Medicine in Poland.
In Poland, the General Health Insurance Act of 01/01/1999 applies. The basic conditions for the provision of medical services to citizens of the country and foreigners, as well as the system of state (publicznej) and private (niepublicznej, przywatnej) medical practices are as close as possible to those that operate throughout the EU.
Medical assistance in the Republic of Poland can be obtained both in public medical institutions, and in private clinics and medical offices. The basic (podstawowe) medical services are Polish citizens and legally working foreigners receive free of charge – under compulsory medical insurance, contributions to which are deducted from wages. In the country, along with compulsory voluntary medical insurance, which can be treated in public and private clinics (klinikach), polyclinics (przychodniach), hospitals (szpitalach) not only at the place of permanent residence / registration, but also in patients chosen by the patient or his specialized institutions. It should be noted that in the struggle for the client insurance companies of the RP very often resort to the application of discounts both for their services and for the size of insurance premiums. Almost every insurance company with great pleasure signs agreements on cooperation with diagnostic and medical institutions through the People’s Health Fund (Narodowego Funduszu Zdrowia – NFZ).
The following categories of the population can purchase the insurance policy of a Polish company operating in the territory of the country:
citizens of Poland; citizens enjoying refugee status; Citizens who received temporary protection in Poland; owners of the Map of the Pole; owners of Maps of Stay (Karty Pobytu) – temporary and with the right to settlement (czasowego i z prawem osiedlenia sie). foreign students; Monks and novices, who are here legally; Foreigners who pass training after graduating from a Polish university.
The services of medical institutions, the cost of which can be covered by the insurance company, are always indicated in the text of the contract with the insurance company (policy). If long-term treatment is anticipated, & # 8212; it is necessary to calculate in advance how much time and which procedures / operations the insured amount will allow. In Poland, insurance companies (more precisely, their policies) are not very different from those that work in the post-Soviet countries. Those. try as little as possible to pay for the treatment of their client. Practice shows that when lingering illnesses / treatment, insurers often go to court to protest the bills for large sums exposed to them by medical institutions. But Poland is a country in which legislation operates. That is why very rarely insurance companies win such claims. Play a medical institution can only in cases where the cost of services provided to the client of the insurance company will be significantly overstated. The word “essential” is & # 8212; key. The difference in prices for the procedure of 20-30 zl or for an operation – in 500-800 zl is not considered significant.
Family members of the insured under the mandatory insurance of employees of firms / private entrepreneurs of residents and non-residents (citizens of the country and foreigners) are also entitled to use insurance policies of policy holders. Those. spouses, children and elderly parents who are under official care or if they are in a common household with the insured, can pay for their treatment through the compulsory insurance policy of their nearest relative.
Contributions to the fund of the Social Insurance Administration (Zakladu Ubezpieczen Spolecznych – ZUS) for the employee are obliged to transfer employers, and in case of job loss – local (concerning residence) Employment Center (Urzad Pracy). In the card of registration of the unemployed, the employee of the Employment Center contributes to all family members who have the right to use the general with unemployed insurance. The citizens of Poland and holders of the Residence Card – on settlement (Karty Pobytu & osiedlenie sie) have the right to register for unemployment as well.
After dismissal from work or death of the insured member of the family, the right to use his health insurance policy is valid for another 30 calendar days.
The choice of the first contact physician (district therapist / family doctor) to which the insured wishes to apply, & # 8212; you can choose at your own discretion. To do this, fill in the form of the Druck Declaration (druk Deklaracji wyboru), where the patient’s personal data, personal identification code (PESEL), insurance card number, number of the Provincial Office of the People’s Health Fund (oddzialu wojewodzkiego Narodowego Funduszu Zdrowia), information about that time This year the doctor / nurse, the date of filling in the form and the patient’s signature are selected. You can change the doctor or nurse for free 2 times a year. For each subsequent change you have to pay 80 zl. The patient who has changed the place of residence and in case the employer has changed the corporate doctor / nurse is released from payment.
The first contact physician is responsible for examining the patient and, if necessary, writing a referral for the examination or referral to a specialist doctor. If the patient is able to pay for the services of a specialized doctor himself, & # 8212; it is possible to not address to the therapist.
Without a preliminary visit to the district therapist, you can get to the doctors:
Obligatory insurance can also be used by tourists who have received a visa of any category in Poland. It should be taken into account that no visa for citizens of countries with which the RP does not have a visa-free travel agreement is issued without prior purchase of medical insurance for the period of planned stay in the country. Buying an insurance policy, every foreigner gets the right to go to any hospital / clinic (szpital / przychodnie) in case of emergency to obtain the necessary medical care. In this case, you need to present an insurance / policy agreement or specify the exact details of the insurance company with which the contract was signed (the policy was bought out) before applying for a visa. Tourists will be provided with medical assistance, and the payment will be paid to the hospital / polyclinic (szpitalu / przychodni) insurance company. In this case, the invoice is issued with a grace period of at least 30 days from the day the patient is discharged.
The payment procedure is as follows:
1. The account submitted to the address of the insurance company must be translated into the official language of the country where the policy was purchased / an insurance contract was signed. 2. Provide this advance and the account itself to the insurance agent, who is the representative of this insurer. 3. Receive a receipt about the delivery of the account to the insurer.
In the event that the illness is delayed or a lethal outcome occurs, all actions are carried out by the nearest adult relative of the insured person.
It is extremely important to know that treatment on the territory of Poland is also possible with the use of compulsory car insurance – in the event that the cause of the illness / injury is a road accident. In this case, it does not matter whether the victim himself is insured – the funds for treatment, with proper registration of documents, will be transferred from the account of the insurer, where the driver of the car that caused the accident was insured. In this case, not necessarily the presence of insurance against accidents, but rather the so-called auto-tsivilki (OS – odpowiedzialnosc cywilna). In this case it is necessary to collect:
& # 8212; the first protocol from the accident site, issued by the traffic police (przez policje drogowa);
& # 8212; an extract about the first contact with the doctor, i.�. act issued by the ambulance (pogotowie ratunkowe);
& # 8212; insurance number, state numbers, driver’s name;
& # 8212; a completed application for the name of the insurance company to cover the damage – physical and moral (except for the financial costs incurred for treatment, it is necessary to include the amount for the moral damage inflicted – everyone has the right to determine it at his own discretion).
Amounts up to 20 thousand zlotys, usually, are paid almost instantly – up to 3 working days. If the account from the hospital inclusive with the amount for damage does not exceed 50 thousand zlotys – the issue is considered the chief manager in the regional branch of the insurance company. But in the case of going beyond this amount, & # 8212; we must reckon with the fact that litigation is possible. It will be necessary to enlist the support of a legal adviser or lawyer. The cost of legal services is also reimbursed by the insurance company. In case of serious bodily injuries and long-term treatment from the same insurance, the victim may receive a disability pension (renta).
In such cases, the citizenship of the victim does not matter. More than 30% of the victims turn to the insurance company, from the policy of which the payment is paid for the treatment of the victims in the accident, again. It’s legal. The insurance policy of the culprit of the car accident is to cover the costs of repairing the property and treating the injured, and to finance the treatment of the complications that have arisen after the accident.
Medicine in Poland.