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Here are the new recommendations of the National Insurance Fund for Ukrainians. Who is free treatment and medicine for?
Who has the right to medical care according to the special law, in what way the people who provide services will check the permission – the National Health Fund clarifies these issues in its messages that appeared on the fund’s website. This also applies to health care and reimbursement of drug costs.
The National Health Service issued five announcements in which it explained the legal aspects and dispelled doubts regarding the provision of medical assistance to citizens of Ukraine in accordance with the Law on Assistance to Citizens of Ukraine in connection with the armed conflict on the territory of their state. The provisions entered into force on March 12, 2022, and will be binding from February 24, 2024.
Refugees from Ukraine – who can count on medical care?
The fund reminded that the special law gives the right to medical care, reimbursement of medicine costs, and the supply of medical products to citizens of Ukraine who came to Poland due to aggression, on the same basis as all insured persons. Moreover, the right to medical care provided by service providers based on contracts for the provision of medical care, as well as by pharmacies based on contracts for the implementation of prescriptions concluded with the National Health Fund, is granted.
The National Health Service reported that according to the provisions of the law, the following are entitled to medical care: citizens of Ukraine and the spouse of a citizen of Ukraine, without citizenship – all those who directly crossed the Polish-Ukrainian border, as well as citizens of Ukraine who have a Pole’s Card (they did not have to directly cross the border of Poland with Ukraine) and the closest family members of a citizen of Ukraine with a Pole’s Card. These rights belong to people who came to Poland after February 24, 2022, including children born in the above two cases.
Who cannot use medical care?
“The right to medical care, according to the special law, does not belong to people who, before February 24, 2022, were legally in Poland on the basis of residence permits or had refugee status, or submitted an application for such status,” the National Health Service noted.
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The fund specified that the following can be counted as “immediate family members”: husband/wife, parents, grandfather/grandmother, children/grandchildren, brothers/sisters, relatives of the same line (son-in-law, daughter-in-law, father-in-law, mother-in-law, brother-in-law, stepson) , an adopted person and his/her husband/wife, as well as persons living in a civil marriage.
The National Health Insurance Fund also explained that everyone has the right to medical care provided in Poland, on the same principles and to the same extent as persons insured in Poland, with the exception of sanatorium treatment, rehabilitation, the right to treatment abroad, reimbursement for treatment abroad according to the “cross-border” directive.
They also have the right to medicines under the program of the Ministry of Health and the right to vaccination against COVID-19, tests for coronavirus (antigen tests and PCR tests), as well as treatment related to COVID-19, and children – preventive vaccinations within the framework of the preventive vaccination calendar (Program of Preventive Vaccinations – PSO for 2022)
All help is free
All these benefits – as the National Insurance Fund reminds – are provided free of charge. It is financed from the state budget through the National Insurance Fund.
A citizen of Ukraine will lose the right to medical care provided by a special law if he leaves Poland for more than one month.
The fund also announced that persons not covered by the special law, who were in Poland because of the war in Ukraine – that is, citizens of Ukraine who lived in Ukraine before February 24, 2022 and their family members, citizens of third world countries and stateless persons who before On February 24, 2022, international protection (refugees) and their family members, as well as citizens of third world countries and stateless persons who were in Ukraine before February 24, 2022 on the basis of a permanent residence permit, and cannot return to their country – have the right to medical care.
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If we talk about the verification of the right to assistance, after the special law enters into force, it can take place on the basis of: a special PESEL number, which will be provided to citizens of Ukraine, an e-document (adults who will register in the commune and receive a PESEL number and create a verified profile (the profile is trusted), will be able to activate an e-document that will confirm the status of the person), a printout of confirmation of the creation of a verified profile (consists of first name, last name, PESEL number).
The NFZ also announced that “the assistance provided to persons entitled to it should be reported through the NFZ reporting message (specifically: SWIAD), together with the calculation of the assistance from March 2022 at the earliest.” The Fund also referred to the guardianship of POZ in the context of the provisions of the special law, noting that a person who is entitled to assistance under the special law can benefit from such guardianship on the basis of the rights of a person who is not on the active list of the service provider.
“Assistance provided to persons entitled to it in accordance with a special law, including assistance provided after February 24 to March 11, 2022, must be reported in accordance with the order of the Minister of Health dated September 08, 2015. In the case of general terms of contracts on provision of medical care (Legislative Gazette of 2020, Item 320, with subsequent amendments), with the application of reporting messages of the National Insurance Fund, at the earliest together with the calculation of assistance from March 2022.” – booked.
Medical prescriptions for refugees from Ukraine
The Fund emphasized that the reimbursement of expenses for medicines and medical products belongs to persons who have the right according to the provisions of the special law on the same terms as the insured person.
“(…) In order to provide material assistance (organization of drugs after prescribing), it is necessary to verify the patient’s right and note it in the medical documentation. The principles of prescribing are the same as for EU citizens with the right to assistance with the condition of obtaining an identifier, which will take on a value dependent on the document, with which the person will be legitimized. A prescription with reimbursement for the cost of medicine for a child who does not have an identity document can be issued if the guardian, who fulfills all the conditions regarding the type of documents that confirm the identity, is instructed by the NFZ.
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He further noted that a prescription for a person entitled under a special law must have an IN code. It is issued to patients other than insured persons who are entitled to free medical care.
“A person who is entitled to assistance under a special law, who does not have a special PESEL number, to whom an e-prescription is issued by a doctor in Poland, must receive an information printout with a written access key, additionally presented in the form of a barcode, which will allow the person, which uses the recipe to read the recipe from the SIM (P1) electronic platform,” the foundation emphasized.
The patient uses such a prescription with an IN code, similar to the case of EU citizens with the right to assistance, with the condition that there is no obligation to have an EKUZ card or an NPF certificate.
“There is no need to copy/scan a document that confirms your right to assistance,” the National Insurance Fund assured
Author: Klaudia Torhala.