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“To your health!” How does really health insurance works? Posted by on Oct 8, 2013 in Regulations

Last time I wrote a little bit about how insurance works in Poland. I have to say that when I moved to USA, I was shocked when I found out details about health insurance here…

So today I wanted to get some more details about health insurance in Poland.

Citizens of all countries should buy themselves appropriate assurance before going to Poland. While crossing the Polish border no protective inoculations are needed. Water from the faucet is safe to drink, although most of tourists prefer bottled mineral water. Polish drugstores are equipped with drugs of all kinds. In the cities it is possible to communicate with the personnel in English or German. Having prescriptions from the country of residence will certainly facilitate buying necessary drugs. In every city there is at least one drugstore open 24 hours a day. The addresses of the drugstores can be found in local press. With more serious problem you should go to a hospital, which will do any necessary explorations and will render any necessary help. In larger cities also function (much more expensive than hospitals) private clinics.

During a temporary stay in Poland, a person entitled to health care can receive health services in the following areas:

✺ primary health care

✺ specialist out-patient care

✺ hospital treatment

✺ dental treatment

✺ rescue services and ambulance transport

In case of necessity of providing health care, a person from a member country entitled to health care, staying temporarily in the territory of Poland, is entitled to free health care on the basis of form E-111 issued in his country, European Health Insurance Card (EHIC) – Europejska Karta Ubezpieczenia Zdrowotnego, and in particular cases, also on the basis of a certificate. Holder of one of these documents will receive free health services at health care providers who have concluded a relevant contract with NFZ.

In case of lack of these documents patient will be obliged to cover costs of treatment by himself. The same obligation arises in case of treatment provided by a health care unit which has no contract with National Health Found.

In each case health care providers or pharmacists require submitting a copy of a form E-111, EHIC or a certificate.

Health care providers are obliged to provide services as soon as possible and to make a list of persons awaiting the treatment. In case of sudden illness, injury, intoxication, life threat or childbirth the admission is immediate.

A person entitled to health care can receive health services directly in the field of primary health care and dental care. In case of specialist out-patient care a referral of the doctor who practices within the health care system is required, and in case of hospital treatment – a referral of any doctor. In case of emergency a person entitled under EEA rules can directly go to a specialist, to a hospital or receive rescue services and ambulance transport in the territory of Poland.

Primary health care

A person entitled to health care who presents form E111 issued by the competent institution, the European Health Insurance Card or a certificate, receives free health services within the general health care system. A doctor, who practices within the health care system, can refer the patient to the diagnostic tests in order to confirm the preliminary diagnosis and to confirm that the referral to a specialist or to a hospital is necessary.

Specialist out-patient care

In case of need of out-patient specialist treatment a referral of the doctor who practices within health care system is required. No referral is required to following specialists:

✺ gynecologist and midwife

✺ dentist

✺ dermatologist

✺ venerologist

✺ oncologist

✺ ophtalmologist

✺ psychiatrist

and for following persons:

✺ suffering from tuberculosis

✺ infected with HIV

✺ addicted to alcohol, stupefacient and psychoactive substances – in case of recovering treatment

✺ in case of sudden illness, accident, injury, intoxication, life threat a patient receives necessary medical benefits

A patient who presented form E-111 issued by his competent institution or EHIC or a certificate receives free health services within the general health insurance system.

Dental treatment

Majority of the costs of health services related to dental care is covered by insured persons from their own means.

Hospital treatment

If there is a need of hospital treatment, a doctor’s referral is required. In case of sudden illness, accident, injury, intoxication, life threat, a patient receives necessary medical benefits without referral. A patient who presented form E-111 issued by his competent institution, European Health Insurance Card or a certificate, receives free dental services within the general health care system.

Rescue services and ambulance transport

In case of accident, injury, childbirth, sudden illness or sudden deterioration of the state of health, a person entitled to health care under EEA rules, can receive in the territory of Poland free rescue services and ambulance transport on the basis of form E-111 issued by the competent institution, European Health Insurance Card or a certificate.

Medicines and medicinal products

An insured person or a person entitled under the EEA rules is provided with medicines or medicinal products on the basis of a prescription issued by a doctor who practices within the health care system or a doctor who does not practice within this system, but has concluded a contract with the Fund authorizing him to issue prescriptions.

Prescriptions can be redeemed in generally available pharmacies on presenting the form.

Do następnego razu… (Till next time…)

 

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About the Author: Kasia

My name is Kasia Scontsas. I grew near Lublin, Poland and moved to Warsaw to study International Business. I have passion for languages: any languages! Currently I live in New Hampshire. I enjoy skiing, kayaking, biking and paddle boarding. My husband speaks a little Polish, but our daughters are fluent in it! I wanted to make sure that they can communicate with their Polish relatives in our native language. Teaching them Polish since they were born was the best thing I could have given them! I have been writing about learning Polish language and culture for Transparent Language’s Polish Blog since 2010.


Comments:

  1. Amandaa:

    I think that there are many good hospitals in Poland for ex. in Warsaw. One of them is the American Clinic. It is graet place for Polish and foreigners, because the staff speaks fluent in many languages. Besides there are accepted medical insurance from all of the world. Each patient gets there his privet tudor, who takes care about him from the first day in the clinic. Furthermore doctors are highly skilled and they work on the highest quality equipment.