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Health care in Poland Basic principles Poland has the health care system based on general health insurance. Polish health care system Persons covered by the general health insurance (on the compulsory or voluntary basis) are entitled to free health services in the territory of Poland. Rules of the general health insurance are provided in the Law of 23 January 2003 on the General Insurance in the National Health Fund (Official Journal 03.45.391, with later amendments).
An insured person and members of his/her family are entitled to free health services in case they receive these services at health care providers who have concluded contracts on providing health services with the regional branch of the National Health Fund (NFZ). The contract on providing health services specifies the kind and the scope of the services contracted by the given health provider with the National Health Fund. Health care providers who have a contract on providing health services can be identified by a board with NFZ logo situated outside the building in the noticeable place.
The information on the health care providers who have concluded contracts with NFZ is available in the competent regional branch office of NFZ.
Besides, every health care provider who practises within the general health insurance system is obliged to impart information on the other health providers who provide services on the basis of the contracts concluded with the regional branch of the NFZ. Institutions of the general health insurance system in Poland The National Health Fund is the institution, which is responsible for assuring health services for insured persons and members of their families. The Fund finances health services and assures refund of medicines within assigned financial means. The National Health Fund is composed of: - Head office of NFZ
- 16 regional branches of NFZ established in accordance with the territorial division of the country.
Public and non-public health care providers who have concluded contracts with the competent regional branch of the National Health Fund are obliged to provide services within the general health insurance system. Health care providers are above all: doctors who practise within the health care system (doctors, dentists), public and non-public health units (hospitals, first aid stations, dispensaries, health centres), out-patient clinics (individual, individual specialist, group). Access to health care in Poland during a temporary stay During a temporary stay in Poland, a person entitled to health care under EEA rules 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) 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 NFZ. 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 practises 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 under EEA rules 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 practises 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 practises within health care system is required. No referral is required to following specialists: - gynaecologist and midwife,
- dentist,
- dermatologist,
- venerologist,
- oncologist,
- ophtalmologist,
- psychiatrist,
and for following persons: - suffering from tuberculosis,
- infected with HIV,
- war invalids,
- addicted to alcohol, stupefacients and psychoactive substances - in case of recovering treatment.
and in case of sudden illness, accident, injury, intoxication, life threat a patient receives necessary medical benefits. A patient who presented form E111 issued by his competent institution or European Health Insurance Card 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.
A patient who presents form E111 issued by his competent institution, European Health Insurance Card or a certificate receives free dental services within the general health insurance system only in the restricted scope specified in the Regulation of Minister of Health of 18 June 2003 (Official Journal 03.115.1088). 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 E111 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 practises within the health care system or a doctor who does not practise 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.
Prescribed medicines can be purchased: - for a lump-sum price (basic medicines and medicines made on recipe),
- for 30 or 50% of the price of a medicine (supplementary medicines).
Polish institutions committed with the coordination of social security systems in the field of health benefits in kind - Competent authority - The Minister of Health
- Liaison body - according to the Polish proposal contained in the project of the Annex to the Regulation No. 574/72, after the approval of the European Commission, the Head office of the National Health Fund will be the liaison body
- Competent institution - according to the Polish proposal contained in the project of the Annex to the Regulation No. 574/72, after the approval of the European Commission, the regional branches of the National Health Fund will be the competent institution.
Teleaddress data of the liaison body Centrala Narodowego Funduszu Zdrowia - Biuro Współpracy Międzynarodowej
(Head office of the National Health Fund - The International Cooperation Office)
ul. Grójecka 186
02-390 Warszawa
tel. +48 (22) 572-60-36, +48 (22) 572-60-36, +48 (22) 572-61-12
fax +48 (22) 572-63-30. Aby dodać komentarz zaloguj się. Jeśli nie masz konta, załóż je sobie.
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