Poland’s National Health Fund will implement significant changes March 5, ending exceptional healthcare access for some Ukrainian patients.
National Health Fund Changes Rules March 5; “Technical” Reform Risk Clinic Paralysis?
The changes stem from the expiration of extraordinary measures introduced after the outbreak of the war in Ukraine. The problem is that the new regulations are set to take effect almost immediately – without a long transition period.
The Ministry of Health’s draft regulation changes the way services provided to persons under temporary protection are billed. In practice, this means introducing new authorization codes and removing previous billing bases.
The Ministry deemed the changes “technical” and costless in its Regulatory Impact Assessment. However, the National Health Fund itself noted in its comments that adapting information systems could take up to six months. This is much longer than the time remaining until March 5.
Who Will Retain Right to Free NFZ Treatment After March 5, 2026? List of Exceptions
The new regulations do not mean a complete closure of the system. Free care will be limited to selected groups, including:
Remaining Ukrainian citizens, to use the full range of services financed by the National Health Fund, will need to have a title to health insurance – for example, from an employment contract, contract mandate, or voluntary contribution – as well as a PESEL number with UKR status. In practice, this means a shift from an extraordinary assistance model to a classic insurance-based model.
Drug Reimbursement and Planned Procedures After March 5. Who Will Pay Out-of-Pocket?
Access to drug reimbursement and some dental services had already been restricted for uninsured adults. Now the catalog of services provided without insurance will further narrow. Selected planned procedures may be excluded from free services if the patient does not have insured status. This concerns situations where treatment is not urgent in nature.
Primary Care Physicians and Pharmacists Sound Alarm: NFZ Changes March 5 Risk Chaos
The primary healthcare community, including the Zielona Góra Agreement, points to the risk of destabilizing the system. They note that changes in service coding – even if formally “technical” – in practice require staff training and software updates. Doctors fear situations where patients will be convinced of their right to a service, but the system won’t allow it to be billed. This creates conflicts in registration and extends queues.
Pharmacists, in turn, raise the issue of reimbursement. If the system does not assign the proper authorization code, the fulfillment of a prescription may be questioned during settlement with the NFZ.
9 Billion Złoty in Contributions, 2.1 Billion Złoty in Treatment Costs. Ministry Data Changes the Picture of the Dispute
According to information from the Ministry of Health and MSWiA, between 2022-2024, Ukrainian citizens contributed over 9 billion złoty to the system through health insurance contributions, while the cost of services provided to them amounted to approximately 2.1 billion złoty.
These figures show that revenue from contributions significantly exceeded expenditures on treating this group of patients. The government therefore argues that the system should return to the principles of universal insurance, since most people are already working and paying contributions.
Will Anyone Be Left Without Treatment After March 5? What About Emergencies?
Emergency cases will still be provided – in accordance with the Act on health care services financed from public funds, assistance in life-threatening situations is available to everyone. The issue concerns planned services and reimbursement. If a patient does not have insurance status, they may be asked to cover treatment costs. In practice, quick confirmation of status in the eWUŚ system and proper marking of the authorization code will become crucial.
End of Special Rules for Ukrainian Citizens. NFZ Returns to the Contribution-Based System
The changes result from a law expiring some of the support measures introduced after February 24, 2022. At that time, Poland accepted about 1.6 million people fleeing the war. The health protection system was widely opened to them. Now the government recognizes that the situation requires a return to a contribution-based model. For working people, this will be a formality. For those without stable employment – a real barrier.
