Blog

Authors:

  • Marta Pelc

    Junior Associate, Duraj Reck & Partners Law Firm

16 January 2024

Who is entitled to out-of-turn treatment and how to benefit from it?

Everyone associates a visit to a doctor “on the National Health Fund” with a long queue of people waiting. As a rule, if you want to use health care services in hospitals, specialist services in outpatient health care, and inpatient and round-the-clock health services other than hospital services, they are provided on a first-come, first-served basis and the patient is placed on a waiting list.

However, there is a certain group of people who are entitled to receive health care services out of turn, i.e. regardless of the waiting list.

WHO IS ELIGIBLE?

  • Pregnant women,
  • Persons under 18 years of age who have been diagnosed with a severe and irreversible disability or an incurable life-threatening disease that arose in the prenatal period of the child’s development or during childbirth,
  • Persons with a certificate of a significant degree of disability,
  • Persons with a disability certificate including the following indications: the need for permanent or long-term care or assistance of another person in connection with a significantly limited ability to live independently and the need for constant daily participation of the child’s caregiver in the process of treatment, rehabilitation and education,
  • Persons holding the title of Distinguished Honorary Blood Donor or Distinguished Transplant Donor,
  • War and military invalids,
  • Soldiers of alternative military service,
  • To the civilian blind victims of war,
  • Veterans
  • Activists of the anti-communist opposition and people repressed for political reasons,
  • Persons deported for forced labour,
  • Eligible soldiers or employees with a fixed percentage of 30% of health impairment,
  • Injured veterans with a fixed percentage of 30% of health impairment
  • Blood donors who have donated at least 3 donations of blood or blood components, including plasma after COVID-19 disease,
  • Professional soldiers, in the case of receiving services in healthcare entities for which the Minister of National Defence is the founding entity and supervised by him,
  • Soldiers performing territorial military service, in the case of receiving services in healthcare entities for which the Minister of National Defence is the founding entity and supervised by him,
  • Persons holding a certificate confirming the granting of a compensatory benefit as a result of a medical event that caused serious health consequences – for the period indicated in the certificate, no longer than 5 years from its issuance.

In addition, persons included in the national waiting lists for transplantation of cells, tissues and organs are eligible, in accordance with the regulations on the procurement and transplantation of cells, tissues and organs, they benefit from health care services out of turn, but only in the field of transplantation.

The above-mentioned persons have the right to use health care services without waiting in line upon presentation of an appropriate document confirming the basis for taking advantage of this type of privilege.

OUT-OF-TURN RULES FOR PROVIDING HEALTH CARE SERVICES

As a rule, the eligible person should be provided with benefits on the day of reporting to the medical unit. If this is not possible, the healthcare provider will set another date outside the order of admission resulting from the waiting list. In the field of outpatient health care, i.e. which does not require round-the-clock or all-day treatment, this deadline should be set within 7 working days from the date of notification.

It is important to note that the right to provide out-of-turn services applies not only to first-time visits, but also to each subsequent visit in the course of treatment, which was confirmed by the Provincial Administrative Court in Warsaw in connection with the doubts that arose in practice.

It is also important that the above entitlement does not apply to admissions in Hospital Emergency Departments, because in this particular ward the order of admission is determined by the patient’s condition, and priority is given to people in a life-threatening condition.

WHAT IF WE ARE NOT ENTITLED TO USE SERVICES WITHOUT A QUEUE AND THE WAITING QUEUE AT THE NEAREST CLINIC IS VERY LONG?

Every patient is entitled to receive services in any medical unit. It is possible to obtain information about the waiting queues in individual medical units:

– via the website: https://terminyleczenia.nfz.gov.pl/

or

– by calling the National Health Fund: 800 190 590.

On this basis, the patient can choose the unit with the shortest waiting queue and, consequently, reduce the waiting time for an appointment and getting help from a specialist.

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