Lubelski Oddział Wojewódzki Narodowego Funduszu Zdrowia

The Act of 27 August 2004 on healthcare services financed from public funds (Dz.U. [Journal of Laws] of 2015 item 581 as amended) provides uninsured people with the opportunity to arrange voluntary health insurance pursuant to art. 68 of the abovementioned Act.

A person covered by the voluntary health insurance is entitled to use healthcare services on the same principles as any other person covered by compulsory insurance in the National Health Fund.

Failure to arrange health insurance may result in high costs arising from healthcare services provided in case of illness or the necessity to receive immediate medical help.

1. Who can conclude an agreement for voluntary insurance in the National Health Fund

Persons who are not entitled to any insurance may conclude an agreement for voluntary insurance. This group includes:

• Polish citizens residing on the territory of Poland who are not subject to compulsory insurance and not subject to a family member’s insurance;

• an employee on unpaid leave;
• persons suspending business activity under the regulations on  the freedom of business activity;
• citizens of European Union member States and of member States of the European Free Trade Association (EFTA) who are not subject to compulsory health insurance on other grounds, if they reside within the territory of Poland;
• foreigners residing on the territory of the Republic of Poland on the basis of a visa for the purpose of performing work activities, a residence permit for a fixed period of time, excluding the permit issued pursuant to art 181, par. 1 of the Act of 12 December 2003 on foreigners, a permanent residence permit, a residence permit for a long-term resident of the European Communities, a residence permit granted for humanitarian reasons, a permit for tolerated stay;
• persons who have been granted refugee status in the Republic of Poland or subsidiary protection or persons eligible to temporary protection on this territory;
• foreigners – students and participants in PhD studies studying and living in the Republic of Poland, and graduates who are undergoing mandatory traineeship in Poland and who are not citizens of European Union member States or of member States  of the European Free Trade Association (EFTA);
• foreigners – members of religious orders and alumni of clerical and theological seminaries, postulants, novices, and junior monks of religious orders or their equivalents, who are not citizens of European Union member States or of member States of the European Free Trade Association (EFTA); residing on the territory of the Republic of Poland on the basis of a visa, a residence permit for a fixed period of time, a permanent residence permit, a residence permit for a long-term resident of the European Union, a residence permit granted for humanitarian reasons, a permit for tolerated stay or persons who have been granted refugee status in Poland or subsidiary protection or persons eligible to temporary protection on this territory;
• persons undergoing an adaptation period internship;
• persons taking a Polish language course or a  preparatory course for studying in Polish, referred to in the regulations on higher education, who are not citizens of European Union member States or of member States of the European Free Trade Association (EFTA);
• volunteers registered for health insurance by a person eligible for health insurance, if they are not covered by other insurance;

2. How to sign for voluntary health insurance in the National Health Fund In order to conclude an agreement for voluntary health insurance, you have to visit the relevant Health Fund Branch competent for the place of residence, where you file an "application for voluntary health insurance coverage by the National Health Fund" as well as  a declaration on your insurance status. You need to attach a document confirming the last period of insurance (e.g. a copy of ZUS ZWUA form, decision on the loss of the unemployed status, certificate from the contribution payer, certificate of employment, E-104 form, etc.) and you have to produce an identity document. In addition, in case of agreements concluded by third parties acting on behalf of the person who wishes to become insured, it is necessary to submit a power of attorney or authorization to undergo talks and activities in order to conclude the agreement.

Pursuant to art. 68 of the Act of 27 August 2004 on healthcare services financed from public funds (Dz.U. of 2015 item 581, as amended) persons covered by voluntary health insurance (listed below) are not required to present documents confirming the last period of health insurance, as they are not subject to additional charge, notwithstanding the length of break in insurance. This group includes:

 -  students and participants in PhD studies, studying and living in Poland, graduates and trainees who are not citizens of EU/ EFTA member states,

-  members of religious orders and alumni of clerical and theological seminaries, postulants, novices, and junior monks of religious orders or their equivalents, who are residing in Poland and are not citizens of EU/ EFTA member states,

- persons undergoing adaptation period internship,

- persons taking a Polish language course or preparatory courses for studying in Polish, who are residing in Poland and are not citizens of EU/ EFTA Member States.

2.1 Documents, which are the basis for concluding the agreement: - a citizen of the EU/EFTA Member State not subject to compulsory health insurance in Poland or any other EU/ EFTA member state

• an identity document (ID card, passport)
• a document confirming the last period covered by health insurance (e.g. a copy of ZUS ZWUA form, decision on the loss of the unemployed status, certificate from the contribution payer, certificate of employment, E-104 form, etc.)
• document confirming the place of residence in the territory of the Republic of Poland.

-persons who are not citizens of the EU/ EFTA member states:

• an identity document (ID card, passport)
• residence permit for a fixed period of time or permanent residence permit or a residence permit for a long-term resident of the European Union, a permit for tolerated stay or a residence permit granted for humanitarian reasons or a visa for the purpose of performing work activities.

