Insured in the National Health Fund: employees, school children, students, unemployed individuals

The right to NHF health care benefits is conditioned by being filed for health insurance.

Who files for insurance

The premium payer files for health insurance, e.g. the employer files the employee, the district employment office files a registered unemployed individual, the Social Insurance Institution files a retiree, and an individual with own business activity files on his or her own.

The information on the insured individuals, paid health insurance premiums, and entitled family members filed for insurance is collected by the Social Insurance Institution (ZUS) and the Agricultural Social Insurance Fund (KRUS).

Based on this information, the National Health Fund maintains the Central List of Insured Individuals (CWU). This, in turn, is the basis for the operation of the eWUŚ system (electronic verification of beneficiaries’ rights). Thanks to this system, when making a doctor’s appointment, the patient only provides his/her personal identification number (PESEL) to confirm the entitlement to NHF benefits online.

Employees

In the case of employees, the employer is the one paying the premium, which is 9 percent of the employee’s income, i.e. the gross remuneration less social insurance premiums.

The level of the health insurance premium is not affected by the number of family members filed for insurance.

Individuals with their own business activity

The grounds for the premium value to be paid by people with their own businesses is a declared amount, which cannot be lower than 75 percent of the monthly remuneration in the enterprise sector, including dividends from profit in the fourth quarter of the preceding year.

The premium is 9 percent of the value.

Children, school students

All children holding Polish citizenship under 18 years of age are entitled to NHF health care benefits without the need of having health insurance. However, this does not exempt parents from the obligation to file their children for health insurance as family members. This should be done no later than 7 days after the child was born.

If parents plan on changing jobs, they must inform the new employer of their family members; the filing with the previous employer is not sufficient.

If neither parent is entitled to the benefits, the child may be filed for health insurance by his/her grandparents.

Students

In order to be entitled to health care benefits, students must be filed for insurance, e.g. by their parents. The application can also be filed by school or the entity conducting Ph.D. studies – on the condition that the student is not a family member of an insured individual and provides the declaration of not falling under mandatory health insurance.

Students who undertake a job while at university, will be filed for insurance by the employer. When the employment period ends, the student must be filed for insurance again by his/her parents or university.

Unemployed individuals

The unemployment status of an individual registered at an employment office provides entitlement to free-of-charge NHF health care benefits. The premium is paid by the employment office.