Expat insurance and health insurance in Poland

Poland’s healthcare system rests on three actors: the Ministry of Health, which sets the legal framework; the National Health Fund (NFZ, Narodowy Fundusz Zdrowia), the single fund that finances care for insured people and negotiates contracts with public and private providers; and regional governments (voivodeships), which organise care provision in their territory. Cover is in theory universal for any affiliated resident, regardless of financial situation, but effective access to the contracted rate requires being personally registered as insured with the NFZ.

The basket of care funded by the NFZ is broad: primary care and emergencies, specialist outpatient and hospital care, certain advanced treatments, psychiatry and addiction treatment, rehabilitation, nursing and long-term care, part of dental care, spa treatments, and medicines and devices on the positive list. Partly or fully at the insured patient’s expense: dental treatments and materials beyond basic care, optical care, part of medicines outside the reimbursed list, spa treatments (flat-rate contribution) and certain long-term care. Insured status is checked in practice via the electronic eWUŚ system, consulted by healthcare facilities when care is provided.

• EU citizen: no visa required, free movement with a valid passport or ID card. Poland does not issue a residence permit to EU citizens for a stay of under 3 months.
• PESEL number: an 11-digit national identifier, to be requested from the municipal office (urząd) of the place of residence. It is required for almost all administrative procedures in Poland — opening a bank account, tax matters, a formal employment contract — including personal registration with the NFZ.
• NFZ affiliation: mandatory for any employee from the signing of the employment contract, with the employer declaring and deducting the contribution (about 9% of income) via the ZUS (Zakład Ubezpieczeń Społecznych) social security agency, which passes it on to the NFZ. A self-employed person registers and contributes directly with the ZUS, on a scale that varies with the chosen tax regime.
• Without a PESEL, NFZ affiliation or EHIC: care is billed at full rate by the facility, public or private, with no access to the contracted rate reserved for affiliated people.
• Student: the EHIC (EKUZ) is enough for a temporary stay (e.g. Erasmus); beyond that, registering with the Polish system or taking out student insurance as a supplement remains recommended during the administrative transition period.
• Seconded employee : up to 24 months (extendable), stays attached to the French scheme via form A1, exempt from NFZ affiliation.
• Retiree: form S1 from the French pension fund before departure, for cover by the Polish system with no new contribution of their own.

No fine is set as such for lacking a PESEL or NFZ affiliation, but the employer has a legal obligation to declare their employee; for the expat themselves, the risk is above all financial, during the administrative period needed to obtain the PESEL and then affiliation, with no help from the French embassy.

As Poland has been an EU member since 2004, there is no classic bilateral agreement with France: coordination runs through EU regulations 883/2004 and 987/2009, as with other member states.

• Temporary stay: the EHIC (EKUZ in Poland) gives the right to the same cover as a local insured person at providers contracted by the NFZ (consultations and hospitalisation with no cost-sharing, basic dental care included); if the card is forgotten or lost, a provisional replacement certificate (PRC), valid for 3 months, gives the same rights.
• Secondment: form A1, stays on the French scheme for up to 24 months (extendable), exempt from NFZ affiliation.
• Long-term move: PESEL number then NFZ affiliation (via the employer and ZUS for an employee, directly with ZUS for a self-employed person); form S1 for a retiree, covered by the Polish system with no new contribution of their own.
• The EHIC/EKUZ covers neither repatriation, nor planned care, nor a long-term move; on return, a stay not covered in advance may be reimbursed retroactively via form S3125, within the limit of actual costs.

1. Before departure: notify French agencies of your departure (CPAM, CAF, France Travail, pension funds).
2. Seconded employee: request form A1 from your French fund before departure.
3. Retiree: request form S1 from your pension fund before departure.
4. Before departure or on arrival: request the EHIC (EKUZ) to cover the transition period.
5. On arrival, for a long-term stay: request a PESEL number from the municipal office (urząd) of the place of residence.
6. Employee: check with your employer about declaration and NFZ affiliation via ZUS as soon as the employment contract is signed.
7. Self-employed: register and contribute directly with ZUS, on the scale corresponding to the chosen tax regime.
8. Check your insured status via the eWUŚ system before a first medical appointment.
9. Register with the roll of French nationals living abroad (French Embassy in Warsaw).