Poland - Health Care System

General - Polish Health Insurance

Since 1999, the reformed health care system in Poland has taken responsibility for general health care. As a consequence of this transformation, January of 1999 saw the founding of 16 regional health insurance funds and a state-wide health insurance fund for uniformed civil servants.

In April 2003, the National Health Fund »Narodowy Fundusz Zdrowia« - NFZ took the place of the health insurance funds. This also possesses a central administration which has 16 voivodeship branches. The branches are organised according to the structural divisions of the national regions.

The NFZ is the most important decision maker and financial management institution of the public health sector and reports directly to the Health Minister.

In order to guarantee the benefits of health insurance, public and non-public care providers are obligated to make a contract with the NFZ.

The most important source of financing for health care is revenue from health insurance contributions.

Structure and Services – Polish Health Insurance
In Poland, "beneficiaries" are entitled to free medical benefits. These include

• People who are subject to statutory health insurance (compulsory and voluntary insurance) and
• Uninsured people with Polish citizenship and residence in Poland who meet the income criteria set forth in Art. 8 of the law of March 12, 2004 regarding social benefits.

The requirements for the guarantee of benefits as well as the scope of entitled medical care were established through the law of August 27, 2007 regarding health care benefits financed by public funds.

A recipient of benefits is entitled to free benefits in kind, insofar as they use the appropriate places allocated for such. It must be a care provider who has made a corresponding contract with the National Health Fund.

Information about statutory health insurance care providers can be obtained from the relevant branch of the National Health Fund (NFZ). In front of the office there is always a sign with the NFZ logo visible.

If medical aid is necessary, the following further advice should be taken into consideration:

1. Seeking out a statutory health insurance physician in a public or non-public health centre is contractually bound to the National Health Fund. Basic medical treatment encompasses treatment and consultation with a general practitioner.
2. In the case of treatment by a specialist, a referral from a general practitioner is necessary, except when the situation involves gynaecologists and obstetricians, dentists, dermatologists, venal disease specialists, oncologists, ophthalmologists, and psychiatrists.
3. In the case of accidents, sudden illness, injury, poison, life-threatening health conditions, or childbirth, medical aid is provided immediately.
4. The number for emergency medical services is 999 for landlines and public phones, 112 for cell phones.
5. Should there be an emergency and it will be necessary to be delivered to a hospital, direct admission to the hospital is possible without a medical letter of referral. In the hospital, the patient receives all treatments, examinations, and medications free of charge.When seeking out a private doctor who has no contract with the NFZ, one must pay all costs privately. Practices have individual price lists available.

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