Dla Pacjenta

If, due to your health condition, it is necessary to carry out treatment or a diagnostic examination which cannot be carried out in facilities in Poland at present, you can apply for a referral for this treatment/testing to be carried out abroad.

The treatment you are planning can be carried out abroad in any specialist facility (either public or private). However, this treatment must be a guaranteed benefit in Poland, and it must be necessary to improve your health or save your life. If your application is successful, we will cover the cost of the treatment requested.

1. Application selection

The application is Appendix 2 to the Regulation of the Minister of Health on granting authorisation.

MODEL APPLICATION NO 2

2. Completing the application

The application is completed by you and the doctor, who must meet the conditions set out in the Act on healthcare benefits.

Complete Part I.B., Part II and Part VI of the application and sign in the required fields. These parts of the application can also be completed on your behalf by:

• a legal representative,
• a spouse,
• a blood relative or relative by affinity within the second degree lineal consanguinity,
• a cohabiting person,
• a person authorised by you – in this case attach a power of attorney to your application.

Then give the application to your doctor so that they can complete Part III of the application. The doctor who refers you for treatment abroad must be:

• a health insurance doctor, or, colloquially, ‘to treat on the National Health Fund’

(according to the definition: a health insurance doctor is a provider of healthcare benefits with whom the National Health Fund has concluded a contract on the provision of healthcare benefits, or a doctor who is employed or practises at a provider of healthcare benefits with whom the national Health Fund has concluded a contract on the provision of healthcare benefits),

• a consultant with a second degree specialty or a consultant in medicine relevant to the extent of the requested treatment or diagnostic tests,
• a specialist with the academic title of professor or the academic degree of doctor of medicine or postdoctoral degree in medicine.”

3. Adding attachments

The application must be accompanied by the following documents:

• a copy of the medical records (relating to the extent of treatment requested),
• Polish translation of medical records – if they are in a foreign language (they do not have to be translated by a sworn translator).

4. Submitting the application together with the attachments

The application together with the attachments should be submitted to Centrala NFZ, ul. Rakowiecka 26/30, 02-528 Warszawa.

You can also submit your application as an electronic document, signed either with a qualified electronic signature, a personal signature or a trusted profile. The required attachments may be represented in digital form.

5. Conducting an investigation

The procedure aims to confirm the coexistence of the following conditions:

• the treatment or diagnostic test cannot be carried out in the country,
• the treatment is a guaranteed benefit, i.e. it is included in the list of guaranteed benefits,
• the treatment is necessary to improve the patient’s health or save their life.

As a result of the investigation, the President of the National Health Fund issues a decision – granting or refusing to grant referral for treatment or diagnostic tests.

If, in the application, you have also indicated a request to cover the costs of transport to the place of treatment abroad, the President of the national Health Fund will decide in the same decision whether or not to agree to cover them.

Please note! If you go for a treatment authorised by the President of the National Health Fund and you need to be transported to Poland because of your state of health after the treatment, you may submit an application to cover the costs of your return transport to Poland. The application is Appendix 3 to the Regulation of the Minister of Health on granting authorisation.

MODEL APPLICATION NO 3

6. Appealing against the decision

The decision of the President of the National Health Fund is final – it cannot be appealed.

If you disagree with the decision, you can lodge a complaint with the administrative court. You must do this within 30 days from the receipt of the decision.

 

Legal bases

• Article 42j of the Act on healthcare benefits
• Regulation on granting authorisation
• Regulation on guaranteed benefits