Medical tourism: opening borders has made treatment abroad increasingly popular. India and Thailand are leading the world ranking. In Europe, most people come for treatment to Germany, Great Britain, Italy, France, Hungary and Poland. When is it possible to get NHF treatment abroad?
More and more Poles usemedical services abroadunder social insurance. In record-breaking 2011, 228 Poles left for scheduled treatment, i.e. 27 percent. more than a year earlier. In 2011, the amount of expenses was also record-breaking: planned treatment abroad (requiring prior approval of the President of the National He alth Fund) cost the National He alth Fund over PLN 17 million. In 2012, the number of patients decreased (152 people) as fewer people applied for such treatment. But the cases were more complicated and the treatment more expensive (almost PLN 15 million for a smaller number of patients than in the previous year). In the first 3 months of this year, 50 consents for over PLN 3 million were issued for planned treatment. The number of refusals remains at 10%.
When is it possible to get medical treatment abroad?
Upon Poland's accession to the EU / EFTA, persons insured in the National He alth Fund have the right to apply for consent for planned treatment in other Member States at the Fund's expense. The consent is issued by the President of the National He alth Fund after considering the relevant application. Currently, consent for surgery or diagnostic tests abroad is granted only in two cases: if this type of procedure (test) is not performed in Poland at all or when the service can be obtained in Poland, but the waiting time, taking into account the patient's current he alth condition, it's too long. There is a waiting list law in Poland.
Each patient referring to specialist treatment should be entered on such a list at the service provider, if the treatment cannot be started on the day the patient comes. Hospitals and outpatient clinics create separate lists for stable and urgent cases, making it possible to treat "urgent" patients first.
However, if an urgent case has the prospect of waiting for the procedure 4 months, and it must be performed earlier due to the current state of he alth, the patient may apply for consent for treatment in another country. Before consenting to treatment abroad, the President of the National He alth Fund determines whetherthere are statutory reasons, including whether the requested treatment belongs to guaranteed services. The fund does not finance experimental treatment or clinical trials of the drug, and there are many such applications.
How to apply for treatment abroad
The basis for applying for treatment abroad is submitting an application to a branch of the National He alth Fund (application form available at: www.nfz.gov.pl or at a branch of the National He alth Fund). The document consists of three parts. The patient completes Part I, II and III - a specialist in the relevant field of medicine, holding the title of habilitated doctor or professor of medical sciences.
Apart from the description of the current he alth condition and the probable course of the disease, the doctor justifies why the given service cannot be provided in the country and indicates the foreign he althcare facility where the treatment is to be undertaken. Part II of the application must be translated by a sworn translator into English or the official language of the country of treatment.
The application with translation and copies of medical documentation should be submitted to the NHF department, where it is subject to verification. Before the NHF sends a patient abroad, it must make sure that it cannot be treated in the country. If there are no formal obstacles, the translation is sent to the selected medical facility abroad in order to agree the costs of treatment, and the medical documentation - reviewed by the voivodship consultant of the medical field to which the application relates.
Then all documentation goes to the president of the National He alth Fund, who issues a decision. Sometimes the consultant indicates national specialist centers and then the National He alth Fund consults whether a specific case can be treated there. If so, the patient is given the place and date of treatment. Many patients are satisfied that they do not have to leave the country. But some do not want to be treated in Poland and appeal against the decision of the president of the National He alth Fund in the Administrative Court.
The procedure, depending on how complicated the case is, may take from several hours to several months. A patient going for treatment abroad to EU countries takes the original E112 form along with a translation of part II of the application (with non-EU countries, the settlement is based on an invoice).
Obtaining the consent of the President of the National He alth Fund for the provision of medical services abroad means that the Fund undertakes to cover the costs of treatment (tests). The E112 form is an international document and is the basis for planned treatment abroad throughout the EU and EFTA countries. What should a Polish woman living and insured in Great Britain do to give birth in Poland? She must have an E112 form completed by her insurer which will allow her to give birth inPoland.
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