National Health Fund

What medical services can I use this year at Luxmed Medical Center facilities under the current contract with the National Health Fund?

CM Luxmed Lublin

Primary Health Care - Family Doctor
Orthopedic clinic
Audiology clinic
Diabetes clinic
Gastroenterology clinic
Hematology clinic
Sports medicine clinic
Neurological clinic
Oncology clinic
Pulmonology clinic
Home hospice
Colposcopy as part of the Cervical Cancer Prevention Program
Mammography as part of the Breast Cancer Prevention Program
Colonoscopy
Gastroscopy
Dentistry
Day rehabilitation center
Rehabilitation clinic
Outpatient physiotherapy
Prenatal Screening Program
Magnetic Resonance Imaging
Computed tomography

CM Luxmed Biłgoraj Branch

Gynecological clinic
Oncology clinic
Pap smear as part of the Cervical Cancer Prevention Program
Mammography as part of the Breast Cancer Prevention Program

CM Luxmed Chełm Branch

Speech therapy clinic
Orthopedic clinic
Endocrinology clinic
Rehabilitation clinic
Outpatient physiotherapy
Day rehabilitation center

What documents constitute proof of health insurance?

Due to the introduction of the electronic verification system for beneficiaries' eligibility (eWUŚ), patient eligibility is verified each time before services are provided based on the PESEL number. In the case of a child under three months of age, who may not yet have their own PESEL number, eligibility for services is confirmed by the PESEL number of the child's parent or guardian.

If there is no registration in the system, the patient, if he or she confirms insurance, will have the opportunity to complete a declaration of the patient's right to health care services.

On this basis, the patient may be admitted on a given day free of charge for a service contracted with the National Health Fund or have a reimbursed prescription issued during a commercial visit.

Do I need to have an insurance document when signing the declaration of accession to primary healthcare?

Since January 1, 2013, due to the introduction of the electronic verification system for beneficiaries' eligibility (eWUŚ), patient eligibility has been verified each time before services are provided based on the PESEL number. For children up to three months of age, who may not yet have their own PESEL number, eligibility for services is confirmed by the PESEL number of the child's parent or guardian.

If the system doesn't register, the patient, if they confirm their insurance, will be able to complete a declaration of their entitlement to healthcare services. Based on this, the patient can be admitted free of charge for a service contracted with the National Health Fund (NFZ) on a given day. Therefore, carrying a current insurance document is not required. At registration, the patient must present an ID document (ID card, passport, driver's license, or, for students under 18, a school ID, and a biometric ID for children) along with their PESEL number.

During a private visit, can a doctor issue a referral for laboratory/diagnostic tests, rehabilitation, to a clinic or to a hospital under the National Health Fund?

As part of commercial treatment, physicians cannot issue referrals for tests reimbursed by the National Health Fund . Such referrals are only possible for treatment at clinics and outpatient clinics that have signed an agreement with the provincial branch of the National Health Fund in the given calendar year. In most cases, a referral from a family doctor is required for specialized treatment. Only a specialist at an NFZ clinic can refer a patient for specialized tests and rehabilitation, based on the patient's documented treatment history at that clinic.

In life- or health-threatening situations, the doctor may issue a referral for hospital treatment.

What should I do if the eWUŚ system does not confirm my insurance?

If there is no registration in the system, the patient has the opportunity to complete a declaration of the patient's right to health care services, on the basis of which he or she can be admitted on a given day free of charge for a service contracted with the National Health Fund.

In such a situation, the patient should verify his or her insurance with the payer of contributions as soon as possible and, with this document, report to the appropriate branch of the National Health Fund, where he or she should explain the lack of registration in the eWUŚ system.