Recently, IT systems have entered into force that enable verification of the beneficiary's insurance - EWUŚ. However, they are not without flaws. Can I claim redress and where (clinic / NHF) if the system has incorrectly verified me as uninsured? It was connected with losses on my part - paid medical visit and 100% payment for the prescribed drugs. Regards
You can always make a claim for lack of availability to a doctor by going to court. However, the patient should know that according to the EWUŚ procedure, in the event that electronic confirmation is not possible, then the patient can present a document confirming the insurance. In the absence of a document, he should submit a declaration that he is insured. The declaration should contain: name and surname, PESEL number, address of residence of the person submitting the declaration and indication of the basis for the right to he althcare services. Additionally, a requirement was introduced for the service provider to confirm with his signature the data identifying the document on the basis of which the identity was confirmed. This is important because in possible enforcement proceedings, such a declaration will be one of the evidence. In the event that a person submits a declaration and did not have the right to he althcare services, the National He alth Fund will charge him / her with the costs of the service provided. It will be similar in the case of using a he alth insurance card or other document confirming the right to he althcare services by a person who has lost this right during the validity period of the card or other document. The procedure for access to a doctor has been strictly specified and basically, always, even in a situation where the system does not show information about the insurance, the patient is en titled to free care if, on the basis of the declaration, he or she indicates that he / she is en titled, and this en titlement will be confirmed.
Legal basis: ACT of 27 July 2012 amending the Act on he alth care services financed from public funds (Journal of Laws of 2012, item 1016)
Remember that our expert's answer is informative and will not replace a visit to the doctor.
Przemysław GogojewiczIndependent legal expert specializing in medical matters.
Othersthis expert's advice
Is it possible to reimburse a private denture by the National He alth Fund? [Expert advice]Can a nurse employed by ZOL inform about a patient's death? [Expert advice] Voluntary he alth insurance for a person working abroad [Expert advice] Business activity and we have to apply for he alth insurance [Expert advice]How do I get a referral for a free PSA test? [Expert advice]I am chronically ill: can ZOL discharge me without my consent? [Expert advice]Continuation of sick leave after the end of sickness benefit [Expert advice]The gambler's husband and the protection of the family against bankruptcy [Expert's advice]The teacher and the stay in the sanatorium that ends at the beginning of the school year [Expert's advice]Renewal / issue of a new disabled parking card [Expert's advice]Stay on L4 after an accident and a sanatorium due to another disease [Expert's advice]Work during maternity and parental leave [Expert's advice] He alth insurance break: what can I do? [Expert advice]Reimbursement of a rehabilitation bed or other equipment for a stroke survivor [Expert advice]Resignation from the sanatorium due to illness and the date of the next stay [Expert's advice]Sanatorium for a person assigned to the insurance of a spouse registered in the PUP [Expert's advice]Referral to the sanatorium: can I change the place? [Expert advice]The effects of orthodontic treatment and compensation [Expert's advice]A dietetics student at the Medical University and a visit to a psychiatrist [Expert advice]The white coat syndrome and the military fitness test [Expert's tip]Vaccinations against ticks. Where can I get vaccinated for free? [Expert advice]Contract-mandate and payable L4 [Expert's advice]Contract-order for a doctor for night duty [Expert's advice]Explosion of the syringe during treatment at the dentist and compensation [Expert advice]Departure to the retiree teacher's sanatorium [Expert's advice]A teacher's trip to a sanatorium during the school year and a sick leave [Expert's advice]Alcohol related car accident and hospital compensation [Expert advice]Thrombophlebitis and the disability group and the pension [Expert's advice]Change in the job size: what is the basis for calculating maternity allowance? [Expert advice]Sick leave for a sanatorium as part of disability prevention [Expert advice]