Health Care Insurance
A foreigner residing in Poland may become insured through the National Health Fund (NHF) or a private insurance plan. Patients insured by the National Health Fund (NHF) do not pay a fee for consultations with a doctor who has an agreement with the National Health Fund
Who is eligible for healthcare benefits paid from public funds?
When you are insured with the National Health Fund (NHF) your health care coverage is paid from public funds. You can become insured with the NHF individually or through your employer. A person insured individually has to individually register with the NHF and pay the healthcare premium coverage individually. A person insured through an employer does not have to individually register with the NHF. If you are employed than your employer will deduct the healthcare premium coverage to the NHF from your salary. The employer is obligated to provide health care coverage for employees.
Foreigners who belong to one of the following categories are eligible for healthcare benefits paid from public funds:
a) Foreigners employed in Poland
In Poland, all legally employed individuals, including foreign nationals, must possess health care coverage, which means that each month your employer deducts from your paycheck to the NHF. This way the employee and his closest family are insured and eligible for free health care services in facilities that signed a contract with NHF.
It is the employer’s responsibility to provide the new employee with access to the health care insurance. In order to do so, the employer needs to register a new employee with the ZUS by filling out application ZUS ZUA as well as ZUZ ZZA.
b) Family members of insured individual (including family members of individuals employed in Poland):
- Children – until the child turns 18 or – if the child is continuing education - until the child turns 26
- Spouse
- Parents and grandparents – if they stay at the same place of residence
Medical care receiver is obligated to register family members with the NHF if they have no medical insurance. In order to register a family member, the medical care receiver has to provide their contact information to the employer.
An individual who signs up for the so called voluntary insurance, is obligated to register with NHF her/his uninsured family members.
c) Refugees
Refugees and foreigners under subsidiary protection on the territory of Poland are eligible for medical coverage if they participate in the 12 month long integration program in cooperation with the regional family help center. The regional family help center pays their premium coverage to NHF during the 12 months long integration program. After the 12 months period ends, these individuals can either get insurance from work (if they are employed) or the Labour Bureau ( if they are registered unemployed). Otherwise, they can purchase individual voluntarily insurance at NHF.
- Foreigners in the asylum procedure receive health care coverage financed by the Office for Foreigners for up to 2 months after the final decision in their case is announced.
- Foreigners in the detention institutions received health care coverage financed by the Border Guards.
d) Registered unemployed
The Labor Bureau is obligated to pay premium coverage for the registered unemployed and their uninsured family members.
e) Clergymen
Premium coverage for clergy is paid by the individual clergymen or by the head of the monastery. More information available at − http://www.zus.pl/pliki/poradniki/porad20.pdf
f) Students
g) Children
All school age children and unaccompanied minors are provided with health care coverage.
h) Individuals under custody (residing in prison or in detention facilities)
i) Individuals insured in other EU Members States or in EFTA states.
Who has to pay the insurance premium?
Private business owners are required to individually purchase healthcare coverage.
Also, individuals who voluntarily purchase healthcare insurance have to pay the insurance premium individually (see Voluntary health care insurance).
Everyone else’s coverage is paid for by a suitable institution or an individual. And so:
If you are legally employed your premium coverage will be paid by the employer.
If you are hired under a contract your premium coverage will be paid by the contractor.
If you are unemployed and registered with the Unemployment Services, your premium coverage will be paid by the Labor Bureau.
Premium coverage for clergy is paid by the individual clergymen or by the head of the monastery.
Premium coverage for students, if they are not covered as family members, is paid by the school they attend.
Premium coverage for refugees or individuals under the subsidiary protection but only those who have joined the integration progremme, is paid by the regional family help centre.
The premium coverage is first collected by the Social Insurance Institution (ZUS) which then forwards it to the National Health Fund. Everyone eligible to receive healthcare benefits is registered with the appropriate NHF branch within the province which corresponds to the insured place or residence. The right to use the health care benefits is granted after the premium for coverage is paid.
