The National Health fund orchestrates the state health insurance scheme in Poland, under the Ministry of Health and the regional governments. You will need to register with a local health insurance provider contracted to the NFZ: they will exhibit the NFZ logo if they are signed up with the national scheme.

Coverage is intended to be universal and the Polish government extends free healthcare to vulnerable groups such as young children, pregnant women, disabled people and the elderly. In practice, however, many Polish residents take out private cover.

Once you are registered with the NFZ you will be able to access primary and secondary public healthcare services: you may need your GP’s referral for some specialist consulations. You will need to take your insurance card, an insurance card for family members, or a pension card, and check that you have the documentation that you need to put in a claim for reimbursement.

Everyone who is paying contributions into the national scheme will be covered, as well as some vulnerable groups, such as low wage earners. As an expat, if you are paying contributions and you have a residency permit, you will be automatically covered by the NFZ.

Your employer should sign you up, but be sure to check that this has been done and that they are paying their share of contributions into the Social Insurance Institution (ZUS). You may have to make contributions directly, rather than payments being deducted at source.

You can also register with the NFZ on a voluntary basis. If you do so, you must register any uninsured family members with the ZUS after signing a voluntary health insurance agreement with the voivodship (your local branch of the NFZ). You will need to supply any of the following documentation that is relevant to you:

• a visa for work
• a temporary residency permit
• a permit to settle in Poland
• a long-term EU residency permit
• a permit for tolerated stay
• proof of refugee status issued in Poland, or proof of temporary protection in Poland

After signing a contract with the NFZ, you must fill out and submit the ZUS ZZA form at an appropriate ZUS branch or inspectorate.

Expats may also take out voluntary insurance through another health insurance company. For example, PZU offers Wojażer (Voyager) insurance for foreigners coming to Poland for a holiday, to study or to work.

NFZ coverage includes:

• GP visits
• visits to specialist doctors, after a consultation with a GP
• hospitalization: treatments, examinations and medicines are free
• private surgeries which have signed contracts with the NFZ

Prescriptions are charged at 100%, 50%, 30% or 0% of the total medicine cost. This depends on the product and your individual circumstances. Polish pharmacies are obliged to inform customers whether it is possible to exchange a prescribed medicine for a cheaper equivalent.

When using your EHIC, people of working age are charged 50% and pensioners are charged in the region of 10%.

Pensioners who are expats from Britain will have to declare that they receive a UK State Pension in order to pay the lower rate.

If you are caring for a child or an adult with a disability, you may also be entitled to carers’ benefits, for instance:

• nursing benefit (świadczenie pielęgnacyjne)
• special attendance allowance (specjalny zasiłek opiekuńczy)
• caregivers’ allowance (zasiłek dla opiekuna)

As a retiree you will be covered by the NFZ if you make voluntary contributions into the system, or if your home country has a reciprocal healthcare arrangement with Poland. If neither of these options apply to you, then you will need to take out private health cover.

Students will not be covered by state medical insurance, but if you are from outside the EU you may be able to make voluntary contributions into the NFZ. Otherwise, you will need to take out private cover and may be able to sign up for a policy specifically designed for international students. Consult with your educational provider to see if they recommend any specific private cover.

Your family will be covered under your insurance if you are registered with the NFZ. This includes:

• children (your own children, your spouse’s children, adopted children, grandchildren, and any other children for whom you are the legal representative or surrogate parent) – until the child turns 18, or until they turn 26 if they are in continuing education; if the child is certified as severely disabled there is no age limit
• spouse
• parents and grandparents - if they form one household with the insured person

You must register family members with the NFZ if they have no medical insurance; for example, if they are not working. In order to register a family member, their personal details must be given to your employer.

The national scheme covers some basic dental treatment, but this is extremely limited. There is also private provision available, for which you will need to take out private insurance or pay out of pocket. Poland is a destination for dental tourism: dental implants will cost on average €1,115; standard ceramic veneers will cost on average €247 per tooth; and tooth whitening procedures can be as low as €89, with crowns from around €630.

Your employer’s overall social security contributions will be 19.21% - 22.41% of your gross salary. This includes an accident insurance element that varies according to the number of employees insured and the business sector you are in. Your contribution rate will be 13.71% of your gross salary. Around 9% of this goes directly to health insurance: 1.2% paid by you, and 7.7% paid by your employer. The social security shares payable by the employer and by you will be tax-deductible.

If you are self-employed or making voluntary contributions, you will pay 9% for health insurance and ZUS will give you your own bank account number into which the contributions must be paid.

Healthcare in Poland is often of a high standard. The country is a destination for medical as well as dental tourism — especially in the areas of cosmetic surgery, orthopaedic, gynaecology and cardiac surgery — particularly in urban areas, but hospitals can have long waiting lists. For swiftness of access to diagnosis and treatment, and better facilities, many expats opt for private health cover.

A full range of primary and secondary healthcare will be covered by private plans. Check your policy for any treatment needs that are specific to you.

You may also opt for out-of-pocket payments in private clinics; some average costs are below:

• hip replacement €5549
• knee replacement €5782
• gastric bypass €6425
• mastectomy €1542
• abdominoplasty €2421
• breast reduction €1273
• breast implants €1577

This will depend on factors such as your age and any pre-existing conditions, and the kind of package you opt for; a more expensive insurance package will give you more a extensive range of treatment and facilities. As so many variables have an effect on the cost of international private medical insurance in Poland, it becomes very difficult to give accurate estimates without knowing the full details of the coverage required. However, as a very rough guide, using a standard profile of a 40-year-old British male with no deductibles, no co-insurance, a middle-tier plan, all modules included and worldwide coverage excluding the US, a ballpark price of around £4,000/$5,000 might be expected. Were coverage to be expanded to include the US then the premium could increase to almost double that amount.

Many of the large international health providers cover Poland, including:

• BUPA
• Cigna Global
• EURAXESS
• Foyer Global
• Lux Med
• Pacific Prime

Narodowy Fundusz Zdrowia (NFZ) - the Polish national health insurance scheme

specjalny zasiłek opiekuńczy - special attendance allowance

świadczenie pielęgnacyjne - nursing benefit

zasiłek dla opiekuna - caregivers’ allowance