- Employment or civil contract, or a sole-trader business = NFZ cover via ZUS.
- With no other basis: voluntary NFZ — 844.38 zł a month in Q4 2026, plus a possible additional fee.
- For a residence card the office also accepts a private policy covering medical costs in Poland.
- Since 5 March 2026 adult Ukrainians without insurance get only life-saving care from NFZ (exceptions: children, pregnant women and a few other groups).
What insurance the office accepts
- A ZUS certificate (RMUA) or confirmation of registration for insurance.
- A voluntary health insurance contract with NFZ.
- A private policy covering medical costs in Poland for the whole stay.
Voluntary NFZ — who it's for
People living in Poland with no other basis for insurance: not working, a non-working spouse, a foreign business owner. Family members are added at no extra cost. If you were uninsured for more than 3 months before, NFZ charges an additional fee.
Ukrainians after 5 March 2026
The special-act rules that gave Ukrainian citizens NFZ access without insurance have expired. Free care remains for children, pregnant and postpartum women, victims of torture and violence, and people in collective accommodation. Everyone else needs a job with ZUS, voluntary NFZ or a private policy.
Private policy or NFZ
NFZ gives full access to public healthcare but costs 844.38 zł a month. A private policy can be cheaper and is enough for a residence card, but has limits and exclusions (e.g. chronic conditions). We'll compare both.
NFZ additional fee for a gap in insurance (Q4 2026)
| Gap in insurance | Additional fee (at least) |
|---|---|
| 3 months to 1 year | 1,876.41 zł |
| 1 to 2 years | 4,691.03 zł |
| 2 to 5 years | 9,382.05 zł |
| 5 to 10 years | 14,073.08 zł |
| Over 10 years | 18,764.10 zł |
Source: nfz.gov.pl; base 9,382.05 zł — Statistics Poland (GUS) notice of 20.10.2026.