Voluntary health care insurance
An individual legally residing in Poland, who is not covered under the obligatory healthcare insurance, can purchase the healthcare insurance voluntarily. In order to purchase the voluntary healthcare insurance, an individual must apply to the appropriate NHF branch corresponding to her/his place of residence within the appropriate province.
The application is available at the NHF branch or can be accessed directly through the website.
Contact information to NHF branches can be access through the following link:
http://www.nfz.gov.pl/new/index.php?katnr=3&dzialnr=2
When applying for voluntary healthcare insurance, foreigners who are not EU/EFTA citizens must to provide a passport and one of the following documents:
-Temporary residency permit
-A permit to settle in Poland
-Residency permit
- Permit for tolerated stay
-Proof of refugee status enquired in Poland or temporary protection.
After signing a contract with the NHF, the applicant has to fill out the ZUS ZZA application at an appropriate ZUS branch or the inspectorate of the Social Insurance Institution (ZUS).
Individuals who purchased voluntary healthcare insurance are obligated to insure family members not covered under the obligatory insurance. In order to apply for benefits for family members, the insured must fill out the ZUS ZCNA application in the ZUS.
The premium is then paid to the ZUS.
The premium coverage for voluntary healthcare insurance constituted 9% of the amount used to establish the base line. In this case the base line is calculated as the average monthly salary in Poland. Information about the premium amount is available in the NHF branches or on the following website –
http://www.nfz.gov.pl/new/index.php?katnr=3&dzialnr=2
In 2009, the monthly premium for students and clergymen from outside the EU came up to 37,80 PLN.
The base line for the premium payment is calculated based on:
- the minimum wage - for voluntary workers;
- the amount of the attendance allowance– for students, Polish as a second language students, and clergymen;
- a monthly income no less than the minimum wage - for all the others.
Proof of the health care insurance
In order to receive healthcare benefits, the insured needs to present proof of insurance.
· Insurance Card
Insurance cards have not yet been introduced, however, there are in planning. The insurance card will act as the main proof of a patient’s eligibility to receive healthcare benefits. This electronic card will contain information such as: name of the insured, date of birth; PESEL number (or the passport or other ID number if the insured does not possess the PESEL number); identification number of the insuring institution; double-symbol code ISO 3166-1 for Poland; the expiration date; and card’s ID number.
The insured will be obligated to show the insurance card when requesting a health care benefit. The insurance card will be free of charge.
· Different proofs of insurance can be used instead the insurance card:
- Health care application document as well as current ZUS RMUA document provided by the employer.
- Current proof from work of the health care coverage payments
- Insurance ID with a current stamp and signature of the employer
- Healthcare application document and the proof of making healthcare coverage payments if the insured is self-employed
- Retirement ID card
- Current proof form the Labor Bureau of being registered with the health care insurance
- Contract with the NHF and a document form the ZUS to prove application for the healthcare benefits including the current proof of coverage payment in the case of voluntary insurance
- Proof form NHF or the EHIC (European Health Insurance Card) if the individual is insured in the EU or EFTA Member State
The family members of the insured individual are also requested to provide a proof of insurance:
- Proof of health care coverage payment including an application copy: ZUS RMUA and ZUS ZCNA (if applied before 1.07.2008) or ZUS ZCZA (if applied after 1.07.2008);
- Current proof from the employer;
- A document stating the family member’s date of birth and current date and stamp of the employer or ZUS;
- Additionally, students between 18 and 26, school ID
- For students 26 and older, the insurance application filled by the school (ZUS ZZA) including student ID
Please, keep in mind that some of the documents listed above such as ZUS RMUA or ZUS ZCNA are only valid for a period of 30 days.
When your coverage ends
The health care coverage expires 30 days after the obligation to receive health care coverage ends, for example:
Ø 30 days after the expiration of the work agreement
Ø In case of death of the insured, the health care coverage of the family members expires 30 days later.
In the case of voluntary healthcare insurance, the healthcare benefits expire at the time of withdrawal for the NHF or within a month due to lack of premium payment.
Students lose their health care coverage within 4 months from graduation or if they drop out of school before the graduation.
