National Contact Point
for cross-border healthcare

EU Regulations on coordination of social security systems

Cross-Border Healthcare Directive

Relevant legislation

Regulation (EC) No 883/2004

Regulation (EC) No 987/2009

Act of 27 August 2004 on healthcare services financed from public funds

• and, in view of the fact that on 31 January 2020 the United Kingdom exited the European Union:

Agreement on the withdrawal of the United Kingdom of Great Britain and Northern Ireland from the European Union and the European Atomic Energy Community

Trade and Cooperation Agreement between the European Union and the European Atomic Energy Community, of the one part, and the United Kingdom of Great Britain and Northern Ireland, of the other part

Directive 2011/24/EU on the application of patients’ rights in cross-border healthcare (CBHC Directive)

Act of 27 August 2004 on healthcare services financed from public funds

Act of 10 October 2014 on amendments to the act on healthcare services financed from public funds and certain other laws (implementation of the CBHC Directive)

Who is entitled to access healthcare in Poland

Persons who:

• are covered under the statutory health insurance scheme of an EU/EFTA Member State or the UK
• live or temporarily reside in Poland
• can present the required documents.

Persons who:

• are covered under the statutory health insurance scheme of an EU/EEA Member State
• live or temporarily reside in Poland.

Eligibility requirements

• EU/EFTA patient did not explicitly request that they want to receive treatment under the CBHC Directive.
• EU/EFTA/UK patient is temporarily staying in Poland, presented a document proving their eligibility for healthcare benefits in Poland and the treatment falls within the scope of benefits to which they are entitled.
• EU/EFTA/UK patient lives in Poland and:

• • has been validated in the Electronic Verification of Patient Entitlement (e-WUŚ system)

or

• • has registered a relevant authorization document with a Regional Branch of the National Health Fund and can present the certificate of registration.

• EU/EEA patient explicitly requested that they want to receive treatment under the CBHC Directive.

Range of healthcare that can be accessed in Poland

Medically necessary healthcare

Healthcare provided to EU/EFTA/UK patients who are temporarily staying in Poland.

It concerns treatment that:

• became necessary during that stay
• was impossible to foresee before the departure and can’t be postponed
• is adapted to the expected duration of the stay
• the necessity to access healthcare was caused by:

• a sudden illness, including an unexpected worsening of a chronic illness
• an injury due to an accident.

The determination of whether a certain medical intervention is necessary rests entirely with the attending physician.

The patient must present:

• a valid European Health Insurance Card (EHIC)

or

• a Provisional Replacement Certificate (PRC).

Full range of healthcare benefits

Healthcare provided to patients who live in Poland (residents of the EU/EFTA/UK) and:

• have been validated in the Electronic Verification of Patient Entitlement (e-WUŚ system)

or

• have registered a relevant authorization document with a Regional Branch of the National Health Fund and can present the certificate of registration.

The range of benefits and the eligibility requirements are determined by the Polish legislation.

These patients are bound by the same rules as Polish patients, including:

• a requirement to present a referral when needed
• appointment queues.

Planned healthcare

Healthcare provided to EU/EFTA/UK patients on the basis of S2/E112 form.

It can be accessed under the same conditions and costs as those available to Polish patients insured under the national health service.

The patient must always obtain prior approval from the national health insurance institution of their Member State of affiliation.

Planned healthcare related to accidents at work and occupational diseases

Healthcare provided to EU/EFTA/UK patients on the basis of DA1/E123 form under conditions that are reserved for cases of accidents at work and occupational diseases.

Healthcare equivalent to the guaranteed benefits available to the patient under the social security legislation of their Member State of affiliation.

EU/EEA patient may access healthcare in Poland when:

• obtaining healthcare is the primary purpose of their stay

or

• the need for care arises during their stay.

The following healthcare is excluded:

• public vaccination programmes against infectious diseases which aim at protecting the health of the population of a Member State
• long-term care services to support people in carrying out routine everyday tasks
• allocation of and access to organs for transplantation.

EU/EEA patient receiving cross-border healthcare in Poland should:

• • be treated as a private patient
• • receive healthcare on the same terms as any other private patient using the services of a given medical facility or pharmacy.

Documents required to confirm entitlement to healthcare in Poland

Documents confirming entitlement to healthcare, which a patient must present in Poland to be granted access:

• a valid European Health Insurance Card (EHIC), or, in the absence of it, a Provisional Replacement Certificate (PRC) – for medically necessary healthcare
• S1/S072/E106/E109/E120/E121 form – for full range of healthcare benefits
• S2/E112 form – for planned healthcare
• DA1/E123 form – for planned healthcare reserved for cases of accidents at work and occupational diseases
• S3 form – for continuation of treatment for a retired frontier worker.

If a patient fails to present the appropriate document, they will be obliged to pay the full cost of treatment directly to the medical facility.

Before seeking healthcare in Poland, patients should research the following:

• the conditions of reimbursement for medical expenses as specified by their Member State of affiliation.
• documents required when submitting a reimbursement request.

For detailed guidance, please consult a relevant National Contact Point in an EU/ EEA country.

Medical facilities and pharmacies that can be accessed

Only medical facilities that:

• provide healthcare services within the public healthcare system operating in Poland

or

• are contracted/affiliated with the National Health Fund for the provision of healthcare services.

For detailed guidance on whether a particular medical facility operates within the public healthcare system contact:

• the NFZ
• he National Contact Point
• the medical facility.

All medical facilities that:

• operate within or outside the public healthcare system in Poland
• are licensed to provide healthcare under the Polish legislation.

For detailed guidance on whether a particular medical facility operates within the public healthcare system contact:

• the NFZ
• the National Contact Point
• the medical facility.

Important:

If an EU/EEA patient has received healthcare in a private facility, i.e. a facility operating outside the public healthcare system, their access to healthcare can only be based on the CBFC Directive.

Reimbursement and costs

The costs of healthcare provided to EU/ EFTA/UK patients in Poland are settled directly between the healthcare provider and the health insurance institution of the their Member State of affiliation.

A patient is responsible only for the applicable co-payment, that is the portion of the medical costs that, under Polish law, is typically borne by local patients.

In exceptional situations, EU/EFTA/UK patients will be required to cover the costs of their treatment directly at a medical facility, if:
• at the time of receiving treatment they are unable to produce the appropriate documents confirming their entitlement to healthcare in Poland:

• a valid European Health Insurance Card (EHIC)

or

• a Provisional Replacement Certificate (PRC)

• received planned treatment but do not hold an S2/E112 form
• received healthcare in a medical facility that:

• o operates outside the public healthcare system
• o is not contracted/affiliated with the National Health Fund for the provision of the granted healthcare.

EU/EEA patients must initially cover the full cost of their healthcare.

Patients settle the bills issued by the Polish medical facility that provided the care, ensuring that the billed amount adheres to the facility's standard price list for all private patients.

Afterwards they may apply to their health insurance institution for reimbursement of the incurred expenses.

Before seeking healthcare in Poland, patients should research the following:

• • the conditions of reimbursement for medical expenses as specified by their Member State of affiliation.
• • documents required when submitting a reimbursement request.

For detailed guidance, please consult a relevant National Contact Point in an EU/ EEA country.