- students and participants in PhD studies, who are not citizens of EU/EFTA member states:

• an identity document (passport, residence card)
• PESEL [National Identification Number] (if any),
• a university certificate confirming studies
• a document confirming residence on the territory of the Republic of Poland,

- members of religious orders and alumni of clerical and theological seminaries, postulants, novices, and junior monks of the religious orders and their equivalents, who are not citizens of EU/ EFTA member state:

• an identity document (passport, residence card)
• PESEL number (if any),
• a certificate confirming membership in a religious congregation,
• a document confirming residence in the territory of Poland

- persons undergoing an adaptation internship, who are not citizens of EU/ EFTA member state:

• an identity document (passport, residence card)
• PESEL number (if any),
• an internship/training obligation agreement,
• a document confirming residence in the territory of Poland

- foreigners - persons taking a Polish language course or preparatory courses for studying in Polish,

• an identity document (passport, residence card)
• PESEL number (if any),
• a certificate confirming course attendance
• a document confirming residence in the territory of Poland.

A person who has concluded an agreement for voluntary health insurance is obliged to register for insurance the family members who are not subject to health insurance obligation on other grounds. Family members registration for insurance does not involve any additional fees.

The following persons are considered to be family members:

• own child, child of the other spouse, adopted child, grandchild or a child for whom custody has been established, or a foster child under 18, or, if they are continuing their education, under 26. If the child has a certificate confirming a significant degree of disability or other equivalent certificate, there are no age restrictions;
• spouse;
• ascendants living together with the insured person in the same household

This obligation does not concern foreigners - students, or participants in PhD studies or graduates who are undergoing mandatory adaptation period internship, or take part in Polish language course or preparatory courses for studying in Polish, as well as members of religious orders, alumni of clerical and theological seminaries, postulants, novices, or junior monks of religious orders or their equivalents, persons undergoing an adaptation internship.

2.2 The obligations of the insured arising from signing the agreement

• registering for a health insurance policy in the Social Security Agency (ZUS) with a ZUS ZZA form
• registering one's family members listed in the application for insurance with a ZUS ZCNA form,
• paying the insurance contribution up to the 15th of the next month for the previous one,
• updating the contribution rate according to the changing base.

2.3 The voluntary health insurance agreement may be terminated:

• via resignation in writing sent to NFZ Branch
• after a month of perpetual default in covering contributions,
• due to transferring of the residence of the insured outside the territory of Poland

• on the day of the Branch Director’s decision on relevant legislation coming into force pursuant to the regulations on coordination determining the relevance of legislation of another EU member State or EFTA member State - Parties to the European Economic Area Agreement.

2.5 Rights of the insured person arising from the agreement: A person who has signed a voluntary insurance, together with their family members, become entitled to health benefits on the date specified in the agreement; this right expires on the date of agreement termination or after a month of perpetual default in covering the contributions.

2.6 Insurance document entitling to healthcare services: The agreement, together with evidence of paid contribution for the previous month, constitute the evidence of insurance for the person with voluntary health insurance and their family members. Please note that application forms (ZUS ZZA, ZUS ZCNA) submitted to ZUS constitute an integral part of the agreement. Please keep one copy of the agreement.

3. The contribution rate for a voluntary health insurance in 2019.

The contribution rate for voluntary health insurance in 2019 amounts to 9% of the contribution assessment basis.

2019	January, February, March	April, May, June	July, August, September	October, November, December
Contribution assessment basis for voluntary health insurance	PLN 5,071.41
Contribution rate for voluntary health insurance	PLN 456.43
Contribution basis for foreign students	PLN 620.00
Contribution rate for foreign students	PLN 55.80

The contribution for voluntary health service is to be paid to the ZUS account.
 

4. Additional charge rate

A person who has signed for voluntary insurance, and who had experienced an interruption to their health insurance coverage is obliged to pay a one-time fee for the non-contributory period. Its rate depends on the length of the period in which the person was not covered by health insurance.

2019	January, February, March	April, May, June	July, August, September	October, November, December
20 % of the contribution assessment basis for the persons with 3 months -1 year interruption to health insurance	PLN 1,014.28
50 % of the contribution assessment basis for the persons with a year up to 2 years interruption to health insurance	PLN 2,535.71
100 % of the contribution assessment basis for the persons with a 2- 5- year interruption to health insurance	PLN 5,071.41
150 % of the contribution assessment basis for the persons with a 5-1- year interruption to health insurance	PLN 7,607.12
200 % of the contribution assessment basis for the persons with  over 10-year interruption to health insurance	PLN 10,142.82

 

An additional charge is paid before signing the agreement to the Voivodeship Branch of the NFZ account given on the agreement form.

In justified circumstances, at the request of the person concerned, NFZ may withdraw from charge or spread the payment into monthly instalments (maximum 12 instalments). The fee for persons with a break in health insurance lasting from three months to one year cannot be spread into instalments.

In order to withdraw from the charge, NFZ should be provided with documentary evidence for:

• difficult financial position,
• family circumstances,
• health condition,
• other circumstances indicating a difficult living situation.

 On the day stipulated in the agreement, the insured person and family members registered for insurance gain entitlement to health insurance services. Monthly health contributions constitute the basis of entitlement to health insurance benefits, in accordance with the voluntary insurance agreement.

Downloads:

• APPLICATION FOR VOLUNTARY HEALTH INSURANCE IN THE NATIONAL HEALTH FUND
• VOLUNTARY HEALTH INSURANCE - AGREEMENT