If you’ve just moved to Poland, one of the first practical questions is: what happens if you need to see a doctor. Here’s how the Polish healthcare system works, and who is required to pay into it.

How the Polish healthcare system works

Unlike countries where healthcare is funded entirely from the state budget, Poland’s system relies mainly on mandatory contributions paid by working people through ZUS.

This contribution-the składka zdrowotna (health contribution): is 9% of the relevant base (for employees on an employment contract, that’s effectively 9% of gross salary; the base is calculated differently for the self-employed-see below).

The money flows into the NFZ (National Health Fund), which distributes it across regions and contracts with individual clinics and hospitals. Once you’re covered, you can get treatment at any clinic that has a contract with NFZ-look for the NFZ sticker near the entrance.

Who is insured and how

Anyone (including foreigners) working under:

is automatically entitled to NFZ services-the employer is required to register you with ZUS. Your PESEL number is usually enough to confirm coverage; if you don’t have one yet, you can prove insurance with a ZUS RCA printout.

Contributions for the self-employed (JDG)

If you run your own business (działalność gospodarcza, JDG), the amount you pay depends on your 2026 tax method:

  • progressive scale (skala): 9% of income;
  • flat tax (podatek liniowy): 4.9% of income;
  • lump-sum tax (ryczałt): a fixed monthly amount based on last year’s revenue: PLN 498.35 (revenue up to PLN 60,000), PLN 830.58 (PLN 60,000-300,000), or PLN 1,495.04 (above PLN 300,000).

From February 1, 2026, the minimum base for skala/liniowy contributions equals 100% of the minimum wage (PLN 4,806), meaning a minimum contribution of PLN 432.54/month under those two methods (the previous, lower 75% base no longer applies).

Relevant for B2B contractors: if the Labour Inspectorate (PIP) reclassifies your B2B contract as an employment relationship under the PIP 2026 reform, your client becomes liable for back-paying ZUS/NFZ contributions as if you’d been on an employment contract all along, not at your JDG rate. More on this risk in our PIP 2026 series.

Can you opt out of NFZ contributions?

You cannot opt out if you work on an umowa o pracę, an umowa zlecenie, run a JDG, or operate a business through a Sp. z o.o. This applies even if you also carry private health insurance-major providers like Medicover, Enelmed, or LuxMed complement your mandatory NFZ contribution, they don’t replace it.

The exception is an umowa o dzieło (specific-task contract, unless signed with your own employer), this type of contract doesn’t trigger a mandatory NFZ contribution, so you can decide for yourself whether to opt into voluntary NFZ coverage or buy private insurance instead.

If you have no coverage at all and need a doctor, paying out of pocket is entirely legal in Poland-you’ll simply get a receipt for the service.

Good to know: as of 2026, almost all prescriptions are issued electronically (e-recepta), and your visit history, prescriptions, and referrals are available in your online patient account-the Internetowe Konto Pacjenta (IKP) at pacjent.gov.pl.

If you plan to travel elsewhere in Europe, being covered by NFZ entitles you to a European Health Insurance Card (EKUZ/EHIC), unchanged, it still covers necessary medical care in other EU/EEA countries.

FAQ

Does my employer pay the NFZ contribution, or do I?
On an employment contract, the employer technically pays it-it’s deducted from your gross salary, so you don’t have to transfer anything yourself. On a JDG, you pay it yourself alongside the rest of your ZUS payments.

What if I work remotely for a foreign client on a B2B basis?
If you have a JDG registered in Poland, you pay the contribution based on your chosen tax method (see above), regardless of where your client is located.

Do I need private insurance if I already pay into NFZ?
Not required, but popular because of long waiting times in public facilities. Private insurance doesn’t exempt you from the mandatory NFZ contribution.

Need advice on legalizing your business or your stay in Poland? Book a free consultation.

Author: MojaFirma team. Last reviewed: July 27, 2026.
This article is for informational purposes only and does not constitute legal or medical advice.