WHAT IS HEALTH INSURANCE?
Health insurance is a special form of coverage that entitles you to government-provided health benefits. These benefits are intended to preserve health, protect against the effects of disease and provide medical treatment. Polish law distinguishes the following types of health insurance:
It is worth noting here that the state insurance – that is, those whose package is offered by state institutions (ZUS, NFZ) – includes not only health insurance. A full insurance package (the so-called ZUS premium) includes:
Social insurance package (pension, disability, sickness and accident insurance premiums),
Labour Fund contribution.
People who are covered by public health insurance can receive all public health care services free of charge. This is because public treatment is financed by Social Insurance contributions, and these funds are at the disposal of the National Health Fund.
Those who are not covered by health insurance, however, may only use basic health care services. However, they will have to pay for a visit to a specialist.
Mandatory health insurance in Poland was first introduced under the Act on Universal Health Insurance of 6 February 1997, which is no longer in force. This document came into force at the beginning of 1999. Its consolidated (although repealed) content can be found in the Journal of Laws No. 28 for the year 1997, under item 153.
At present, the legal act, which specifies the originally established guidelines on state health insurance, is the Act of 27 August 2004 on health care services financed from public funds. This document has a consolidated text, the text of which can be found in the Official Gazette No. 210 for 2004, under the entry 2135.
The following shall be entitled to use health care services financed from public funds under the rules laid down in this Act
1) persons covered by universal – compulsory and voluntary health insurance, hereinafter referred to as “the insured”,
2) persons other than the insured who have their place of residence in the territory of the Republic of Poland, who have Polish citizenship or have been granted refugee status or subsidiary protection in the Republic of Poland, or a temporary residence permit […].
3) persons other than those mentioned in points 1 and 2, who are under 18 years of age:
a) who have Polish citizenship or
b) who have obtained in the Republic of Poland the refugee status or subsidiary protection, or a temporary residence permit […];
HEALTH INSURANCE FOR EMPLOYEES
Polish citizens may, must or may not be covered by state health insurance. It all depends on their form of employment.
Form of employment and health insurance
Employees in the strict sense (those earning money on the basis of an employment contract) and Contractors are by definition covered by the obligatory health insurance. The issue of social security contributions is more complicated, but for the purpose of today’s article – irrelevant.
Contractors of work, i.e. persons who earn money on the basis of a contract for work are not subject to any contributions. This means that if they do not have any other title of insurance (due to, for example, studying or being subject to an employment relationship), they are not able to benefit from state medical care (except for Primary Health Care).