioners and their family members.

In order to obtain the S1 document in Poland, you need to apply to NFZ.

The document should be registered in health insurance institution in the country of the new habitual residence.

Useful links - Brexit:

Polish National Health Fund: Information on Brexit and healhcare services after 2020

UK Government: Healthcare for UK nationals in Poland